Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committee minutes

Updated 13 December 2023

Date: Thursday 30 November 2023

Sponsor: Graham Hart

Recommendation

The Advisory Board is asked to note the minutes of 14 July 2023 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 10 October 2023.

Minutes, UKHSA Equalities, Ethics and Communities Committee, Friday 14 July 2023

Present at the meeting were:

• Graham Hart – non-executive Chair
• Mark Lloyd – non-executive member
• Susan Hopkins – Chief Medical Adviser (Executive Lead)
• Shona Arora – Director, Health Equity and Clinical Governance
• Jennifer Dixon – Non-executive member
• Raj Long – Associate non-executive member
• Marie Gabriel – Associate non-executive member
• Hannah Taylor – Director, Policy
• Scott McPherson – Director General, Strategy, Policy and Programmes
• Ollie Munn – Director General, Health Protection Operations

In attendance were:

• Steven Riley – Director General, Data, Analytics and Surveillance
• 6 attendees with names and titles redacted
• 1 attendee with name and title redacted (minutes)

Apologies from:

• 1 attendee with name and title redacted

Welcome, apologies and declarations of interest

23/057 The Chair welcomed participants to the meeting, welcomed new Committee member Hannah Taylor who replaced Linda Kennedy as Director of Policy, and confirmed that there were no declarations of interest.

Minutes of previous meeting and matters arising

23/058 The Equalities, Ethics and Communities Committee agreed the minutes of the 28 April 2023 meeting (enclosures EEC-23-012). All actions were complete and full explanations provided (enclosure EEC-23-013).

Asylum seeker, refugee and migrant health update

23/059 The Director of Health Equity and Clinical Governance and [title redacted] gave an update on the health protection risks of accommodation for undocumented migrants, asylum seekers, and refugees arriving by small boat.

The estimate of the number of migrants arriving via boats was so far this year slightly lower than expected. [Information withheld in accordance with the Freedom of Information Act 2000]. The implications for UKHSA of the Illegal Migration Act were not yet clear.

UKHSA was managing the detection of  probable tuberculosis (TB) cases of the same strain in an asylum seeker hotel [number of cases redacted in accordance with the Freedom of Information Act 2000]. The cases have since moved on from the hotel. Contact tracing and screening of a wide range of contacts was currently in progress, as per public health protocol for TB; this screening would involve several school age children. UKHSA was standing up a Standard National Incident to coordinate work with the Home Office. [Information withheld in accordance with the Freedom of Information Act 2000]

23/060 The Equalities, Ethics and Communities Committee provided the following comments.

The Home Office do not have a place-based policy which could make co-ordination of health policies difficult, however a suggested approach would be to encourage discussions with local councils. UKHSA engaged through place based multi-agency forums and strategic migration partnerships and worked closely with Directors of Public Health. TB commissioning was very different across the country and thought should be given to where migrants were placed because complex needs in various areas could be hard to address. A suggestion was to think through how areas/councils could use resource from other areas to support the needs of the local community. This could be done through Regional TB Control Boards.

Safeguarding issues were also noted where some children and young people were being mis-classified as adults.

23/061 The Equalities, Ethics and Communities Committee noted that a recent table top exercise on Asylum Seekers had taken place in the East of England (Red Horse) – it was agreed that UKHSA would follow involvement in future exercises.

23/062 The Equalities, Ethics and Communities Committee recommended that the national team send a note to DHSC via the Chief Executive highlighting risks around migrant healthcare. (Shona Arora) / [Title redacted]

Health and Justice update

23/063 The [Title redacted] provided a paper to discuss proposed work and initiatives on health and justice at UKHSA (Enclosure EEC-23-014). The purpose was to provide an update on how the UKHSA Delivering Health Equity for Health Security Strategy’s people and place approach would be used to improve health protection outcomes for Health and Justice populations.

23/064 The Equalities, Ethics and Communities Committee noted that in order to get better engagement and buy in from cross government teams, the links between health protection and other factors important to prison services such as improved health and re-offending should be looked into.

23/065 Comments noted an increased emphasis on health interventions when people arrive in prison. However, it was not clear about what happens once people leave prison. Samaritans are doing some work in prisons with ‘listening interventions’ to support mental health.

23/066 The Committee recommended that the Chair write to:

• His Majesty’s Prison and Probation Service (HMPPS) Executive committee referencing the presentation on health security in Health and Justice settings (Shona Arora) / [Title redacted]
• NHSE/HMPPS regarding the publication of the HIV in prisons report and Women’s prison H&SC review (Shona Arora) / [Title redacted]

Health security threat assessment

23/067 The [Title redacted] introduced a paper to outline plans for the health inequalities component of the Health Security Threat Assessment (HSTA) and inform discussions regarding its purpose and development (Enclosure EEC/23/015).

23/068 Comments noted:

• the HSTA team will need to think through how or to what extent to weight a risk and how to embed the risk framework
• thought should be given to the clinically vulnerable
• there is a ranking of risks, and a question was raised if inequalities affect ranking of the risk

23/069 The Committee noted that regarding the elderly population, work was underway with Adult Social Care UK to bring a focus on domiciliary care, to try and capture this group who are in receipt of care at home, recognising they were not well represented in data or evidence.

Forward look and topics for future meetings

23/070 The committee recommended that a deep dive on Vaccine Preventable Diseases be scheduled for October 2023 (ECC-23-011).

Any other business and close

23/071 The meeting closed at 10:52am.