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Policy paper

Framework agreement between DHSC and the UK Health Security Agency: 2026 to 2029

Published 15 July 2026

© Crown copyright 2026

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This publication is available at https://www.gov.uk/government/publications/framework-agreement-between-dhsc-and-the-uk-health-security-agency-2026-to-2029/framework-agreement-between-dhsc-and-the-uk-health-security-agency-2026-to-2029

Introduction

This document has been agreed between the Department of Health and Social Care (DHSC) and the UK Health Security Agency (UKHSA) in accordance with HM Treasury’s (HMT) managing public money (MPM) handbook (as updated from time to time) and has been approved by HMT.

The framework document sets out:

  • the broad governance framework within which UKHSA and DHSC operate
  • UKHSA’s core responsibilities
  • the governance and accountability framework that applies between the roles of DHSC and UKHSA, including the role of the Chief Medical Officer (CMO) and the relationship with other parties including the NHS, other arm’s length bodies (ALBs), local authorities and devolved governments
  • how the day-to-day relationship works in practice, including in relation to governance and financial matters

The document does not convey any legal powers or responsibilities, but both parties agree to operate within its terms. 

Copies of the document and any subsequent amendments have been placed in the libraries of both Houses of Parliament and made available to members of the public on GOV.UK.

This framework agreement should be reviewed and updated at least every 3 years unless there are exceptional reasons or circumstances that have been agreed with HMT and the principal accounting officer of DHSC. The latest date for review and updating of this document is July 2029.

Objectives

DHSC and UKHSA share the common objective of delivering better public health outcomes for the population. To achieve this UKHSA and DHSC will work together in recognition of each other’s roles and areas of expertise to:

  • provide an effective environment for UKHSA to achieve its objectives through the promotion of partnership and trust
  • ensure that UKHSA also supports the strategic aims and objective of DHSC and wider government as a whole

Classification

UKHSA has been classified as a central government organisation by the Office for National Statistics (ONS) and the HMT Classifications team.

It has been administratively classified by Cabinet Office as an executive agency.

Purposes, powers and duties, and aims

Purposes

UKHSA has been established by the Secretary of State for Health and Social Care (Secretary of State) and DHSC, and as an executive agency does not have a separate legal personality to DHSC.

UKHSA’s purpose is to protect people from health threats. The agency mitigates and prevents harm from infectious disease and a range of hazards in the environment (including chemical, radiological and nuclear) so that people can live safer and more healthy lives, supporting a more equitable and prosperous future.

Powers and duties

In performing its role, UKHSA fulfils the Secretary of State’s statutory duty to:

  • protect the public’s health from infectious diseases and other public health hazards
  • assist in their statutory duty to address health inequalities

UKHSA and DHSC have specific responsibilities for planning for and managing the response to emergencies and health protection incidents and outbreaks in an extended team that works across government. UKHSA exercises specific functions on behalf of the Secretary of State under the:

  • National Health Service Act 2006
  • Health and Social Care Act 2012
  • Civil Contingencies Act 2004

See annex B for the statutory functions of the Secretary of State for Health and Social Care which are exercised through UKHSA and/or by UKHSA officials.

The Secretary of State has cross-government responsibility to provide assurance on the health system’s emergency preparedness.

UKHSA provides government, local government, the NHS, Parliament, public health professionals, social care settings, academia, industry and the public with evidence-based professional, scientific and delivery expertise and support, and will carry out the statutory functions and duties of the Secretary of State as notified by the Secretary of State to UKHSA in the annual remit letter or otherwise in writing.

Aims

UKHSA’s 3 strategic aims (pillars) are set out in the UKHSA strategic plan 2026 to 2029, the annual remit letter and the vision for UKHSA’s future as a science-led, data-driven and operationally excellent organisation.

Aim 1: understand

UKHSA detects and understands threats early through integrated surveillance, laboratory science, data science and horizon scanning. The agency analyses patterns, predicts risks and provides the intelligence that enables others to act as the nation’s eyes and ears for health security.

Aim 2: prevent

UKHSA works to stop threats before they become crises. Through vaccination programmes, novel and scalable diagnostics, prophylactic and therapeutic countermeasures, public health advice and system preparedness, the agency reduces risk and builds resilience. UKHSA provides evidence that is both cheaper and more effective than response.

Aim 3: respond

When threats emerge, UKHSA acts decisively. The agency provides 24/7 incident command, deploys specialist capabilities, co-ordinates wider system response and communicates clearly with the public. UKHSA learns from every incident to improve future responses.

Governance and accountability

UKHSA shall operate corporate governance arrangements that, so far as is practicable and in the light of the other provisions of this framework document or as otherwise may be mutually agreed, accord with good corporate governance practice and applicable regulatory requirements and expectations.

In particular (but without limitation), UKHSA should:

  • comply with the principles and provisions of the corporate governance in central government departments code of good practice (as amended and updated from time to time) to the appropriate extent and in line with their statutory duties, or specify and explain any non-compliance in its annual report
  • comply with MPM
  • in line with MPM, have regard to the relevant functional standards as appropriate and in particular those concerning finance, commercial and counter fraud
  • take into account the codes of good practice and guidance set out in annex A of this framework document, as they apply to UKHSA
  • in line with MPM annex 3.1, provide an account of corporate governance in its annual governance statement including the board’s assessment of its compliance with the code with explanations of any material departures. To the extent that UKHSA does intend to materially depart from the code, DHSC should be notified in advance

Role of DHSC

The responsible minister

The Secretary of State is accountable to Parliament for all matters concerning UKHSA.

