Corporate report

UKHSA Advisory Board: 30 January 2025 minutes

Updated 11 March 2025

Date: 30 January 2025

Present at the meeting were:

• Ian Peters – Chair of UKHSA Advisory Board
• Jon Friedland – Non-executive member
• Dame Marie Gabriel – Associate non-executive member
• Dame Jenny Harries – Chief Executive
• Graham Hart – Non-executive member
• Susan Hopkins – Chief Medical Adviser
• Mark Lloyd – Non-executive member
• Sir Gordon Messenger – Non-executive member
• Isabel Oliver – Director General, Science and Research and Chief Scientific Officer
• Cindy Rampersaud – Non-executive member
• Thom Waite – Deputy Chief Medical Officer (England)

Observers at the meeting were:

• Lee Bailey – Director of Communications
• Jon Cocking – Director, People and Workplace
• Catherine Frances – Director General, Global and Public Health (DHSC)
• Richard Pebody – Director, Epidemic and Emerging Infections
• Steven Riley – Chief Data Officer
• Richard Smith – Deputy Director, Finance Business Partnering

In attendance at the meeting were:

• 11 attendees at their name and title redacted

Apologies were received from:

• Sir Frank Atherton – Chief Medical Officer (Wales)
• Simon Blagden – Associate non-executive member
• Luke Heath – Interim Chief Finance Officer
• Raj Long – Associate non-executive member
• Sir Michael McBride – Chief Medical Officer Northern Ireland
• Sir Gregor Smith – Chief Medical Officer (Scotland)
• Sir Chris Whitty – Chief Medical Officer England

1. Announcements, apologies and declarations of interest

25/001 The Chair noted the challenging context of recent geopolitical changes, fragile economic growth, NHS pressures and climate change impacts expected to affect the health agenda. UKHSA had opportunity to support the life sciences and growth missions of the UK government and the rapid pace of technology innovation.

25/002 The announcements on upcoming retirement of Jenny Harries as Chief Executive and departure of Isabel Oliver as Chief Scientific Officer were noted. Both were thanked for the support to UKHSA. The Chair was inputting into the recruitment for these positions with strong support from DHSC, alongside succession for two  non-executive and associate non-executive posts.

25/003 Marie Gabriel was congratulated on her damehood announced in the New Years Honours.

25/004 The Chair welcomed participants to the meeting and noted apologies. Catherine Frances as the incoming Director General, Global and Public Health at DHSC, and Jon Cocking the interim Director for People and Workplace were welcomed.

2. Minutes of previous meeting and matters arising

25/005 The Advisory Board noted the minutes of the previous meeting (enclosure AB/24/001) and list of actions (enclosure AB/24/002). The current actions were on track or not yet due.

25/006 The Advisory Board agreed updated executive membership of the Board following the Senior Civil Service restructure. Future executive members would include the:

• Chief Executive
• Chief Medical Advisor
• Chief Scientific Officer
• Chief Data Officer
• Chief Operating Officer

25/007 Standing invitations would be provided to the Director of Finance, Performance Risk and Assurance, and the Director of People and Workplace.

25/008 It was noted that the extensions to the appointments to the Advisory Board of the Chair, Sir Gordon Messenger, Jon Friedland and Mark Lloyd had been approved.

3. Chief Executive’s update

25/009 The Chief Executive presented her update on UKHSA’s activity (enclosure AB/25/003). She noted implementation of the SCS restructure and gave formal thanks to colleagues:

• Isabel Oliver who would continue as an invitee to the UKHSA Board in her upcoming capacity as Chief Medical Officer in Wales;
• Scott McPherson who departed UKHSA in December 2024.

