Corporate report

UKHSA Advisory Board: 24 January 2023 meeting minutes

Updated 10 May 2023

Date: Tuesday 24 January 2023

Present at the meeting were:

• Ian Peters – Chair
• Jon Friedland – non-executive member
• Simon Blagden – associate non-executive member
• Jennifer Dixon – non-executive member
• Marie Gabriel – associate non-executive member
• Dame Jenny Harries – Chief Executive, UK Health Security Agency (UKHSA)
• Graham Hart – non-executive member
• Susan Hopkins – Chief Medical Advisor
• Mark Lloyd – non-executive member
• Raj Long – associate non-executive member
• Sir Gordon Messenger – non-executive member
• Scott McPherson – Director General, Strategy, Policy and Programmes
• Isabel Oliver – Chief Scientific Officer (interim)
• Andrew Sanderson – Director General, Finance, Commercial and Corporate Services

Observers at the meeting were:

• Lee Bailey – Director of Communications
• Sarah Collins – Commercial Director
• Jac Gardner – Chief People Officer
• Oliver Munn – Director General, Health Protection Operations and Chief Operating Officer, Testing
• 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)
• Sir Chris Whitty – Chief Medical Officer (England)

In attendance were:

• Katherine Beesley – Business and Governance Senior Officer
• Hannah Frude – Head of Governance (minutes)
• Adam Hardisty – Deputy Director, People Strategy
• Gemma Lien – Head of Global Strategy
• Diana Randall – Deputy Director, UKHSA Global Strategy, Sponsorship and COVID-19 Lessons Learned
• Rachel Scott – Deputy Director, Governance, Risk and Assurance
• Nicola Steedman – Deputy Chief Medical Officer (Scotland)

Apologies from:

• Thom Waite – Deputy Chief Medical Officer

Announcements, apologies and declarations of interest

23/001 The Chair welcomed participants to the meeting and noted apologies.

Minutes of the previous meeting and matters arising

23/002 The Advisory Board agreed the minutes of the meeting held on 16 November 2022 (enclosure AB/23/001) as an accurate record.

23/003 The Advisory Board noted the list of actions from the previous meeting (enclosure AB/23/002).

Chief Executive’s update

23/004 The Advisory Board noted the update from the Chief Executive (enclosure AB/23/003). Highlights since the previous meeting (enclosure AB/23/003) included:

• support from UKHSA to healthcare partners facing severe pressure during winter months
• results of the people survey
• New Year’s honours for UKHSA’s staff work on vaccination and the coronavirus (COVID-19) data dashboard

23/005 Discussion continued on the importance of UKHSA’s relationships. Health protection teams (HPTs) relied on local relationships and continued lesson identified exercises for every incident raised in UKHSA. The Advisory Board showed interest in the strategic partnership between His Majesty’s Government (HMG) and Moderna as an indication of further opportunities with industry. The Vaccine Development Centre would capitalise on streamlining of processes for vaccine development.

23/006 It was noted that UKHSA reviewed principles for accepting new functions into UKHSA to ensure alignment with its remit letter and appropriate resourcing.

Financial report

23/007 The Advisory Board noted the financial update (enclosure AB/23/004). UKHSA’s Annual Report and Accounts for 2021 to 2022 would be published on 26 January 2023. A significant amount of work and improvements would take place; future sessions would update the Advisory Board on this follow-up work from the accounts. UKHSA continued to forecast an underspend with areas of intended growth underspending due to recruitment delays and challenges.

23/008 Discussion followed on protecting the intended growth of new capabilities facing low spending in this financial year. UKHSA continued to prioritise spending and focus budget decisions on capabilities that would be expected as standard business of the organisation as it moved into a stabilisation phase.

23/009 The Advisory Board noted concern from delays in setting the next year’s budget so close to April 2023. UKHSA would continue its collaborative relationship with the Department of Health and Social Care (DHSC) to normalise COVID-19 related spending as part of the core budget, understanding the business case for each element of core capability.

Preparedness for health threats from infectious disease

23/010 The Chief Medical Advisor presented the paper on preparedness work in UKHSA for current infectious disease threats (enclosure AB/23/005). Infectious diseases remained a key reason to attend primary care and an important factor in hospital admission or treatment.

23/011 The Advisory Board noted the activities under way in UKHSA to build capacity and capability to prevent, detect and manage infectious disease threats. As UKHSA continued strengthening its capability, there would be strategic choices on investments. It was noted that the work continued through the All Hazards Intelligence (AHI) Directorate to assess the relative importance of current public health threats and would feed into strategic budget conversations in coming months. The conclusions of the AHI would be brought back to the July 2023 meeting.

(Steven Riley)

23/012 UKHSA built certain strengths as an organisation and demonstrated the importance of pathogen genomics in tackling health threats. The main enabling factors for the ability to respond included:

• our people and enabling staff to be part of a wider health science family where they can move through the system while maintaining knowledge networks
• data and technology which was as much about creating a supportive working environment to encourage good partnerships and attractive career paths across the data, digital and technology space
• partnerships and UKHSA’s role to provide thought leadership in the space of infectious disease and external health threats. There was opportunity for close working with devolved administrations and modelling work of novel agencies abroad
• communication with the public, both in the knowns and uncertainty of information

23/013 The discussion generated further areas of consideration for the Advisory Board including antimicrobial resistance, health equity, public communications integration of strategies across UKHSA and public engagement during health response scenarios, all of which would brought back to future Board meetings.