The Secretary of State’s specific responsibilities regarding UKHSA include:

  • supporting the integrity of the system by ensuring that UKHSA’s funding, legislation and accountability arrangements protect the best interests of health service users, the public and the taxpayer
  • setting objectives for UKHSA through an annual remit letter and approving the agency’s strategic plan and annual business plan
  • responsibility for the policy framework within which UKHSA operates
  • providing guidance and direction to ensure the strategic aims and objectives of UKHSA are consistent with those of DHSC and the government
  • a power of appointment in relation to UKHSA’s chair and non-executive members, in line with the Governance Code on Public Appointments

Appointments to the board

The Secretary of State shall have the following appointment and approval rights in relation to UKHSA’s board:

  • the chairperson is appointed by the Secretary of State
  • all non-executive members are appointed by the Secretary of State
  • all such appointments should have regard to the principle that appointments should reflect the diversity of the society in which we live, and appointments should be made taking account of the need to appoint boards which include a balance of skills and backgrounds

The principal accounting officer

The principal accounting officer (PAO) is the Permanent Secretary of DHSC.

PAO’s specific accountabilities and responsibilities

The PAO of DHSC designates the chief executive as UKHSA’s accounting officer (AO) and ensures that they are fully aware of their responsibilities. The PAO issues a letter appointing the AO, setting out their responsibilities and delegated authorities.

The respective responsibilities of the PAO and AO for ALBs are set out in chapter 3 of MPM.

The PAO is accountable to Parliament for the issue of funding to UKHSA.

The PAO is also responsible, usually via the sponsorship team, for advising the responsible minister on:

  • an appropriate framework of objectives and targets for UKHSA in light of DHSC’s wider strategic aims and priorities
  • an appropriate budget for UKHSA in light of DHSC’s overall public expenditure priorities
  • how well UKHSA is achieving its strategic objectives and whether it is delivering value for money (VfM)
  • the exercise of the ministers’ statutory responsibilities concerning UKHSA as outlined above

The PAO via the sponsorship team is also responsible for ensuring arrangements are in place in order to:

  • monitor UKHSA’s activities and performance
  • address significant problems in UKHSA, making such interventions as are judged necessary
  • periodically and at such frequency as is proportionate to the level of risk, carry out an assessment of the risks both to DHSC and UKHSA’s objectives and activities in line with the wider departmental risk assessment process
  • inform UKHSA of relevant government policy in a timely manner
  • bring ministerial or departmental concerns about the activities of UKHSA to the UKHSA board and chief executive and, as appropriate, to the DHSC board requiring explanations and assurances that appropriate action has been taken

The role of the sponsorship team

The UKHSA sponsorship team in DHSC is the primary contact for UKHSA. The responsible senior civil servant for this relationship (senior sponsor) is the Director General for Global, Public Health and Emergencies. They are the main source of advice to the responsible minister on the discharge of their responsibilities in respect of UKHSA. They also support the PAO in their responsibilities towards UKHSA.

The sponsorship team will work alongside DHSC’s Finance directorate, which will act as the departmental finance business partner to UKHSA. They will be responsible for:

  • oversight of financial management and accounting
  • planning and reporting
  • spending approvals
  • managing DHSC’s financial interests in UKHSA

Officials of the sponsorship team in DHSC will liaise regularly with UKHSA officials to review performance against plans, achievement against targets and expenditure against its departmental expenditure limit and annual managed expenditure targets.

Resolution of disputes between UKHSA and DHSC

Any disputes between DHSC and UKHSA will be resolved in as timely a manner as possible. DHSC and UKHSA will seek to resolve any disputes through an informal process in the first instance. If this is not possible, then a formal process, overseen by the senior sponsor, will be used to resolve the issue. Failing this, the senior sponsor will ask the relevant policy director general to oversee the dispute. They may then choose to ask the Permanent Secretary to nominate a non-executive member of DHSC’s board to review the dispute, mediate with both sides and reach an outcome, in consultation with the Secretary of State.

Freedom of information requests

Where a request for information is received by either party under the Freedom of Information Act 2000, Data Protection Act 1998 or Data Protection Act 2018, the party receiving the request will consult with the other party prior to any disclosure of information that may affect the other party’s responsibilities.

UKHSA shall provide a quarterly update to the sponsor on the existence of any active litigation and any threatened or reasonably anticipated litigation. The parties acknowledge the importance of ensuring that legal risks are communicated appropriately to the sponsor in a timely manner.

In respect of each substantial piece of litigation involving UKHSA, the parties will agree a litigation protocol which will include specific provisions to ensure appropriate and timely reporting on the status of the litigation and the protection of legally privileged information transmitted to the sponsor to facilitate this. Until such time as a protocol is agreed, the parties shall ensure that:

  • material developments in the litigation are communicated to the sponsor in an appropriate and timely manner
  • legally privileged documents and information are clearly marked as such
  • individual employees handling the legally privileged documents are familiar with the principles to which they must adhere to protect legal privilege
  • circulation of privileged information within government occurs only as necessary

UKHSA governance structure

Chief executive

Appointment

The chief executive of UKHSA is appointed by the Prime Minister following a recruitment process chaired by the Civil Service Commissioner. This process is governed by the Civil Service Commission’s recruitment principles and is in line with Permanent Secretary-level appointments across the Civil Service.

Responsibilities of UKHSA’s chief executive as accounting officer

The chief executive as AO is personally responsible for:

  • safeguarding the public funds for which they have charge
  • ensuring propriety, regularity, VfM and feasibility in the handling of those public funds
  • the day-to-day operations and management of UKHSA

In addition, they should ensure that UKHSA as a whole is run on the basis of the standards, in terms of governance, decision making and financial management, that are set out in box 3.1 of MPM. These responsibilities include the below and those that are set in the AO appointment letter issued by the PAO of DHSC.

