Corporate report

UKHSA Advisory Board: strategy update

Updated 3 November 2022

Title of paper: UKHSA strategy update
Date: Thursday 29 September 2022
Sponsor: Scott McPherson
Presenter: Caroline Middlecote

Purpose of the paper

This paper updates the Advisory Board on the development of the UK Health Security Agency’s (UKHSA) 3-year strategy, plans for publication, and stakeholder engagement.

Recommendation

The Advisory Board is asked to note the next steps for launching UKHSA’s 3-year strategy set out in this paper.

Introduction – purpose of UKHSA’s strategy and business planning

The creation of UKHSA is a tremendous opportunity to improve how the UK tackles health threats and contributes to global health protection, drawing on learnings from the pandemic and the demonstration of the impact that threats to public health can have on our lives and the economy.

Our impact is much broader than our primary health protection focus. Within the wider health system, UKHSA plays a key role in protecting the NHS and its most vulnerable patients, for example by reducing pressure on the system and cost through our collaborative work on immunisation to reduce infectious disease, enabling early access to community treatments and assessing effectiveness of new interventions. Work on evidenced infection control interventions can significantly improve quality of life and reduce recurrent hospital demand for the elderly, frail and for care home residents.

Through our preparedness, we provide the UK’s insurance policy against the economic shocks caused by pandemics and other health security incidents. We work with the life sciences industry on areas of mutual benefit, including innovation in diagnostics and testing technologies, and in the development and evaluation of new vaccines. The life sciences industry is a significant driver of the UK economy and UKHSA will be at the heart of driving that industry forward with our expertise and partnerships to build the UK’s position as a science super-power.

The UKHSA strategy sets out in high level terms what we aim to achieve and where we will focus our efforts for the next 3 years. It covers:

• UKHSA’s mission, role and purpose – what we are here for
• key challenges and opportunities – the context in which UKHSA works
• UKHSA’s outcome goals – the impact we wish to have
• UKHSA’s strategic objectives – where UKHSA will focus its efforts
• UKHSA’s enablers – how we will ensure we are the best we can be

Process

Under the process set out in the framework document between Department for Health and Social Care (DHSC) and UKHSA, UKHSA would normally be expected to develop a 3-year strategy ahead of other planning documents.

DHSC would then produce an annual remit letter, confirming UKHSA’s budget and the deliverables it is to achieve for the year.

This would take into account the strategy and key information from UKHSA’s business planning. In parallel, UKHSA would produce a one-year business plan setting out in more detail how we will achieve the objectives set out in the strategy, and the deliverables from the remit letter.

For this first UKHSA strategy, we are adapting these timelines. Given the compressed timescale for the establishment of UKHSA and the need for all planning processes to reflect UKHSA’s initial funding settlement for 2022 to 2023, agreed in March 2022, the 3-year strategy will be published mid-year and has been developed in parallel with the Remit Letter and one-year business plan.

The Remit Letter was published on 12 August, while clearance and publication of the 3-year strategy will be completed now a new Secretary of State has been appointed.

As we have developed the strategy, we have continued to ensure that our thinking informs discussions with DHSC on priorities, as well as our plans for developing and strengthening UKHSA.

In parallel with this UKHSA is developing a detailed business plan with priority activities, key milestones and metrics for the forthcoming year. We are also developing an outcomes framework, which will add further detail to key performance metrics and the key milestones as defined in the business plan. These outputs will be completed once the strategy is finalised.

Stakeholder engagement

Health security involves a wide range of individuals and organisations, from the public to the NHS, the life-sciences industry and international bodies such as the World Health Organization (WHO). Delivering UKHSA’s strategy will require working closely with, and often delivering through, our partners at the local, national and global level.

The strategy highlights how UKHSA is maximising the impact of our work through relationships with key delivery partners, such as the NHS, Local Authorities and the life-sciences industry. For instance, UKHSA is strengthening preparedness by collaborating on planning using a ‘whole system’ approach. We work closely with the NHS to undertake analysis and evaluate interventions to combat health hazards such as human immunodeficiency virus (HIV) and antimicrobial resistance (AMR).

UKHSA also has a system leadership role in accelerating the development of relevant diagnostics, vaccines and other countermeasures, acting as a catalyst to harness the wider capabilities of academia and industry to drive preparedness and innovation and achieve better health outcomes.

As part of the development of the UKHSA strategy, we have worked to identify and understand relationships with key partners. To support the strategy and business plan, deep dives were conducted to identify what UKHSA could achieve under each objective and how. The process required, amongst other things, strategy leads and programme experts to identify key relationships for delivery.