(Ian Peters)

23/014 An important topic was how UKHSA would scale up health responses with different levels of demand and involvement from wider government. This should cover UKHSA’s areas of confidence in response, and be clear on the risks, how these were being managed, and the trade-offs between carrying cost and speed of response if large scale-up is needed. The Advisory Board noted interest in the understanding of boundaries and involvement from partners in a scale-up scenario.

(Oliver Munn)

Global strategy

23/015 The Director General, Strategy, Policy and Programmes presented the paper on development of UKHSA draft global strategy (enclosure AB/23/006).

23/016 The Advisory Board endorsed the approach to the draft global strategy as initial phase of work with interest in prioritisation of UKHSA activity. A future discussion was expected to understand the prioritisation choices made by UKHSA. The conclusions will be incorporated in the integrated strategic update.

(Scott McPherson)

23/017 It was noted that work must align with activity across the UK and the government’s health strategies. In particular, the UK Chief Medical Officers had recently agreed to establish a 4 nations UK Global Health Forum, which should link with UKHSA work to avoid overlap in activity.

23/018 UKHSA was encouraged to challenge group-thinking amongst international fora, noting our role in providing an evidence base and utilising opportunity to challenge what is possible in the global health space. A separate note comparing UKHSA with broadly equivalent global organisations would be circulated to Board members.

(Scott McPherson)

People Delivery Plan

23/019 The Chief People Officer introduced the update on development of UKHSA’s People Delivery Plan (enclosure AB/23/007). The plan was focused on immediate actions of the organisation to build a foundation for longer term priorities. The Advisory Board noted progress in the previous 6 months.

23/020 Discussion followed on the need to allow flexibility in career opportunities as UKHSA meets the needs of the future workforce. Further work was needed as part of the people strategy to consider long-term career opportunities and training of future staff over extended periods of time.

23/021 A discussion followed on how UKHSA would address the people survey results. The People and Culture Committee would discuss in further detail, although the Executive Committee was concerned with results on bullying and harassment. Focus would be on understanding drivers behind results, local action planning and Pulse surveys to better target actions. The survey included demographic indicators to address inclusivity challenges alongside challenges from existing internal networks.

Workforce update

23/022 The Chief People Officer presented the update on UKHSA’s workforce (enclosure AB/23/008).

23/023 The Advisory Board acknowledged the extraordinary scale and pace of downsizing by UKHSA in the previous 12 months, and the challenges that had resulted. Work continued to stabilise underlying composition of the workforce to permanent positions.

23/024 It was noted that the People Group continued work to support a science pay framework, alongside the Digital, Data and Technology (DDAT) capability framework and existing professional networks in the civil service. Science pay was a critical area of focus where UKHSA could influence development of a pay framework in conjunction with wider health family partners.

Advisory Board Committees

Audit and Risk Committee

23/025 The Advisory Board noted the minutes of the Audit and Risk Committee (ARC) meeting on 11 October 2022 (enclosure AB/23/009). The 2 November 2022 meeting had included a review of the strategic risk register, the vaccine taskforce transfer and cyber risk. An update on the latter will be circulated to ARC members and to others who request it.

People and Culture Committee

23/026 The People and Culture Committee was due to meet after the Advisory Board and would present an update at the next meeting. It was noted that people survey results were cascaded through UKHSA Live, internal sites and local groups. Action plans would be discussed locally and in place by March 2023.

Equalities, Ethics and Communities Committee

23/027 The Advisory Board noted the minutes of the Equalities, Ethics and Communities Committee meeting on 6 October 2022 (enclosure AB/23/010). The 12 January 2023 meeting had discussed winter health impact of difference communities, a deep dive on migrant health issues and the imbedding health equity into the corporate strategy.

Science and Research Committee

23/028 The Advisory Board noted the minutes the Science and Research Committee meeting on 30 September 2022 (enclosure AB/23/011). The 1 December 2022 meeting had discussed pay issues in scientific roles, radiation risks and ongoing development of the Science Strategy.

Questions from members of the public

23/029 A written question was received on the Water Treatment Work at Countess Wear Plant in Exeter which was passed to the South West health protection team for response.

Forward look

23/030 The Advisory Board noted the topics for future meetings (enclosure AB/23/012). Additional topics during 2023 would include:

• scaling up health responses in a large or multiple incident scenarios
• health equity strategy, which may include detail on the public health communications approach
• antimicrobial resistance

23/031 The Advisory Board noted interest in horizon scanning and analysis of UKHSA’s gaps which would be weaved into future discussion on other topics.

Any other business and close

23/032 There being no other business, the meeting closed at 12:30pm.

Hannah Frude
Head of Governance
January 2023