Responsibilities for accounting to Parliament and the public

Responsibilities to Parliament and the public include:

  • signing the accounts and ensuring that proper records are kept relating to the accounts, and that the accounts are properly prepared and presented in accordance with any directions issued by the Secretary of State
  • preparing and signing a governance statement covering corporate governance, risk management and oversight of any local responsibilities, for inclusion in the annual report and accounts
  • ensuring that effective procedures for handling complaints about UKHSA in accordance with the Parliamentary and Health Service Ombudsman’s principles of good complaint handling are established and made widely known within UKHSA and published on GOV.UK
  • acting in accordance with the terms of MPM and other instructions and guidance issued from time to time by DHSC, HMT and Cabinet Office
  • ensuring that as part of the above compliance they are familiar with and act in accordance with:
    • any governing legislation
    • this framework document
    • any delegation letters
    • any elements of any settlement letter issued to DHSC that is relevant to the operation of UKHSA
    • any separate settlement letter that is issued to UKHSA from DHSC
  • ensuring they have appropriate internal mechanisms for monitoring, governance and external reporting regarding non-compliance with any conditions arising from the above documents
  • giving evidence, normally with the PAO, when summoned before the Public Accounts Committee (PAC) on UKHSA’s stewardship of public funds

Responsibilities to DHSC

Responsibilities to DHSC include:

  • establishing, in agreement with DHSC, UKHSA’s strategic and business plans in light of DHSC’s wider strategic aims and agreed priorities
  • informing DHSC of progress in helping to achieve the DHSC’s policy objectives and in demonstrating how resources are being used to achieve those objectives
  • ensuring that:
    • timely and sufficiently detailed forecasts and monitoring information on performance and finance are provided to DHSC
    • DHSC is notified promptly if overspends or underspends are likely and that corrective action is taken
    • any significant problems whether financial or otherwise (and whether detected by internal audit or other means) are notified to DHSC in a timely fashion

Responsibilities to the board

The chief executive is responsible for:

  • advising the board on the discharge of their responsibilities as set out in this document and in any other relevant instructions and guidance that may be issued from time to time
  • advising the board on UKHSA’s performance compared with its aims and objectives
  • ensuring that financial considerations are taken fully into account by the board at all stages in its provision of advice scrutiny, and that financial appraisal techniques are followed

The board

Composition of the board

UKHSA will have a board in line with good standards of corporate governance. In line with chapter 2 of executive agencies: a guide for departments and guidance set out in annex A of this document, UKHSA will have an advisory board with an Audit and Risk Committee (ARC) that contains both executive and non-executive members.

The board will provide advice, scrutiny and challenge to the chief executive and executive team. However, non-executive members will not have decision-making authority - as is the case with other executive agencies. Detailed responsibilities of the board shall be set out in the board terms of reference. Remuneration of its members will be disclosed in line with the guidance in the government financial reporting manual (FReM).

The board will consist of:

  • a non-executive chairperson
  • at least 3, but not more than 7, non-executive members, one of whom chairs the ARC
  • the chief executive and other executive members as agreed by the board from time to time
  • no more than 3 associate non-executive members appointed by the board, who are non-voting and shall bring particular skills and expertise relevant to UKHSA’s business
  • one of the deputy chief medical officers

In addition, the CMO and other UK chief medical officers will be able to attend and speak at board meetings as observers. A representative from DHSC - usually the senior sponsor - will also attend the board.

Members will have a balance of skills and experience appropriate to directing UKHSA’s business, including academic medical science, large scale operations, infectious disease, health inequalities, data, technology, organisational performance management and corporate services. The board should include a majority of independent non-executive members to ensure that executive members are supported and constructively challenged in their role.

Board committees

The board may set up such committees as necessary for it to fulfil its functions. As is detailed below, at a minimum this should include an ARC chaired by an independent and appropriately qualified non-executive member of the board.

While the board may make use of committees to assist its consideration of appointments, succession, audit, risk and remuneration, it retains responsibility for and endorses advice to the chief executive in all of these areas. The chair should ensure that sufficient time is allowed at the board for committees to report on the nature and content of discussion, on recommendations and on actions to be taken.

Where there is disagreement between the relevant committee and the board, adequate time should be made available for discussion of the issue with a view to resolving the disagreement. Where any such disagreement cannot be resolved, the committee concerned should have the right to report the issue to the sponsor team, PAO and responsible minister. They may also seek to ensure the disagreement or concern is reflected as part of the report on its activities in the annual report.

The chair should ensure board committees are properly structured with appropriate terms of reference. The terms of each committee should set out its responsibilities and the authority delegated to it by the board. The chair should ensure that committee membership is periodically refreshed and that individual independent non-executive directors are not over-burdened when deciding the chairs and membership of committees.

The board shall meet at least quarterly with a commitment to meet in public once a year, as outlined in the advisory board terms of reference published on the UKHSA website.

Duties of the board

The board shall provide advice, support and constructive challenge to the chief executive and executive team on:

  • establishing and taking forward the strategic aims and objectives of UKHSA consistent with its overall strategic direction and within the policy and resources framework determined by the Secretary of State
  • providing effective leadership of UKHSA within a framework of prudent and effective controls which enables risk to be assessed and managed
  • ensuring the financial and human resources are in place for UKHSA to meet its objectives
  • reviewing management performance
  • regular financial and management information concerning the management of UKHSA
  • changes which are likely to impact on the strategic direction of the UKHSA board or on the attainability of its targets, and determining the steps needed to deal with such changes and where appropriate bringing such matters to the attention of the responsible minister and PAO via the executive team, sponsorship team or directly
  • ensuring that:
    • any statutory or administrative requirements for the use of public funds are complied with
    • delegated authority is agreed with DHSC, and is in accordance with any other conditions relating to the use of public funds
    • in supporting decision making, the board takes into account guidance issued by DHSC
  • ensuring that, as part of the above compliance, the board is familiar with:
    • this framework document
    • any delegation letter issued to UKHSA
    • any elements of any settlement letter issued to DHSC that is relevant to the operation of UKHSA
    • any separate settlement letter that is issued to UKHSA by DHSC
    • appropriate internal mechanisms for the monitoring, governance and external reporting regarding any conditions arising from the above documents, and supporting the chief executive and UKHSA as a whole to act in accordance with their obligations under the above documents
  • demonstrating high standards of corporate governance at all times, including by using the independent ARC to help the board to address critical financial and other risks
  • putting in place mechanisms for independent appraisal and annual evaluation of the performance of the chair by the senior sponsor, taking into account the views of relevant stakeholders. The outcome of that evaluation should be made available to the responsible minister
  • determining all such other things which the board considers ancillary or conducive to the attainment or fulfilment by UKHSA of its objectives

