Corporate report

UKHSA Advisory Board: 19 November 2024 minutes

Updated 28 January 2025

Date: 19 November 2024

Present at the meeting were:

• Ian Peters – Chair of UKHSA Advisory Board
• Simon Blagden – Associate non-executive member
• Jon Friedland – Non-executive member
• Marie Gabriel – Associate non-executive member
• Dame Jenny Harries – Chief Executive
• Graham Hart – Non-executive member
• Susan Hopkins – Chief Medical Advisor
• Mark Lloyd – Non-executive member
• Sir Gordon Messenger – Non-executive member
• Scott McPherson – Director General, Strategy, Policy & Programmes
• Isabel Oliver – Director General, Science and Research
• Cindy Rampersaud – Non-executive member

Observers at the meeting were:

• Lee Bailey – Director of Communications
• Richard Pebody – Director, Clinical and Emerging Infections
• Suzy Powell – Director, Emergency and Health Protection (DHSC)
• Steven Riley – Director General, Data, Analytics and Surveillance
• Sir Gregor Smith – Chief Medical Officer (Scotland)
• 3 attendees had their name and title redacted

In attendance at the meeting were:

• 6 attendees had their name and title redacted

Apologies were received from:

• Sir Frank Atherton – Chief Medical Officer (Wales)
• Luke Heath – Interim Chief Financial Officer
• Raj Long – Associate non-executive member
• Sir Michael McBride – Chief Medical Officer Northern (Ireland)
• Thom Waite – Deputy Chief Medical Officer (England)
• Sir Chris Whitty – Chief Medical Officer (England)

1. Announcements, apologies, and declarations of interest

24/127 The Chair welcomed participants to the meeting and noted apologies.

24/178 The Chair noted a period of busy activity for UKHSA which included the conclusion of the SCS reorganisation, and the emerging vision and details of the government’s growth mission. UKHSA was preparing to support the growth and health missions, alongside the upcoming 10-year plan for the NHS with a particular move towards prevention over treatment.

24/179 Scott McPherson would be departing UKHSA in December 2024. He was thanked for his support and advice to UKHSA and through its formation and the subsequent years.  The Board wished him well.

24/180 Sir Gordon Messenger noted his own upcoming engagement with DHSC to advise on talent management and leadership in the NHS reporting in February 2024.

2. Minutes of previous meeting and matters arising

24/181 The Advisory Board noted the minutes of the previous meeting (enclosure AB/24/042) and list of actions (enclosure AB/24/043). The current actions were on track or not yet due.

3. Chief Executive’s update

24/182 The Chief Executive presented her update on UKHSA’s activity (enclosure AB/24/044).

24/183 The main areas of activity included:

• engaging with DHSC on the first budget statement of the new administration and the system £460million capital investment for pandemic preparedness and health protection;
• supporting efficiency savings across the civil service and NHS.

24/184 The SCS reorganisation was due to conclude on 6 January, including a slimmed down executive team;

• managing the first cases of mpox clade Ib detected in the UK; thanks were noted to all staff and the wider health network for their support enabling UKHSA to respond. UKHSA remains vigilant for any further cases;
• preparing to input into development of the NHS 10-year plan;
• routine monitoring of seasonal infections;
• planning of the UKHSA Conference which was moved to March 2025 to accommodate a greater gathering of colleagues and external partners in response to increased demand;
• successful rollout of the new maternal and older adult RSV vaccination campaign;
• providing multiple statements and numerous staff providing evidence at the Covid-19 Public Inquiry;
• supporting the Dawn Sturgess Inquiry;
• contributing to the Spending Review to ensure ongoing health protection for the UK.