25/010 The main areas of activity included:

• implementation of the SCS reorganisation with Jon Cocking welcomed into his new role
• the first annual review of the Science Strategy which demonstrated progress of the organisation and commitment to supporting growth missions across government
• laying of the Annual Report and Accounts in December 2024 – the Board noted its thanks to Maddie Fieldman and finance colleagues for their dedication to ensuring accounts were laid in time with a qualified opinion as the highest achievable outcome
• preparation for the Spending Review and articulating value of UKHSA’s activity
• monitoring of emerging infectious diseases across the globe including recent cases of H5N1 and Sudan virus (ebolavirus) reported in the USA and Uganda respectively
• COVID-19 Public Inquiry hearings and preparation for later modules

25/011 The Advisory Board noted the update and provided comments as below:

• the Board would discuss the changing policy context at a strategy session on 6 February and strengthening recognition of UKHSA’s identity locally
• the government missions provided a platform to articulate the value of UKHSAs scientific contribution and collaborate with other departments, the private sector and academia
• the AI Strategy to be discussed in March would support discussion on the role of data in prevention and partnership opportunities with the public and private sectors

4. Financial Report

25/012 The Advisory Board noted the financial update to the end of December 2024 (enclosure AB/25/004) presented by the Deputy Director, Finance Business Partnering.

25/013 The following points were raised in respect to the financial position:

• UKHSA was confident it could balance Core pressures by the end of the year with no emergency actions required to address a £3.5million full year RDEL overspend which was driven by changes in fiscal rules
• teams were confident of increased capital spending through February and March in line with forecasts. Indicative capital budgets were provided to teams in November 2024 to strengthen forecasting outturn of capital projects for the next financial year
• welcomed change in the revenue position compared to previous reports
• UKHSA continued working closely with DHSC on indicative spending assumptions to enable conclusion of business planning by March and preparation for the Spending Review to align UKHSA resourcing with wider government objectives
• finance colleagues were briefing ExCo on opportunities of funding provided through other organisations

5. Core preparedness for infectious diseases

25 /014 The Chief Medical Advisor introduced the update on UKHSA activities to support preparedness for infectious diseases (enclosure AB/25/005).

25/015 The Board noted the launch of mSCAPE (the metagenomics surveillance collaboration and analysis programme) to monitor trends, epidemiology and pathogen emergence in collaboration with academic partners and NHS.

25/016 There was an increase in prevalence for endemic and epidemic infectious diseases related to post-COVID-19 pandemic factors, such as the return of social mixing, international travel, migration and underlying epidemiology. Many plans and strategies were in place to mitigate this trend.

25/017 Encouraging data trends included the impact of RSV vaccine on the 75-to-79 age group and the impact of Hepatitis C interventions, seeing the lowest mortality rate for a decade.

25/018 The Advisory Board noted the update on activities.

25/019 The following points were raised in discussion:

• the agency had matured its diverse range of preparatory and response capability in the previous three years
• the 2026 to 2030 HIV Action Plan was under development and recognised the importance of engagement with specific groups and PrEP (pre-exposure prophylaxis) services to meet the World Health Organization target of ending the HIV/AIDs epidemic as a public health threat by 2030
• UKHSA’s role in presenting science and evidence to government would ensure action and advocacy could be taken forward by other partners
• the pathogen priority tool was in use within UKHSA
• the success of latent tuberculosis screening depended on consistent implementation
• it was not well understood that a lesser increase in antimicrobial resistance burden could have significant impact with the National Action Plan focusing on achievable targets
• importance of learning from behaviours in the COVID-19 pandemic that reduced infectious disease prevalence in future response planning
• the rising prevalence of infectious diseases had seen increased demand across all UKHSA laboratory services

25/020 The Board noted interest in further discussion on:

• the tier 1 pandemic exercise planned for autumn 2025 which presented an opportunity to showcase UKHSA as a leading scientific organisation
• vaccine uptake with the multi-agency partners invited to the discussion (Jenny Harries / Susan Hopkins)
• the HIV Action Plan which could be discussed at the Equalities, Ethics and Communities Committee
• discussing preparedness from the lens of determinants of health rather than hazards

25/021 It was agreed that the next annual update should ideally include showing the impact of UKHSA interventions and strengthening of equality insights leading to a focused response.

