Corporate report

UKHSA Advisory Board: 30 November 2023 meeting minutes

Updated 29 January 2024

Date: 30 November 2023

Present at the meeting were:

• Ian Peters – Chair of UKHSA Advisory Board

• Dame Jennifer Dixon – Non-executive member

• Jon Friedland – Non-executive member

• Marie Gabriel – Associate non-executive member

• Mark Lloyd – Non-executive member

• Graham Hart - Non-executive member

• Dame Jenny Harries – Chief Executive

• Susan Hopkins – Chief Medical Advisor

• Mark Lloyd – Non-executive member

• Sir Gordon Messenger – Non-executive member

• Scott McPherson – Director General, Strategy, Policy and Programmes

• Cindy Rampersaud – Non-executive member

• Thom Waite – Deputy Chief Medical Officer (England)

• Andrew Sanderson – Chief Financial Officer

Observers at the meeting were:

• Lee Bailey – Director of Communications

• Oliver Munn – Director General, Health Protection Operations

• Steven Riley – Director General, Data, Analytics and Surveillance

• Sir Gregor Smith – Chief Medical Officer (Scotland)

• Clara Swinson – Director General, Global Public Health (Senior Departmental Sponsor)

• Jac Gardner – Chief People Officer

In attendance were:

• Adrian Belton – Lead Reviewer, Public Bodies Review

• Richard Gleave – Director, Scientific Strategy and Development

• Caroline Middlecote – Director of Strategy

• Nick Watkins – Director – Analytics and Data Science (Acting)

• Ed Wynne-Evans – Director of Radiation, Chemical and Environmental Hazards

• 10 attendees had their name and title redacted

Apologies were received from:

• Sir Frank Atherton – Chief Medical Officer (Wales)

• Simon Blagden – Associate non-executive member

• Sir Michael McBride – Chief Medical Officer Northern (Ireland)

• Sir Chris Whitty – Chief Medical Officer (England)

• Raj Long – Associate non-executive member

• Isabel Oliver – Director General, Science and Research

Announcements, apologies, and declarations of interest

23/072 The chair welcomed participants to the meeting, noted apologies, and confirmed that there were no declarations of interest.

Minutes of the previous meeting and actions

23/165 The chair noted the busy period for UKHSA in the preceding week including for H1N2 response. Additionally, formal thanks were conveyed to the Chief Executive for her and her team’s extensive preparation ahead of her COVID-19 Public Inquiry appearance. Work continued to finalise the Annual Report and Accounts which was expected in early 2024.

23/166 The chair noted apologies and welcomed additional participants, including from UKHSA’s Accelerate Programme supporting leadership of internal colleagues. Adrian Belton attended in his capacity leading the scheduled and mandatory review of UKHSA as an arm’s length body. Richard Gleave and Ed Wynne-Evans attended in the absence of Isabel Oliver who was hosting the Deputy Prime Minister at UKHSA’s Porton Down.

23/167 There were no new declarations of interest.

Minutes of the previous meeting and matters arising

23/168 The Advisory Board agreed the minutes of the meeting held on 13 September 2023 (enclosure AB/23/058) as an accurate record.

23/169 The Advisory Board noted the list of actions from the previous meeting (enclosure AB/23/059).

Chief Executive’s update

23/170 The Advisory Board noted the update from the Chief Executive (enclosure AB/23/60). Highlights from UKHSA activity included:

• providing further witness testimony at the COVID-19 public inquiry. Thanks were noted to all UKHSA teams for their support in preparing material to support the Chief Executive’s appearance

• 1 October 2023 marked the second birthday of UKHSA and one year since establishment of the COVID Vaccine Unit

• The CEO met with the new Secretary of State, Rt Hon Victoria Atkins MP

• thanks were given to Lee Bailey and Communications colleagues for bringing together the second Annual UKHSA Conference in Leeds. The conference was a resounding success with increased external attendance and positive engagement with directors of public health across the UK

• A small number of senior UKHSA staff planned to attend the upcoming COP28 with a dedicated day on the health effects of climate changes. It would coincide with publication of the Health Effects of Climate Change Report

• UKHSA’s support of the Joint Committee on Vaccines and Immunisation saw recommendations to the Department of Health and Social Care (DHSC) on vaccination pathways for chicken pox and respiratory syncytial virus

23/171 Discussion followed on the level of investment in addressing climate change challenges. It was noted that devolved administrations placed high importance on the topic and were working with UKHSA to input the into Health Effects of Climate Change report and impress framing as a public health emergency. An agenda item was planned on the Advisory Board forward look with welcome input from devolved administrations to support a collaborative discussion.

23/172 A further query was raised on a new strain of Clostridioides difficile bacteria. A total of 48 cases were identified from 15,000 samples with initial analysis suggesting the small number of cases could be from one point source. UKHSA had alerted the NHS to be vigilant and send samples to UKHSA for genome sequencing. Monitoring would continue and was considered sufficient to control further spread.