The board should ensure that effective arrangements are in place to provide it with assurance on risk management, governance and internal control.

The board should provide advice on the strategic choice about the style and shape of risk management and should lead the assessment and management of opportunity and risk. The board should ensure that effective arrangements are in place to provide assurance over the design and operation of risk management, governance and internal control in line with HMT’s Orange Book management of risk - principles and concepts.

The board must set up an ARC chaired by an appropriately qualified non-executive member to provide independent advice to the chief executive on risk and ensure that DHSC’s Audit and Risk Assurance Committee is provided with routine assurances with escalation of any significant limitations or concerns. The board is expected to assure itself of the adequacy and effectiveness of the risk management framework and the operation of internal control.

The chair’s role and responsibilities

The chair is responsible for leading the board in the delivery of its responsibilities. Such responsibility shall be exercised in light of their duties and responsibilities as set out in their contract of employment, any appointment letter, this document and the documents and guidance referred to within this document.

Communications between UKHSA’s board and the responsible minister should normally be through the chair.

The chair is bound by the code of conduct for board members of public bodies, which covers conduct in the role and includes the Nolan principles of public life.

In addition, the chair is responsible for:

  • ensuring, including by monitoring and engaging with appropriate governance arrangements, that UKHSA’s affairs are conducted with probity
  • ensuring that policies and actions support the responsible minister’s wider strategic policies and that, where appropriate, these policies and actions shall be clearly communicated and disseminated throughout UKHSA

The chair has the following leadership responsibilities in support of the chief executive who holds formal responsibility for UKHSA:

  • supporting UKHSA’s organisational and strategic design and development, including through assisting the chief executive to develop a leadership model to recruit, build and retain UKHSA’s top talent
  • developing and maintaining a diverse and high-performing non-executive board team, helping to foster collaborative relationships at all levels within UKHSA, with DHSC, across government and devolved governments, and with other major stakeholders
  • establishing sound governance for the agency including through ensuring effective non-executive leadership of UKHSA’s ARC and establishing and maintaining other committees and sub-committees as needed
  • formulating the board’s strategies and ensuring that the board, in reaching decisions, takes proper account of guidance provided by DHSC or the responsible minister
  • supporting the chief executive’s accountability relationship with DHSC and providing advice, support and challenge to UKHSA’s executive team in delivering the priorities set out in UKHSA’s strategic plan
  • supporting the chief executive in promoting the efficient and effective use of staff and other resources
  • delivering high standards of regularity and propriety

The chair also has an obligation to ensure that:

  • the work of the board and its members is reviewed and that they are working effectively, including ongoing assessment of the performance of individual board members with a formal annual evaluation and more in-depth assessments of the performance of individual board members when being considered for re-appointment
  • in conducting assessments, the views of relevant stakeholders including employees and the sponsorship team are sought and considered
  • the board has a balance of skills appropriate to directing UKHSA’s business, and that all members including the chair continually update their skills, knowledge and familiarity with UKHSA to fulfil their role both on the board and committees. This shall include, but not be limited to, appropriate skills and training in relation to financial management and reporting requirements, risk management and the requirements of board membership within the public sector
  • board members are fully briefed on their terms of appointment, duties, rights and responsibilities
  • the chair, together with other board members, receives appropriate training on financial management and reporting requirements and on any differences that may exist between private and public sector practice
  • the responsible minister is advised of UKHSA’s needs when board vacancies arise
  • there is a board operating framework in place setting out the role and responsibilities of the board consistent with the government code of good practice for corporate governance
  • there is a code of practice for board members in place that has at its heart all the requirements set out within the Cabinet Office code of conduct for board members of public bodies

Individual board members’ responsibilities

Individual board members should:

  • comply at all times with the code of conduct for board members of public bodies, which covers conduct in the role and includes the Nolan principles of public life as well as rules relating to the use of public funds and to conflicts of interest
  • demonstrate adherence to the 12 principles of governance for all public body non-executive directors as appropriate
  • not misuse information gained in the course of their public service for personal gain or for political profit, nor seek to use the opportunity of public service to promote their private interests or those of connected persons or organisations
  • comply with the board’s rules on the acceptance of gifts and hospitality, and of business appointments
  • act in good faith and in the best interests of UKHSA
  • ensure they are familiar with any applicable guidance on the role of public sector non-executive members and boards that may be issued from time to time by Cabinet Office, HMT or wider government

Role of the Chief Medical Officer (CMO)

UKHSA’s relationship with the CMO is of high importance to the agency’s successful operation.

As the UK’s most senior medical adviser, the CMO will have a close relationship with the UKHSA chief executive. The CMO will be the ultimate arbiter for advice on scientific and medical matters, will be formally consulted on wider health protection strategy and will be the professional lead for UKHSA’s most senior medical professionals.