6. Health economics

25/022 The Chief Data Officer introduced the paper setting out current economic evidence supporting UKHSA activity and strategic discussions (enclosure AB/25/005).

25/023 A robust literature review to support a value for money assessment of the agency identified a conservative benefit cost-ratio (BCR) of 7.2. Cataloguing of ICD-10 codes related to infections and infectious diseases enabled assessment of their burden on NHS hospitals (admitted care) in England. This evidence would be utilised to support Spending Review discussions with DHSC.

25/024 Upcoming health economics activity would cover coding using ONS mortality statistics, labour market outcomes of hospitalisations (using sepsis as a case study and the impact of healthcare work absences using the SIREN survey.

25/025 The Advisory Board noted the contents of paper and encouraged further development in this area.

25/026 Feedback noted:

• UKHSA could expand the use of health economics data to drive investment and health adaptation efforts to address the impacts of climate change
• UKHSA teams to work with DHSC to ensure analysis uses standard Government Economic Service practices; DHSC undertook to facilitate a discussion with HM Treasury on the impact of UKHSA work; (Action: Steven Riley / Catherine Frances)
• solid financial logic would ensure impact across government by demonstrating money saved through a prevention lens and growth opportunities for the UK economy
• an mpox case study had supported counterfactual evidence to support economic benefit of prevention activity indicating a BCR of up to 14.9 with up to 166,000 cases prevented, £110million in NHS resources saved and £242million in loss productivity averted
• discussion below aggregate level on the areas of business generating most value was challenging due to variation in literature and data available
• teams were beginning to improve the rigour of BCR information to support internal business cases
• the breadth and depth of UKHSA’s activities enabled efficiencies in addressing health security – it was suggested to analyse the impact of integrating UKHSA’s functions and remit against comparator organisations to show the economic value of the single organisation approach
• UKHSA aspired to include BCR figures in the Annual Report and Accounts or other published documents, dependent on further collaboration and consistency with other government departments
• the impact of surveillance remained difficult to quantify but was essential to pandemic preparedness and long-term economics savings for the UK

25/027 The Advisory Board welcomed a further update at a time to be confirmed by the Chief Data Officer. This was expected to include an assessment of capability and demand for programmatic work. (Action: Steven Riley)

7. Advisory Board Committees

25/028 The Advisory Board noted verbal updates from the latest committee meetings as below:

• the Science and Research Committee November meeting discussed strategic risk from a science and research perspective, identification of research needs, pandemic preparedness and health protection research units (HPRUs) – the January meeting discussed UKHSA’s role and priority areas in the science ecosystem, reviews of the Centre for Climate and Health Security and the Vaccine Development and Evaluation Centre, artificial intelligence and pathogen prioritisation
• the Equalities, Ethics and Communities Committee January meeting considered ethics in pathogen genomics, HPRUs approach to health equity and equity impact for inclusion health groups
• the People and Culture Committee November meeting discussed the diversity and the inclusion dashboard, the performance management dashboard, internal communications, and emphasised efficacy of appraisals over completion numbers
• the Audit and Risk Committee December meeting considered the Annual Report and Accounts, strategic risk through the science lens including science infrastructure, information governance and overdue internal audit actions

25/029 The Advisory Board noted the confirmed minutes as below:

• the Science and Research Committee meeting on 11 September (enclosure AB/24/007)
• the People and Culture Committee meeting on 23 July 2024 (enclosure AB/25/008)
• the Audit and Risk Committee meeting on 10 September 2024 (enclosure AB/25/009)

25/030 The Advisory Board noted increasing maturity, challenge and support of the committees.

8. Questions from members of the public

25/031 A late question was submitted on the agency’s approach to artificial intelligence. This topic would be discussed at the March 2025 meeting.

9. Forward Look

25/032 The Advisory Board noted the forward look (enclosure AB/25/010).

10. Any other business and close

25/033 There being no other business, the meeting closed at 11:41am.