In addition, UKHSA has discussed the highlights of the strategy with key external and government partners including the UK Chief Medical Officers (CMOs). The purpose of these meetings was to raise awareness of these partners to the overall shape of the strategy before publication, receive feedback, and initiate conversations on areas of future collaboration.

Aspects of the strategy are UK-wide or relate to UKHSA’s role in representing the interests of the whole UK with international partners, while other areas specifically relate to UKHSA’s role as the health protection agency for England. As part of our engagement with partners, UKHSA has engaged informally with government officials in Scotland, Wales and Northern Ireland, but the strategy has not been formally agreed with other nations.

Engagement will continue as we finalise the strategy and we will consider further the right way to engage the full breadth of our stakeholders up to and following publication.

Content

The following paragraphs set out key elements of the draft strategy (which may be adjusted as the strategy is finalised). Since we last presented this emerging work to the Advisory Board, we have consolidated our work under 3 key goals and merged some of our strategic priorities in line with steers from the Board.

All UKHSA’s work contributes to achieving one or more of our 3 goals.

Goal 1

Be ready for future health security hazards

Protect against future health security hazards through high quality surveillance and horizon scanning and through system preparation and readiness, to minimise harmful impacts to our health, society, public services and economy.

Goal 2

Save lives and reduce harm through effective health security response

Tackle infectious disease and other health security hazards to reduce harm to health, protect the economy and address health inequalities.

Goal 3

Build the UK’s health security capacity

Ensure the UK has the skills, expertise, infrastructure and collaborations to deliver health security for the UK now and evolve skills and capacity for the future. We will contribute to the UK’s strength in science through partnership with industry, driving innovation, ensuring we have the right health protection capabilities for the future, and supporting economic growth.

Strategic objectives

In order to achieve these goals, we have identified 10 strategic objectives for the next 3 years, where UKHSA will focus energy and effort to make a significant difference.

These are grouped under the 3 goals.

Prepare for future health security hazards

1. Strengthen preparedness across UKHSA for all health security hazards, including through the development of countermeasures.

2. Protect the UK through strengthening global surveillance and health security systems.

3. Ensure robust capacity and capability to respond to chemical, radiological and nuclear incidents

Save lives and reduce harm through effective health security response

4. Lead ongoing COVID-19 response in England, including on new variants, and support national recovery.

5. Reduce vaccine preventable diseases amongst adults and children in England, including COVID-19.

6. Reduce the impact of AMR.

7. Reduce health harm from climate and environmental hazards.

8. Reduce the harmful impact to health of blood-borne viruses, including Hepatitis B, Hepatitis C and HIV.

Strengthen health security capability

9. Enhance the resilience and scalability of national and local health protection systems.

10. Strengthen UKHSA’s data and analytics capability.

The 10 strategic objectives are not intended to cover everything that UKHSA will deliver over the next 3 years. Rather these objectives will enable us to focus extra energy on areas where we can make significant improvements for the public. They will help inform ongoing prioritisation and resource allocation.

In building our foundation, it is imperative that we invest in our people, facilities, modernise our technology, build the culture of a new agency, ensure strong relationships with our partners and maximise our value for money. This is especially true during the first year of the plan. Underpinning the delivery of UKHSA’s strategic objectives are four strategic enablers, which will ensure UKHSA can maintain and develop the appropriate capacity and capabilities to protect the public now and in the future:

• people and culture
• operational excellence and developing our infrastructure and technology
• partnerships and relationships
• data, science and research

Health equity is central to the successful delivery of all our objectives and is included in each underpinning delivery plan. A specific milestone on health equity has been included in the Annual Business Plan: “by the third quarter of 2022 to 2023, UKHSA will develop a comprehensive health equity strategy and ensure we have a mechanism for embedding and monitoring health equity across our programmes”.

Diagram: UKHSA’s strategic framework

Next steps

We are currently finalising the internal draft of the strategy. We are working with DHSC on approval by the Secretary of State, with the aim of publishing the UKHSA strategy in mid-October 2022.

To promote understanding of who we are and what our work will achieve, the strategy launch will include sharing an internal video with all staff. We will produce a toolkit to support teams in discussing how their work contributes to UKHSA’s strategic goals. We will also provide a 2-page summary of the strategy to highlight to key stakeholders what our work will achieve for the UK.

We will work our external stakeholders to identify common goals and areas of collaboration. This includes plans to consult with CMOs, NHS, Office for Health Improvement and Disparities (OHID), devolved administrations, WHO, representatives of local health partners, public health bodies, industry partners and academia.