24/184 The Advisory Board noted the update and provided comments as below:

• clarity on responsibilities and remit of each department in a future pandemic response was critical. Recent incidents demonstrated awareness of the need for early escalation to Cabinet Office for whole government oversight in specific incidents;
• UKHSA has skills and capabilities to support all three strands of the draft NHS long term plan (hospital to community; analogue to digital; and sickness to prevention). The Board were reassured on the intention to expand the narrative on UKHSA’s capabilities beyond response to a wider health system approach;
• continued understanding of the relationship with the Office for Health Improvement and Disparities was critical to delivering wider public health benefits in light of health system changes;
• it was clarified that HM Treasury would reimburse departments to neutralise the impact of the increase in Class 1 Employer National Insurance Contributions.

4. Core preparedness for vector borne diseases

24/185 The Director General, Science and Research introduced the paper on preparedness for health threats from vector borne diseases (VBDs) (enclosure AB/24/045). The UK must plan for and be prepared to respond appropriately to greater number of cases from VBDs with global change in patterns attributed to climate and environmental change, and change in human behaviours (urbanisation, land use and travel).

24/186 The Advisory Board noted the activities underway at UKHSA to build its core preparedness on vector borne diseases which included:

• a task and finish group to map capabilities of the agency;
• surveillance capability (including for ticks, mosquitos and human disease) which had increased in scale with development of the Centre for Climate and Health Security;
• detection and diagnosis of associated human clinical infections supported through the Rare and Imported Pathogens Laboratory and a clinical advice line for health workers;
• working with local authorities who play a critical role in surveillance and control of species establishment;
• understanding the profile of diseases through Europe and how the epidemiology may change and adapt to the UK’s ecology;
• working with partners (transport network, the Animal and Plant Health Agency, local authorities and environmental agencies) across the sector using a One Health approach;
• updated guidance to support management of VBDs through local authorities;
• reviewing availability of diagnostics against priority pathogens.

24/187 Addressing the increased risk from VBDs required strengthened surveillance, increased laboratory space, scalable testing and differential diagnostics.

24/188 UKHSA would be launching a collaborative open research consortium with the World Health Organisation, leading on specific virus families including bunyaviridae viruses.

24/189 The following comments were raised in response to the paper:

• further investment was needed to strengthen diagnostics and surveillance for late diagnosis of Lyme disease and understand long term implications of the disease;
• it was crucial to increase participation in managing recreational and workplace risks associated with sports such as game shooting. The British Association of Shooting and Conversation for example could support connection across partners;
• metagenomics provided opportunity to understand more about ticks and interaction of pathogens in deer populations;
• the investment in VBD response infrastructure was expected to receive more attention as government understood the future threats alongside current response activity;
• the achievements of the small UKHSA team were noted, although resourcing may be an issue to achieve intended ambitions;
• current positive and further future cooperation between UKHSA’s specialised teams and devolved administrations was welcomed;
• it was important to better define roles and responsibilities across the country for surveillance and incident response, including closer working which local authorities;
• publishing more detail more widely for public awareness would build on previous engagement and support understanding beyond scientific and medical communities;
• collaboration on risks must consider health inequalities and the One Health Approach to ensure effectiveness of interventions.

24/190 A future discussion on vector borne diseases would be added to the forward look for 12-18 months (Action: Isabel Oliver)

5. Annual Science Review

24/191 The Director General, Science and Research introduced the paper on the Annual Science Review (enclosure AB/24/046). The review showed progress of UKHSA towards commitments outlined in the Science Strategy and offered opportunity to reflect on impact of scientific activities.

24/192 Positive progress was made to date including establishment of the Centre for Climate and Health Security and the Vaccine Development and Evaluation Centre. UKHSA continued to develop ambition of the science strategy and grow impact of our science.

24/193 It was challenging to collate the impact of scientific activities with measurement through three domains (health, prosperity and contribution to scientific advancement).

24/194 The Advisory Board noted the forthcoming publication of the Science Review with detailed drafting comments requested in correspondence.