As head of the public health profession, and its representative within government, the CMO also acts as the professional lead on technical issues for UKHSA’s Chief Medical Adviser (CMA) and chief executive (if they are a public health professional), feeding into their appraisal process and providing informal mentoring. The CMO plays an important role in supporting UKHSA’s scientific integrity and excellence, and in ensuring optimal co-ordination with the Office for Health Improvement and Disparities (OHID), noting that the CMO is senior professional lead for both entities.

As set out earlier, the CMO will receive all UKHSA board meeting papers and holds the right to attend as a speaking observer. One of the deputy CMOs is a member of the board.

The CMO also works closely with the other UK CMOs in support of UKHSA’s ambition to develop strong national partnerships across the 4 nations of the UK. Additionally, the CMO co-ordinates closely with UKHSA in support of its global health remit, given their role representing the UK internationally on public health issues, including in global health institutions.

In discharging their responsibilities, the chief executive has an unfettered right of access to the Secretary of State, the minister with responsibility for health security and the CMO to raise any matters or concerns and to respond personally to any issues they wish to raise.

Management and financial responsibilities and controls

Delegated authorities

UKHSA’s delegated authorities are set out in the delegation letter from the PAO. The PAO currently delegates the issuing of financial delegation letters to the Finance director general. This delegation letter may be updated and superseded by later versions which may be issued by DHSC in agreement with HMT.

In line with MPM annex 2.2, these delegations will be reviewed on an annual basis.

UKHSA shall obtain DHSC’s approval and, where required, HMT’s prior written approval, before:

  • entering into any undertaking to incur any expenditure that falls outside the delegations or which is not provided for in UKHSA’s annual budget as approved by DHSC
  • incurring expenditure for any purpose that is or might be considered novel or contentious, or which has or could have significant future cost implications
  • making any significant change in the scale of operation or funding of any initiative or particular scheme previously approved by DHSC
  • making any change of policy or practice which has wider financial implications that might prove repercussive or which might significantly affect the future level of resources required
  • carrying out policies that go against the principles, rules, guidance and advice in MPM

Spending authority

Once the budget has been set by DHSC, UKHSA shall have authority to incur expenditure approved in the budget without further reference to DHSC, on the following conditions:

  • UKHSA shall comply with the delegations set out in the delegation letters. These delegations shall not be altered without the prior agreement of DHSC and as agreed by HMT and Cabinet Office as appropriate
  • UKHSA shall comply with MPM regarding novel, contentious or repercussive proposals
  • inclusion of any planned and approved expenditure in the budget shall not remove the need to seek formal departmental approval where any proposed expenditure is outside the delegated limits or is for new schemes not previously agreed
  • UKHSA shall provide DHSC with such information about its operations, performance, individual projects or other expenditure as DHSC may reasonably require

Banking and managing cash

UKHSA must maximise the use of publicly procured banking services (accounts with central government commercial banks managed centrally by Government Banking).

UKHSA shall only hold money outside Government Banking service accounts where a good business case can be made for doing so and HMT consent is required for each account to be established. Only commercial banks which are members of relevant UK clearing bodies may be considered for this purpose.

Commercial accounts where approved shall be operated in line with the principles set out in MPM.

The AO is responsible for ensuring that UKHSA has a banking policy as set out in MPM and ensuring compliance with that policy.

Procurement

UKHSA shall ensure its procurement policies are aligned with and comply with any relevant UK or other international procurement rules in particular the Procurement Act 2023.

UKHSA shall establish its procurement policies and document these in a procurement policy and procedures manual.

In procurement cases where UKHSA is likely to exceed its delegated authority limit, procurement strategy approval for the specific planned purchase must be sought from DHSC through the sponsorship team.

Competition promotes economy, efficiency and effectiveness in public expenditure. Works, goods and services should be acquired through competition unless there are convincing reasons to the contrary. The form of competition chosen should be appropriate to the value and complexity of the goods or services to be acquired.

Contracts awarded without competition (above £25,000) shall be limited and exceptional and a report explaining those exceptions should be sent to DHSC as part of the direct award process.

For contracts awarded under sections 41 to 43 of the Procurement Act 2023, DHSC reviews these awards and sends them on to the DHSC Finance director general for approval.

For those below the Procurement Act 2023 threshold (but over £25,000), UKHSA sends DHSC details of the award and these are then logged for reporting purposes.

This process does not apply to direct awards that have been called off from an existing framework.

Procurement by the UKHSA of works, equipment, goods and services shall be based on an appraisal of options and VfM. That means securing the best mix of quality and effectiveness for the least outlay over the period of use.

UKHSA shall:

  • engage fully with department, health family and government-wide procurement initiatives that seek to achieve VfM from collaborative projects
  • comply with all relevant procurement policy notes issued by Cabinet Office
  • co-operate fully with initiatives to improve the availability of procurement data to facilitate the achievement of VfM

UKHSA shall comply, as appropriate, with both the:

These standards apply to the planning, delivery and management of government commercial activity, including management of grants in all departments and ALBs, regardless of commercial approach used, and form part of a suite of functional standards that set expectations for management within government.

Risk management

UKHSA shall ensure that the risks that it faces are dealt with in an appropriate manner, in accordance with relevant aspects of best practice in corporate governance, and develop a risk management strategy in accordance with HMT’s Orange Book management of risk - principles and concepts.

Data protection, information risk and assurance

DHSC is the data controller and has ultimate accountability for the processing of all personal data by UKHSA under applicable data protection legislation. The data protection officer (DPO) for DHSC, which includes UKHSA as one of its executive agencies, will ensure registration is made and renewed annually with the Information Commissioner’s Office.

Responsibility for low to medium risk data processing and information risk activities is delegated to UKHSA, who appoint their own senior information risk owner (SIRO), DPO and Caldicott Guardian. UKHSA shall seek prior advice and consultation from the DHSC’s DPO and SIRO prior to a decision being taken on any high risk data actions, but DHSC retains overall accountability for UKHSA’s data processing activities.