Financial report

23/173 The Chief Financial Officer presented an update on UKHSA’s finance for month end October (enclosure AB/23/062).

23/174 The following points were raised on the financial position:

• a trend of underspending continued within COVID-19 and ringfenced budgets. This was primarily due to the demand driven nature of vaccines and secondly the priority to reduce spending trajectory in the final year of COVID-19 funding

• UKSHA had sufficient resourcing support to recruit but faced challenge on availability of candidates and attraction to specialist skillsets. Recruitment activity remained high, although internal staff mobility was affecting the pace at which the net workforce was growing

• business planning for next year was underway but complicated until the budget for financial year 2024 to 2025 was confirmed. Separate advice would go to Ministers on pandemic preparedness alongside continued discussion on activity currently funded from the separate COVID-19 budget.  This will need to be resourced from core funding in the next year (for example, genomics, surveillance and public inquiry) and support enduring capability of UKHSA

• the progress towards approval of the annual report and accounts for 2022 to 2023 continued with further work on the audit process expected for completion in January

23/175 It was queried whether civil service requirements on office attendance and capping headcount would affect recruitment. UKHSA did not expect much impact, from these aspects, especially as most staff are based in laboratories and fulfil front line roles.  Remuneration competitiveness is a much more material factor. Career development in the civil service encourages movement between departments and UKHSA’s focus was to attract staff through its mission of protecting from public health threats.

23/176 The Civil Service People Survey results would be brought back for discussion in March and will include an analysis of attrition within UKHSA.

(Action: Jac Gardner)

Development and impact of UKHSA’s science and research activities 

23/177 The Director of Scientific Strategy and Development presented the paper updating on Science Strategy implementation and the forward plan for science and research activities (enclosure AB/23/063). Early progress on implementation was positive and aligned with UKHSA’s corporate strategy. An annual science review would assess progress against the roadmap of activities, alongside existing reporting against UKHSA’s strategic plan.

23/178 The Advisory Board noted the implementation progress of the science strategy and development of UKHSA’s activities. The focus on partnership and monitoring impact of activity was welcomed.

23/179 Feedback included:

• building upon recommendations from the Paul Nurse Landscape Review which emphasised the need for overhead recovery on research grants

• reviewing work of health protection research units annually to ensure they deliver on the scientific activities UKHSA needs

• fostering future people capability through involvement with science, technology, engineering and mathematics (STEM) programmes, schools, universities and alternative programmes encouraging lateral move towards scientific careers. The Executive Committee would develop this discussion on functional scientific skillsets, including use of apprenticeships

• ensuring non-scientific capability (for example, marketing) was available to deliver the desired impact of activity

• developing understanding of partners of the advantages offered through engaging with UKHSA activities. It was noted that the health and economic impact of current activity was not well understood across the health sector

(Actions: Jac Gardner / Isabel Oliver)

23/180 Partnerships and income generation were a key enabler for UKHSA’s scientific activity. A working group was due to meet to develop the growth potential of UKHSA’s science activities. It was suggested to discuss through the Science and Research Committee before a fuller discussion at the Advisory Board as part of an annual review on UKHSA’s Science and Research activities.

(Action: Jon Friedland / Isabel Oliver)

23/181 Pathogen genomics remained an area to demonstrate strong impact and transformational potential of UKHSA’s scientific work. UKHSA was in the process of finalising its pathogen genomics strategy which would be presented to a future Advisory Board meeting.

(Action: Susan Hopkins)

23/182 Discussion followed on the desirability of looking at health threats from an economic perspective. Individual responsibility to stop the spread of infection remained strong for COVID-19 but could be extended to other routine illnesses (for example, influenza). Much of UKHSA’s work was focused on addressing health threats before they impacted the larger population.

Artificial intelligence (AI) strategy development

23/183 The Director General, Data, Analytics and Surveillance (DAS) introduced the paper on AI discovery work and how it would change the way UKHSA operates. The discovery exercise included scoping out opportunities, risks and ensuring UKSHA was well informed on the possible solutions AI could provide. Proof of concept work would be developed into generic models as a base for adapting bespoke applications across the agency.

23/184 The Advisory Board noted the progress of the UKHSA Artificial Intelligence Task Force in developing organisational readiness for adoption and utilisation of AI.

23/185 UKHSA should consider how to keep pace with the exponential growth of AI. Frameworks were in use across government departments to leverage the potential of AI, including value for money and efficiencies in public spending. Working with private sector partners could support keeping pace with change but would be difficult in light of pricing barriers. UKHSA would continue scanning cross government opportunities to leverage the right commercial contracts. 

