Corporate report

UKHSA Advisory Board: Chief Executive's report

Updated 12 March 2024

Date: 13 March 2024

Sponsor: Jenny Harries

1. Purpose of the paper

The purpose of the paper is to provide a forward look of priorities and brief overview of the recent operational and response status of the UK Health Security Agency (UKHSA) since the last Advisory Board.

2. Recommendations

The Advisory Board is asked to note the update.

3. Overview

I am sorry to let you know that Ollie Munn, our Director General Health Protection Operations, will be leaving UKHSA on 31 March. Ollie joined UKHSA in 2022, originally on a one-year appointment. We’d previously been able to extend that appointment by a further year but civil service rules prevent us from extending it any further. We will therefore sadly be bidding farewell to Ollie when his fixed term appointment ends on 31 March.

I would like to take this opportunity to thank Ollie for his huge contributions to Health Protection Operations and the wider organisation. This has included leading the Health Protection Operations (HP Ops) modernisation programme, the ramp-down of Testing Operations, work to increase UKHSA’s readiness to respond and much else besides. He has also been a valued member of the Executive Committee (ExCo), shaping the agency’s direction in countless ways.

We hope to issue a cross-government Expression of Interest for interim cover before launching a fair and open competition for a permanent role in due course. In the interim Will Welfare (Director of Regions) and Martin Sellars (Director of Assurance, Change and Transformation) will share the chairing of HP Ops Senior Leadership Team and will take turns representing HP Ops at ExCo and other relevant meetings.

The National Audit Office Report into the UKHSA’s Health Security Campus Programme was published on 28 February. The report concluded that replacing and modernising UKHSA’s facilities is of crucial importance but criticised the lack of clear decision-making on where the site should be located. In particular, the report noted the need for clarity between all parties in order to progress the programme and reduce further delays or costs.

4. Strategic Forward Look

Following the government’s announcement in May 2022 of its plan for Living with COVID-19, UKHSA has been preparing to ensure the management of COVID-19 is in line with other respiratory pathogens. I noted last month that financial year 2024 to 2025 will be the first year of UKHSA’s existence that, apart from Covid Vaccine Unit, no clear distinction is made between COVID-19 and other preparedness and response provision, as (non-vaccine) COVID-19 work will no longer be separately funded in UKHSA’s budget.

Testing Operations close down: the Testing Operations team is due to close on 31 March. Most of the staff on that team will roll off when their contracts end on 31 March with a core staff retained for at least six additional months to embed key operational knowledge and capability within UKHSA’s ongoing capabilities, support residual work and decommissioning, and provide expertise with operational requirements and modernisation across UKHSA.

COVID-19 testing in Adult Social Care (ASC): we sent a submission to Ministers on 22 February outlining the management of COVID-19 in line with other respiratory pathogens in ASC settings, including care homes and in hospices. In practice this will include ending routine asymptomatic discharge testing of patients from NHS to ASC and hospice settings and handing over responsibility for testing of symptomatic staff on wards for profoundly immunocompromised individuals to NHSE. However all areas where routine provision has previously been delivered will still be able to utilise testing where this is required for appropriate clinical management.

Test Digital: the digital infrastructure for COVID-19, known as Test Digital, was decommissioned on 15 February and replaced with a simpler and more effective test results upload service. This will continue to allow test providers to fulfil their legal obligation to report COVID-19 lateral flow test results to UKHSA while greatly reducing the running costs (previously around £600,000 per week for Test Digital).

I have been invited to appear in front of several parliamentary committees in February and March.

I gave evidence to the Science Innovation and Technology Select Committee on 28 February for its inquiry on ‘Emerging diseases and lessons learned from COVID-19’. Topics covered included diagnostics, vaccines, pandemic preparedness, and public-private partnerships.

I then appeared at the Health and Social Care Committee on 4 March for its inquiry on ‘Coronavirus: lessons learned (follow-up)’. Topics covered included the impact of COVID-19 on the social care sector, face coverings, excess death data and vaccine uptake.

Finally, on Wednesday 13 March I will be attending the Public Accounts Committee - Annual Report and Accounts (ARA) alongside colleagues from the Department of Health and Social Care (DHSC) – Sir Chris Wormald, Shona Dunn and Andy Brittain. The committee will enquire about DHSC and UKHSA’s ARA for 2022 to 2023 and 2023 to 2024, as well as the UKHSA strategy and future budgets.

We continue to respond to a range of requests from the COVID-19 Public Inquiry. We submitted the first of two statements in relation to Module 4 (Vaccines and Therapeutics), addressing the work of the Vaccine Task Force, on 1 March 2024. A second statement, addressing the work of Public Health England and the lessons learned by UKHSA in relation to vaccines and therapeutics, is due for submission on 2 April 2004. In addition, there is significant work underway in relation to Module 5 (procurement), where we have received two separate requests for corporate statements which will require very careful handling given the complex commercial and strategic issues they raise.

We know that other Inquiry-related work is beginning or due to arrive shortly. As discussed at the Strategy session on 20 February, we are preparing for the publication of the Module 1 report on Pandemic Preparedness in early Summer, both participating in relevant discussions with other Government Departments and considering the UKHSA strategic narrative on pandemic preparedness. In addition, the Inquiry have advised that I will receive a request for a personal witness statement in relation to Module 3 (Healthcare) and we expect to receive a request for a corporate statement in relation to Module 6 (Adult Social Care) just after Easter.

5. Update on activities

In my last update I provided details of the increase in measles infections and the work that was ongoing. On 4 March, UKHSA and DHSC launched a national childhood immunisation communications campaign, aiming to help tackle the spread of infection, by increasing confidence for, and uptake of, vaccinations, particularly in areas of low coverage and support Secretary of State’s priorities by keeping people protected and easing pressures on the NHS. This followed a pilot programme run in the North West in December 2023 with the campaign based on views from parents in that region and based on work with Liverpool County Council, NHS North West and NHS Greater Manchester. UKHSA has identified an additional £1.7M funding this financial year to deliver a national campaign, and we are also recommending bringing forward planned 2024-to-2025 activity from July and August to create a summer surge campaign.

To support the launch of this campaign, on 29 February I travelled to Salford and Liverpool for an interesting, busy day when I:

• appeared live from Media City in Manchester on BBC Breakfast to talk about the launch
• visited a catch-up vaccination clinic being run from Newbury Green Medical Practice in Salford including to provide more interviews
• travelled to Liverpool to attend the Health Equity Liverpool Project Learning Event
• met with North West Health Protection colleagues and stakeholders at our UKHSA NW offices in the Cunard Building in central Liverpool

The UKHSA Framework Document requires UKHSA to establish and maintain arrangements for internal audit in accordance with HM Treasury’s Public Sector Internal Audit Standards. This is delivered by the Government Internal Audit Agency, who undertake an annual programme of audits to inform an annual opinion on our risk management, internal controls and governance. They undertake between 15 and 20 audits each year, based on a programme agreed with ExCo and the Audit and Risk Committee.

A number of recommendations have been raised in the first three years of UKHSA, reflecting that we are a new organisation, nearly all of which have been accepted by management. Many of these have already been delivered, as set out in the attached table, and we are working hard to ensure we complete a number which are now overdue.  These latter are being actively managed to ensure that progress is made as rapidly as possible. As part of this proactive approach, a small number are being revisited to ensure that, given the passage of time and changes to the context in which we operate, the actions and outcomes sought remain appropriate and timely. Clearing the overdue actions is a priority for me and my ExCo colleagues, and we continue to review progress on a regular basis, including at the Audit and Risk Committee.

Jenny Harries

Chief Executive

March 2024