UKHSA will conduct all processing activities in accordance with an agreed information assurance and data protection working protocol, ensuring compliance with applicable legislation and overarching departmental policies. This protocol is currently under review to ensure it remains aligned with evolving legislative requirements and best practice standards.

Counter fraud and theft

Commitment to counter fraud

UKHSA acknowledges that fraud, bribery and corruption pose significant risks to public funds and the integrity of health services. UKHSA and DHSC agree that preventing, detecting and responding to fraud is a shared responsibility and a priority under the government counter fraud standard.

Fraud reporting and co-operation

UKHSA should:

  • adopt and implement policies and practices to safeguard itself against fraud and theft
  • take all reasonable steps to prevent and detect fraud within its operations
  • keep records of and prepare and forward to DHSC an annual report on fraud and theft suffered by UKHSA and notify the DHSC Anti-Fraud Unit (AFU) and, where appropriate, the NHS Counter Fraud Authority (NHSCFA) of any unusual or major incidents as soon as possible
  • manage the prevention, detection and recovery of fraud losses in UKHSA. Where trained resource is in place, this includes the investigation of fraud, bribery and corruption to a criminal standard, working with law enforcement partners as appropriate
  • report detected loss from fraud, bribery, corruption and error, alongside associated recoveries and prevented losses, to the counter fraud centre of expertise in line with the agreed government definitions as set out in the counter fraud standard
  • co-operate fully with DHSC and NHSCFA in any investigation or assurance activity, including providing timely access to relevant information, staff and systems

Notification and escalation

Where fraud is identified or suspected, UKHSA must notify DHSC without delay and follow agreed escalation protocols. Serious cases should be reported immediately to DHSC AFU.

Compliance and assurance

UKHSA should act in line with guidance as issued by the Government Counter Fraud Function and in compliance with the procedures and considerations as set out in MPM annex 4.9 and the counter fraud standard. This includes:

  • completing fraud risk assessments
  • implementing proportionate controls
  • participating in periodic reviews or audits as requested by DHSC
  • taking all reasonable steps to appraise the financial standing of any firm or other body with which it intends to enter a contract or to provide grant or grant-in-aid

UKHSA will maintain effective counter fraud arrangements aligned with DHSC’s counter fraud strategy and MPM guidance.

Culture and training

UKHSA will promote a culture of integrity and vigilance, ensuring staff are aware of fraud risks and know how to report concerns. Training and awareness activities should be embedded within governance and operational processes.

Staff

Broad responsibilities for staff

Within the arrangements approved by the Secretary of State and HMT, UKHSA will have responsibility for the recruitment, retention and motivation of its staff. The broad responsibilities towards its staff are to ensure that:

  • the rules for recruitment and management of staff create an inclusive culture in which:
    • diversity is valued and promoted
    • appointment and advancement is based on merit
    • there is no discrimination against employees with protected characteristics under the Equality Act 2010
  • the level and structure of its staffing, including grading and staff numbers, are appropriate to their functions and the requirements of economy, efficiency and effectiveness
  • the performance of its staff at all levels is satisfactorily appraised and UKHSA performance measurement systems are reviewed from time to time
  • its staff are encouraged to acquire the appropriate professional, management and other expertise necessary to achieve UKHSA’s objectives
  • proper consultation with staff takes place on important issues affecting them
  • adequate grievance and disciplinary procedures are in place
  • whistleblowing procedures consistent with the Public Interest Disclosure Act 1998 are in place
  • a code of conduct for staff is in place reconciling the Civil Service code with the requirements of professional bodies’ codes of conduct

Staff costs

Subject to its delegated authorities, UKHSA shall ensure that the creation of any additional posts does not incur forward commitments that shall exceed its ability to pay for them.

Pay and conditions of service

UKHSA’s staff are subject to levels of remuneration and terms and conditions of service (including pensions) within the general pay structure approved by DHSC and HMT. UKHSA has no delegated power to amend these pay terms and conditions.

If Civil Service terms and conditions of service apply to the rates of pay and non-pay allowances paid to the staff and to any other party entitled to payment in respect of travel expenses or other allowances, payment shall be made in accordance with the Civil Service management code and the annual Civil Service pay remit guidance, except where prior approval has been given by DHSC to vary such rates.

Some of UKHSA’s staff are employed on NHS Agenda for Change and NHS medical and dental terms and conditions. Agenda for Change staff remuneration is subject to the government response to the recommendations of the NHS Pay Review Body. Remuneration for professional medical staff employed within UKHSA inside its clinical ringfence (particularly, although not exclusively around medical and dental, public health, nursing and healthcare professional regulated roles) is subject to responses to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) as notified through NHS Employers.

Staff terms and conditions shall be set out on the UKHSA intranet. Copies should be provided to DHSC together with subsequent amendments as required.

UKHSA shall abide by public sector pay controls, including the relevant approvals process dependent on its classification as detailed in the senior pay guidance and the public sector pay and terms guidance.

UKHSA may operate a performance-related pay scheme that shall form part of the general pay structure approved by DHSC and HMT and, where relevant, with due regard to the senior pay guidance.

The travel and subsistence expenses of members of the UKHSA advisory board shall be determined by the UKHSA business expenses policy. Reasonable actual costs shall be reimbursed.

Pensions, redundancy and compensation

Compensation scheme rules should reflect legislative and HMT guidance requirements regarding exit payments. Other contractual redundancy schemes, such as the rules set out in the Agenda for Change handbook, will also be applied for relevant staff within the clinical ringfence.

UKHSA staff shall normally be eligible for a pension provided by either the Civil Service Pension Scheme or the NHS Pension Scheme, depending on whether roles are inside or outside the clinical ringfence. Staff may opt out of this occupational pension scheme, but the employer’s contribution to any personal pension arrangement, including stakeholder pension, shall normally be limited to the National Insurance rebate level.