24/195 Feedback from discussion suggested:

• UKHSA should maintain awareness of limitations and constraints that can be overcome to maximise the vision of the agency;
• a newly established lead for public and patient involvement could support dissemination of material to the public;
• UKHSA was exploring models to utilise and appropriately govern third party data to support activity and realisation of its scientific vision;
• time spent to ensure quality of final publication would support it being used as a template for future communication of UKHSA’s activity and value;
• it was worthwhile considering a shortened version of the document to engage with different audiences (public and staff) beyond the primary audience (industry and academia)
• reflections from drafting demonstrate the value of building pathways to impact into the design process, making it easier to demonstrate direct outcomes of UKHSA activity;
• a closed session of the Advisory Board would consider risks and opportunities of engagement with the commercial sector to achieving its scientific vision. (Action: Sarah Collins)

6. Financial Report

24/196 The Advisory Board noted the financial update to end of September 2024 (enclosure AB/24/047) presented by the Director of Finance.

24/197 The following points were raised in respect to the financial position:

• UKHSA had finalised plans to achieve a balanced budget by the end of the financial year with £18.8m support from DHSC and remaining pressures addressed through recruitment pauses, curtailing in year spend and delaying spending where appropriate;
• overprogramming of CDEL was agreed in the budget although spending remained behind year to date;
• reassurance was provided on the cost of exit packages from SCS restructuring which had received initial Cabinet Office approval based on payback after 14 months. The People and Culture Committee would discuss the impact of costs associated with the restructure at its November meeting.

24/198 The Annual Report and Accounts were due to be laid in mid-December, subject to final National Audit Office sampling. Thanks were noted to the Finance teams and other colleagues for their hard work in preparing the accounts.

7. Advisory Board Committees

24/199 The Advisory Board noted verbal updates from the latest Committee meetings as below:

• the Equalities, Ethics and Communities Committee October meeting discussed reflections on the new government priorities; Immunisation equity strategy; responding to extreme weather events and climate change from and inequality perspective;

24/200 The Advisory Board noted the confirmed minutes as below:

• the Science and Research Committee meeting on 8 May 2024 (enclosure AB/24/048).
• the Equalities, Ethics and Communities Committee meeting on 16 July 2024 (enclosure AB/24/049).

8. Questions from members of the public

24/201 Two questions were received in advance of the meeting covering:

8.1 If another pandemic hits tomorrow, how well equipped do you feel you are to scale up your operations to enable you to respond effectively?

24/202 The Chief Executive responded to the question noting UKHSA was part of a wider health and government system. Overall responsibility with pandemic preparedness sat with DHSC and core capabilities across partners. Understanding roles and responsibilities were critical for strong response.

24/203 However UKHSA held critical areas of responsibility including the establishment of strong baseline specialist health protection capabilities, the capability to initiate surge with partners as required, and averting the need for large scale response where possible.

24/204 UKHSA had progressed as an organisation to support future pandemic response including:

• modernised data systems, infrastructure and linkage to signal risks across data networks;
• supporting the 100-day mission with focus on vaccines, therapeutics and diagnostics as critical to manage early response;
• developing frameworks for commercial and other partnerships ahead of time;
• accelerating development of vaccines and diagnostics through the Vaccine Development and Evaluation Centre, and the Diagnostics Accelerator;
• building infrastructure capacity for wider population diagnostic systems, within the confines of resourcing priorities and proportionality.

8.2 How are you building strategic relationships with suppliers to support innovation and who is responsible for this?

24/205 In addition to the comments previously on 100 day mission industry work, the Commercial Director answered the question noting engagement with industry was vital for delivering innovation. UKHSA looked across its whole supplier base to support innovation which included approximately 500 suppliers and 1000 business development contracts.

24/206 UKHSA had developed a comprehensive framework and operating procedures to manage these relationships incorporating innovations as a core element. Pilots were underway to define ‘what it means to be a strategic partner’. The next financial year would see a plan to foster greater connection with small to medium enterprises.

24/207 The Commercial Director maintained accountability to set the framework while Senior Responsible Officer from the SCS cohort led on account management.

9. Forward Look

24/208 The Advisory Board noted the forward look (enclosure AB/24/050).

10. Any other business and close

24/209 There being no other business, the meeting closed at 11:57am.