Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committee minutes

Updated 11 March 2025

Date: March 2025

Sponsor: Graham Hart

1. Recommendation

The Advisory Board is asked to note the minutes of 8 October 2024 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 28 January 2025.

2. Minutes (confirmed), UKHSA Equalities, Ethics and Communities Committee, 8 October 2024

Present at the meeting were:

• Graham Hart – Non-Executive Member of UKHSA Advisory Board (Chair)
• Shona Arora – Director, Health Equity and Clinical Governance
• Susan Hopkins – Chief Medical Advisor (Executive Lead)
• Marie Gabriel – Associate non-executive member
• Mark Lloyd – Non-Executive Member of UKHSA Advisory Board
• Raj Long – Associate Non-Executive Member of UKHSA Advisory Board
• Jake McClure – Deputy Director, Culture, Learning and Development
• Hannah Taylor – Director, Policy

In attendance were:

• Mary Ramsay – Director, Public Health Programmes
• 12 attendees had their names and titles redacted

Apologies:

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

3. Welcome, apologies and declarations of interest

24/072 The Chair welcomed participants to the meeting and noted apologies. There were no declarations of interest.

4. Minutes of the previous meeting and actions

24/073 The Equalities, Ethics and Communities Committee agreed the minutes of the 16 July 2024 meeting (enclosure EEC/24/019) and noted the action log (enclosure EEC/24/020).

5. Reflections on new government priorities

24/074 The Director, Policy provided a verbal update on the impact of new government priorities of UKHSA’s work in health equity community approaches. Current activity included:

• significant establishment of the five key missions to address cross cutting issues in government – UKHSA was monitoring implications of all missions with particular interest in the health and growth agendas (for example impact of sickness leave on the economy)
• publication of the Lord Darzi report which highlighted worrying health inequalities and impact of reduction in the public health grant since 2015
• increased focus on demonstrating outcomes through metrics and data
• preparation for the spending review which would consider investment in prevention activity leading to savings across the wider health system
• a marked interest in vaccination rates

24/075 The committee suggested ways to increase engagement and support of government priorities:

• showing the value of CORE20PLUS approach to reducing health inequalities
• there was opportunity to showcase UKHSA’s role in delivery or development of strategies and the NHS Long Term Plan – the response to mpox provided an example to demonstrate our capabilities alongside current constraints
• success of the health missions relied on interdependencies within UKHSA and across the wider health system
• vaccine uptake remained the best tool for health prevention – it would remain a regular discussion item in committee meetings for the first 18 months of the new government to support UKHSA’s impact in this area

6. Immunisation Equity Strategy

24/076 [Title redacted] presented the paper on the Immunisation Equity Strategy (enclosure EEC/24/021). It was intended to complement the NHS vaccination strategy which focused on delivery and aligned with the Delivering Health Equity for Health Security Strategy.

24/077 Updates from the previous strategy included:

• strengthening of evidence and immunisation outcomes over just delivery outcomes
• ensuring core delivery offer right to support expertise and capacity across the organisation
• intersectionality with other access barriers in the health sector
• positioning technical expertise in the system and clarity on capacity
• ensuring senior level engagement across the health sector to improve governance connections

24/078 The Equalities, Ethics and Communities Committee endorsed the direction outlined in the draft Immunisation Equity Strategy.

024/079 Discussion raised the following points:

• evidence on the impact of unvaccinated individuals could support the economic perspective for investment in health services
• UKHSA should be clear what it needed from partners and leverage ICB involvement in review of the NHS operating framework
• the strategy should be clearer on place elements and how to work with local communities
• it was important to emphasis role of the workforce in addressing immunisation equity
• Marie Gabriel offered to support engagement with the Integrated Care System
• it was vital to address challenges of vaccine hesitancy alongside vaccine uptake
• UKSHA should consider what is needed from other health sector partners outside tripartite of NHS and DHSC
• there was further support for a national vaccination register and active discussion with vaccine digital services to support flow on equity data

8. Responding to Extreme Weather Events from a health equity and communities perspective

24/080 [Title redacted] presented the paper on the Adverse Weather and Health Plan Equity Review and Impact Assessment (enclosure EEC/24/022).

24/081 The Adverse Weather and Health Plan was developed with consideration of mechanisms to support groups most at risk from extreme weather events. It was developed through engagement with key stakeholders including the Met Office.

24/082 Focus of the programme moving forward would include:

• supporting evaluation work on the frontline
• addressing intersectionality of vulnerabilities
• strengthening evidence on best interventions to recommend to partners

24/083 The Equalities, Ethics and Communities Committee noted the remit and scope of the Adverse Weather and Health Plan Equity Review and Assessment 2024.

24/084 Discussion noted the following points:

• description of extreme weather events issues was well articulated and should extend to consider the policy levers to reduce impact
• UKSHA should consider how to measure impact from actions planned in the coming year
• targeted communications could avoid information fatigue and ensure key messages were heard by each audience
• the Director, Policy offered to share input from policy perspective to align communications and ensure sufficient awareness of the team’s work
• the majority of communication was targeted to NHS and social care sector rather than general public
• the team worked closely with the behavioural insights team to understand analysis on an iterative basis
• simple powerful messaging would support integration of work in the prevention agenda, alongside response
• there was value in prioritising responder channels over general public to be clear on UKHSA’s role in adverse weather alerts
• there was an issue of wider health system communications with not all groups aware of their vulnerability to heat and cold

9. Responding to climate change from a health equity and communities perspective

24/085 [Title redacted] presented the paper (enclosure EEC/24/023) covering the centre’s development of a heath equity framework.

24/086 Dimensions of vulnerability to the health effects of climate change included:

• pre-existing susceptibility (for example long term health conditions and age as most prominent factor)
• groups less likely to have needs identified (for example inclusion health groups, racial or ethnic minorities)
• increased exposure to the impacts of climate change (for example coastal communities)
• ability to access interventions (for example people with disability and in deprived areas)
• significant global inequity and intergenerational inequity

24/087 Activities to integrate health equity into existing work of the centre included a vulnerability mapping tool, the Adverse Weather and Health Plan and integration of equity into the assessment cycle for the Health Effects of Climate Change report.

24/088 The Equalities, Ethics and Communities Committee noted the remit and scope of work of the centre and existing work relating to health equity.

24/089 Discussion raised the following points:

• framing health equity as routine thinking within the centre’s activities was welcomed
• considering lived experience would add a powerful dimension to the framework – this should include long term challenges requiring cross government collaboration (for example housing needs)
• the Joseph Roundtree Foundation had developed evidence linking impacts of climate change with other societal issues (for example poorer opportunities in affected geographies)
• applying the CORE20PLUS approach would enable consistency across UKHSA and the health sector
• it was agreed to discuss the framework at the Health Equity Board
• worked examples of the social care sector acting on warning would promote further awareness of UKHSA’s role
• the centre continued developing the storytelling elements with a strong narrative around vector borne disease threats

10. Forward look and topics for future meetings

24/090 The Equalities, Ethics and Communities Committee noted the Forward Look (enclosure EEC/24/024).

24/091 The following topics were suggested for the forward look:

• an update on health equity in prisons, in light of the recent mass release programme and the impact on individuals and communities
• a joint discussion on the strands of vaccine uptake, equity and hesitancy
• an update on ethics approaches in UKHSA for April meeting
• approach to the next health equity strategy later in 2025

11. Any other business and close

24/092 The committee noted the exceptions report from the Health Equity Board which ensured oversight of equity work across the organisation.

24/093 The meeting closed at 3.50pm.