Any proposal by UKHSA to move from the existing pension arrangements, or to pay any redundancy or compensation for loss of office, requires the prior approval of DHSC. Proposals on severance shall comply with the rules in chapter 4 of MPM.

Business plan, financial reporting and management information

Corporate and business plans

UKHSA shall:

  • submit annually to DHSC a draft of the strategic plan covering 3 years ahead
  • agree with DHSC the issues to be addressed in the plan and the timetable for its preparation

The strategic plan shall:

  • reflect UKHSA’s statutory and/or other duties and, within those duties, the priorities set from time to time by the responsible minister (including decisions taken on policy and resources in the light of wider public expenditure decisions)
  • demonstrate how UKHSA contributes to the achievement of DHSC’s medium-term plan and priorities and aligned performance metrics and milestones

The business plan shall be updated to include targets and milestones for the year immediately ahead and shall be linked to budgeting information so that resources allocated to achieve specific objectives can readily be identified by DHSC.

The business plan shall include:

  • objectives and associated performance targets for the forward years, and the strategy for achieving those objectives
  • non-financial performance targets
  • a review of performance in the preceding financial year, together with comparable outturns for the previous 2 years, as applicable, and an estimate of performance in the current year
  • alternative scenarios and an assessment of the risk factors that may significantly affect the execution of the plan but that cannot be accurately forecast
  • the risks aligned with the plans, in accordance with HMT’s Orange Book management of risk - principles and concepts
  • other matters as agreed between DHSC and UKHSA

Subject to any commercial considerations, the strategic and business plans should be published by UKHSA on GOV.UK and separately be made available to staff.

Budgeting procedures

Each year, in the light of decisions by DHSC on the business plan, DHSC will send to UKHSA by a date to be mutually agreed:

  • a formal statement of the annual budgetary provision allocated by DHSC in the light of competing priorities across DHSC and of any forecast income approved by DHSC
  • any planned change in policies affecting UKHSA

The approved annual business plan will:

  • take account of both approved funding provision and any forecast receipts
  • include a budget of estimated payments and receipts together with a profile of expected expenditure and drawdown of any departmental funding and/or other income over the year

These elements form part of the approved business plan for the year in question.

Annual report and accounts

UKHSA must publish annual reports of its activities together with its audited accounts after the end of the financial year. A draft of the report should be submitted to DHSC at least 2 weeks before the proposed publication date. The draft and finalised (audited) accounts should be provided to DHSC in line with the agreed annual timetable established by DHSC in order for the accounts to be consolidated within DHSC’s accounts. These accounts should be prepared in accordance with the relevant statutes and specific accounts directions issued by DHSC, as well as with HMT’s FReM.

The annual report and accounts must:

  • cover any corporate, subsidiary or joint ventures under its control
  • comply with the FReM and in particular have regard to the illustrative statements for an executive agency
  • outline main activities and performance during the previous financial year and set out forward plans in summary form

Information on performance against critical financial targets is included within the annual report and subject to the auditor’s consistency opinion. The report and accounts shall be laid in Parliament and made available on UKHSA’s website, in accordance with the guidance in the FReM.

Reporting performance to DHSC

UKHSA shall operate management, information and accounting systems that enable it to review in a timely and effective manner its financial and non-financial performance against the budgets and targets set out in the corporate and business plans.

UKHSA shall inform DHSC of any changes that make achievement of objectives more or less difficult. It shall report financial and non-financial performance, including performance in helping to deliver ministers’ policies, and the achievement of critical objectives regularly.

UKHSA’s performance shall be formally reviewed by DHSC twice a year.

The responsible minister will meet the board, chair and chief executive once a year.

The PAO will meet the chief executive at least once a year.

Information sharing

DHSC has the right of access to all UKHSA records and personnel where there is a legitimate and lawful purpose including, for example, sponsorship audits and operational investigations.

UKHSA shall provide DHSC with such information about its operations, performance, individual projects or other expenditure as DHSC may reasonably require.

DHSC and HMT may request the sharing of data held by UKHSA in such a manner as set out in central guidance except insofar as it is prohibited by law. This may include requiring the appointment of a senior official to be responsible for the data sharing relationship.

As a minimum, UKHSA shall provide DHSC with monthly information that will enable DHSC satisfactorily to monitor:

  • UKHSA’s cash management
  • forecast outturn by resource headings
  • other data required for the Online System for Central Accounting and Reporting (OSCAR)
  • data as required in respect of its compliance with any Cabinet Office controls pipelines or required in order to meet any condition as set out in any settlement letter

Audit

Internal audit

UKHSA shall:

  • establish and maintain arrangements for internal audit
  • ensure that any arrangements for internal audit are in accordance with the Global Internal Audit Standards
  • ensure DHSC is satisfied with the competence and qualifications of the head of internal audit and the requirements for approving appointments in accordance with the Global Internal Audit Standards
  • forward the audit strategy, periodic audit plans and annual audit report, including UKHSA’s head of internal audit’s opinion on risk management, control and governance, as soon as possible to DHSC
  • keep records of and prepare and forward to DHSC an annual report on fraud and theft suffered by UKHSA and notify DHSC of any unusual or major incidents as soon as possible
  • share with DHSC information identified during the audit process and the annual audit opinion report (together with any other outputs) at the end of the audit, in particular on issues impacting on DHSC’s responsibilities in relation to financial systems within UKHSA

External audit

The Comptroller and Auditor General (C&AG) audits UKHSA’s annual accounts and lays them before Parliament together with their report.

