Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committee minutes

Updated 22 May 2023

Date: Wednesday 24 May 2023

Sponsor: Graham Hart

Recommendation

The Advisory Board is asked to note the minutes of the 12 January 2023 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 28 April 2023.

Minutes, UKHSA Equalities, Ethics and Communities Committee, Thursday 12 January 2023

Present at the meeting were:

• Graham Hart – Non-executive Chair
• Shona Arora – Director Health Equity and Clinical Governance
• Jennifer Dixon – Non-executive member
• Marie Gabriel – Associate non-executive member
• Susan Hopkins – Chief Medical Adviser (executive lead)
• Linda Kennedy – Director of Health Protection Policy
• Mark Lloyd – Non-executive member
• Raj Long – Associate non-executive member
• Scott McPherson – Director General, Strategy, Policy and Programmes
• Oliver Munn – Director General, Health Protection Operations and Chief Operating Officer (Testing)

In attendance were:

• 10 attendees with names and titles redacted
• 1 attendee with name and title redacted (minutes)

Apologies from one attendee with name and title redacted.

Welcome, apologies and declarations of interest

23/001 The Chair welcomed all participants to the meeting.

Minutes of the previous meeting and matters arising

23/002 The Equalities, Ethics and Communities Committee agreed the minutes of the 6 October 2022 meeting which were circulated on 21 November 2022.

Winter health hazards and response

23/003 The Director General, Health Protection Operations and Chief Operating Officer, Testing presented the discussion on winter health hazards from an equalities, ethics and communities perspective (enclosure EEC/23/001).

23/004 There are high incidents of influenza and COVID-19. Case numbers of group A streptococcus are higher than usual so considered a threat to health security. Combined with industrial action and elective care backlog it has been a difficult winter.

23/005 Certain ethnic groups faced a higher burden from COVID-19, particularly Pakistani populations. UKHSA was taking steps to mitigate and minimise those disparate impacts as part of our mission to reduce inequalities.

23/006 Discussion noted that the Committee should consider how well the system is responding given the immense challenges in the NHS, particularly major reorganisation and staffing pressures.

23/007 It was noted that topics such as inequalities and that healthcare that is perceived as public health may not be prioritised, especially during a crisis. UKHSA’s role was to advocate health equity using data, taking into consideration health economics.

23/008 Discussion noted that the Committee should consider UKHSA’s relationship with integrated care systems (ICSs), which was held by regional teams. UKHSA does not provide data on specific inequalities issues at present. The Director General for Health Protection Operations would speak with regional Deputy Directors and ask ICSs how we can use data to address inequalities. Oliver Munn

23/009 It was suggested there needs to be a central leadership team dealing with health inequalities. The Director of Health Equity and Clinical Governance has reached out to make sure we are aligned with the ICS agenda. Experience so far was that each ICS is unique.

23/010 It was noted that NHSE were developing a vaccine strategy that should include addressing inequalities.

Migrant health

23/011 The Director of Health Equity and Clinical Governance introduced the paper on UKHSA’s role within the cross-government response to migrant health issues (enclosure EEC/23/002). It included discussion on the development of a longer-term work programme to reduce the public health risks in asylum seeker/migrant populations.

23/012 It was noted that UKHSA’s recent intervention had been very helpful and impactful but that challenges remained in working relationships with the Home Office and other partners, such as efficient and effective data sharing.

23/013 It was noted that increased engagement with the Home Office will be beneficial for forward planning.

23/014 It was noted the risk of diphtheria for the UK population is low. UKHSA has built good relationships with the Director of Manston, but we need to understand the pathway clearly. The UK is expecting similar numbers of people to arrive across the channel this year as 2022.

23/015 It was noted that there is an important theme around focusing on vulnerable population groups and it would be beneficial to look at how the UKHSA can obtain data on early intervention.

23/016 The Committee observed that the importance of understanding the roles and responsibilities of each party, to hold all partners to account in the health delivery system. It was suggested a demonstration project would be useful to understand what is possible by coordination and how we can clearly define each system’s role.

UKHSA corporate strategy and health equity strategy

23/017 The Director of Health Protection Policy introduced the item on development of the Health Equity Strategy and alignment with UKHSA’s corporate strategy (enclosure EEC/23/003).

23/018 It was noted that the corporate strategy team was aiming to publish the corporate strategy by spring or summer with the cross-cutting aim to achieve more equitable outcomes. This will be underpinned by an action plan, the draft of which was sent in the papers.

23/019 Discussion noted that the Committee should consider how the UKHSA can use the strategies to share ownership across the organisation.

23/020 It was noted that the committee agreed using ‘CORE20Plus5’ was a sensible approach to take with the health equity strategy, and that initially focusing on high-risk settings is a good option.

23/021 It was noted that looking at one of the Marmot cities could be a sensible way of testing the health equity strategy team’s approach.

23/022 It was suggested focusing on 3 population groups may be challenging as each group has sub-population groups. The committee agreed that focusing on Prions and Places of Detention was a sensible approach to achieve ‘quick wins’ and demonstrate that there is benefit in the work the UKHSA is undergoing.

23/023 It was agreed for the health equity strategy team to share the slides with each leadership group within UKHSA and obtain feedback. [Name redacted]

23/024 The Committee agreed that the strategy team should focus on people and place as opposed to focusing on a pathogen approach.

Forward look and topics for future meetings

23/025 To Committee suggested future topics of discussion as below:

a) inclusion health
b) customer strategy for the Committee to consider community engagement and focus on the community aspect of its role
c) defining UKHSA’s customers, for example clinicians, local government, or institutions
d) looking at the vaccine strategy with a focus on inequalities
e) co-creation strategy

23/026 Future discussion should reference real-life examples and consider who else is affected by ethical issues.

Any other business and close

23/027 Thanks were noted to all participants for their papers, contributions, and organisation ahead of the meeting.

23/028 The meeting closed at 11:55am.

[Name redacted]
[Title redacted]
January 2023