23/186 Discussion noted limitations in the adoption of AI such as reliability of data returns. Management should maintain awareness of the risks in adopting AI and ensure appropriate mitigations. It was acknowledged the public remained a key stakeholder in UKHSA’s use of AI to ensure public trust in the use of data.

23/187 Comments noted the importance of having the right skillset to leverage opportunities from AI. While AI specialists were required, there would be upskilling required across the whole workforce.

23/188 Recruitment of AI skills was a main concern for UKHSA and wider government. Technology and DAS groups had talented people at present and continued exploring opportunities to recruit (for example, Office for National Statistics data science campus). Public sector pay would always be prohibitive to attracting top talent and UKHSA’s focus to attract candidates was the culture and mission of the organisation. 

23/189 Further updates would return to the Advisory Board as per below:

• a short update in January to note the conclusions on use cases

• a longer update on the AI strategy in March. This should consider points raised in the meeting around stakeholder approach and involvement of public, commercial partnerships and context within the wider government ecosystem

(Action: Steven Riley)

Annual summary of major incident learnings

23/190 The Director General, Health Protection Operations and [Title redacted] presented the first annual summary of learning for incident responses (enclosure AB/23/065). The summary covered lessons from incident debriefs and learning from UKHSAs health security simulation exercises. Many aspects of incident response worked well and one third of 266 lessons identified had already been implemented.

23/191 The Advisory Board noted the volume and breadth of captured lessons and the agency-wide changes arising.

23/192 Feedback from the discussion suggested the next iteration of annual summary should consider:

• expanding the incidents considered to encompass five routes of transmission for infectious disease

• learning from incidents that occurred outside UKHSA, including those in other countries which could have resulted in greater public health impact in the UK

• strengthening learning from incidents that did not expand into larger response; utilising lessons from exercise simulations could strengthen preparedness for health threats rarely seen or considered high impact in the future

• reviewing efficiency within incident response

• assessing feedback from external parties on UKHSA’s effectiveness

(Actions: Oliver Munn)

23/193 The Advisory Board welcomed embedding the cycle of learning across the agency.  Further consideration should be given to what assurance this provided for preparedness to respond within UKHSA and with wider partners. From the COVID-19 response this included scalable capability, ramping up of testing and ability to respond to concurrent incidents. Progress on implementing COVID-19 lessons and addressing system capability would be discussed at the Advisory Board in January 2024.

(Action: Oliver Munn / Scott McPherson)

23/194 Further discussion suggested utilising opportunity to share lessons across the health ecosystem and learn from similar exercises in the NHS or DHSC. Additionally, UKHSA should consider how to take advantage of AI and emerging technology to support the continued cycle of learning.

Advisory Board Committees

23/195 The chair presented updates on Advisory Board Committees and membership (enclosure AB/23/060). The Advisory Board noted that:

• Cindy Rampersaud has been confirmed as Deputy Chair of the Advisory Board

• Professor Jon Friedland would become a member of the Audit and Risk Committee and step down from the People and Culture Committee

• Cindy Rampersaud would join the People and Culture Committee

• The Science and Research Committee terms of reference would be updated to include a specific focus on science related skills development and pay

Audit and Risk Committee

23/196 The Advisory Board noted the minutes of the Audit and Risk Committee meeting on 5 September 2023 (enclosure AB/23/066). The most recent committee had discussed good progress with the 2022 to 2023 Annual Report and Accounts. It was noted that next year’s audit would include increased sampling activity and a full audit scope.

Equalities, Ethics and Communities Committee

23/197 The Advisory Board noted the minutes of the Equalities, Ethics and Communities Committee meeting on 14 July 2023 (enclosure AB/23/67). The October meeting included an extended discussion on vaccines from the equalities perspective including availability and structural issues affecting access over vaccine hesitancy. A general discussion on the landscape for vaccines would be added to the Advisory Board for discussion alongside NHS strategy for vaccinations.

(Action: Susan Hopkins)

People and Culture Committee

23/198 The Advisory Board noted the minutes of the People and Culture Committee meeting on 11 July 2023 (enclosure AB/23/068). The recent meeting built upon baseline discussions of workforce number to focus on workforce culture, talent management and line manager support.

Science and Research Committee

23/199 The Advisory Board noted the minutes of the Science and Research Committee meeting on 4 September 2023 (enclosure AB/23/069). Key topics in future meetings would include health effects of climate change, science workforce and artificial intelligence.

Questions from members of the public

23/200 One question was received from the public on lead poisoning and was answered in written correspondence before the meeting.

Forward look

23/201 The Advisory Board noted the topics for future meetings (enclosure AB/23/070).

Any other business and close

23/202 The Chair thanked all colleagues for their hard work to prepare and present materials for the Board meeting and Committees throughout the year.

23/203 There being no other business, the meeting closed at 12:02pm.

November 2023