C&AG:

  • will consult DHSC and UKHSA on who shall undertake the audits on their behalf, the National Audit Office (NAO) or a commercial auditor, although the final decision rests with C&AG
  • has a statutory right of access to relevant documents, including by virtue of section 25(8) of the Government Resources and Accounts Act 2000, held by another party in receipt of payments or grants from UKHSA
  • will share with DHSC information identified during the audit process and the audit report (together with any outputs) at the end of the audit, in particular on issues impacting on DHSC’s responsibilities in relation to financial systems within UKHSA
  • will consider requests from departments and other relevant bodies to provide regulatory compliance reports and other similar reports at the commencement of the audit. Consistent with C&AG’s independent status, the provision of such reports is entirely at C&AG’s discretion

C&AG may carry out examinations into the economy, efficiency and effectiveness with which UKHSA has used its resources in discharging their functions. For the purpose of these examinations, C&AG has statutory access to documents as provided for under section 8 of the National Audit Act 1983. In addition, UKHSA shall provide, in conditions to grants and contracts, for C&AG to exercise such access to documents held by grant recipients and contractors and sub-contractors as may be required for these examinations. UKHSA shall use its best endeavours to secure access for C&AG to any other documents required by C&AG which are held by other bodies.

Reviews and winding up arrangements

Review of UKHSA’s status

UKHSA will be reviewed as part of the wider Public Bodies Reviews Programme, at a time determined by DHSC’s ministers and their PAO.

Arrangements in the event that UKHSA is abolished

DHSC shall put in place arrangements to ensure the orderly winding up of UKHSA. In particular, it should ensure that the assets and liabilities of UKHSA are passed to any successor organisation and accounted for properly. (In the event that there is no successor organisation, the assets and liabilities should revert to DHSC.) To this end, DHSC shall:

  • have regard to Cabinet Office public bodies guidance on the winding up of ALBs
  • ensure that procedures are in place in UKHSA to gain independent assurance on major transactions, financial commitments, cash flows and other information needed to handle the wind-up effectively and to maintain the momentum of work inherited by any residuary body
  • specify the basis for the valuation and accounting treatment of UKHSA’s assets and liabilities
  • ensure that arrangements are in place to prepare closing accounts and pass them to C&AG for external audit, and that, for non-crown bodies, funds are in place to pay for such audits. It shall be for C&AG to lay the final accounts in Parliament, together with their report on the accounts
  • arrange for the most appropriate person to sign the closing accounts. In the event that another ALB takes on the role, responsibilities, assets and liabilities, the succeeding ALB’s AO should sign the closing accounts. In the event that DHSC inherits the role, responsibilities, assets and liabilities, DHSC’s AO should sign

UKHSA shall provide DHSC with full details of all agreements where UKHSA or its successors have a right to share in the financial gains of developers. It should also pass to DHSC details of any other forms of clawback due to UKHSA.

Annex A: guidance

UKHSA shall comply with the following guidance, documents and instructions.

Corporate governance

This includes:

Financial management and reporting

This includes:

Management of risk

This includes:

Commercial management

This includes:

Public appointments

The following are relevant where public bodies participate in public appointments processes:

Staff and remuneration

This includes:

General

This includes:

Annex B: statutory functions to be exercised by UKHSA

This annex sets out the statutory functions of the Secretary of State for Health and Social Care which are exercised through UKHSA and/or by UKHSA officials:

  • section 2A of the National Health Service Act 2006 (the 2006 Act) - a duty to take such steps as the Secretary of State considers appropriate for the purpose of protecting the public in England from disease or other dangers to health
  • section 247B of the 2006 Act - a duty of co-operation between any body or other person that exercises functions similar to those of the Secretary of State under section 2A (whether or not in relation to the UK) in the exercise by it of those functions
  • section 1A of the 2006 Act - insofar as this duty relates to the statutory functions performed by UKHSA, a duty to exercise their functions in relation to the health service with a view to securing continuous improvement in the quality of services provided to individuals for or in connection with (a) the prevention, diagnosis or treatment of illness, or (b) the protection or improvement of public health
  • section 1C of the 2006 Act - insofar as this duty relates to the statutory functions performed by UKHSA, a duty to have regard to the need to reduce inequalities between the people of England with respect to the benefits that they can obtain from the health service
  • section 1E of the 2006 Act - insofar as this duty relates to the statutory functions performed by UKHSA, a duty to facilitate or otherwise promote research on matters relevant to the health service (including public health), and the use of evidence obtained from research
  • section 2 of the 2006 Act - a general power (also available to NHS England and an integrated care board (ICB)) to do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any of its functions
  • paragraph 12 of schedule 1 to the 2006 Act - a power to carry on such activities as in the Secretary of State’s opinion can conveniently be carried on in conjunction with a microbiological service provided under section 2A
  • section 58 of the Health and Social Care Act 2012 - a duty (where the Secretary of State is the appropriate authority) to take such steps as they consider appropriate for the purpose of protecting the public from radiation
  • paragraph 13 of schedule 1 to the 2006 Act - insofar as this power relates to the statutory functions performed by UKHSA, a power (also available to NHS England and an ICB) to conduct, commission or assist the conduct of research into any matters relating to the causation, prevention, diagnosis or treatment of illness, and any such other matters connected with any service provided under the 2006 Act as the Secretary of State considers appropriate
  • UKHSA acts as a Category 1 responder under the Civil Contingencies Act 2004 insofar as its functions include responding to emergencies by virtue of its functions under section 2A of the 2006 Act and section 58 of the Health and Social Care Act 2012
  • Health Service (Control of Patient Information) Regulations 2002[footnote 1] permit UKHSA, insofar as it relates to the statutory functions performed by UKHSA, to process patient information, including confidential patient information in certain circumstances as specified within the regulations

  1. Made under section 251 of the 2006 Act as amended - it was originally section 60 of the Health and Social Care Act 2001. ↩

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