Corporate report

UKHSA Advisory Board: Chief Executive's Report

Updated 4 July 2025

1. Purpose of the paper

The purpose of the paper is to provide a forward look of priorities and a brief overview of the recent operational and response status of the UK Health Security Agency (UKHSA) since the last Advisory Board.

2. Recommendations

The Advisory Board is asked to note the update.

3. Overview

Since the Advisory Board last met, Jenny Harries formally departed her role as Chief Executive (CEO) of the agency on 31st May. With our Chief Scientific Officer (CSO) post also currently vacant, I have been working closely with our Chief Medical Officer and Chief Data Officer to ensure continuity of leadership and operations across the agency.

The recruitment for the new CEO is progressing to time. We have sought a rapid recruitment approach for the interim Chief Scientific Officer (CSO) position due to critical leadership gaps in the organisation, especially with over 2,500 members of staff in the CSO group. The interim appointment will provide up to a twelve-month period of oversight and development of the CSO group leaving flexibility for the new CEO to make a substantive appointment during their first year in office.

The Chancellor announced the outcomes of Phase two of the Spending Review (SR) on 11 June, setting departmental funding for the next three to four years (from financial year 25/26) and covered day to day spending such as the NHS, schools and transport, and how the government will invest in research, energy security and infrastructure to drive economic growth across the country. The Health Group received a positive settlement overall; the Chancellor announced a record £29 billion investment for the NHS. UKHSA’s funding is allocated by the Department of Health and Social Care (DHSC), therefore we will receive our settlement through the DHSC business planning process which is expected to commence imminently.

In early April, the Government announced a review of all arm’s-length bodies (ALBs). UKHSA is an executive agency of DHSC and an ALB. We supported DHSC to respond to the Cabinet Office led process and will continue to contribute to the review, which we expect to conclude in September. The structure and remit of UKHSA - including its critical and sometimes unique functionalities - are aligned with the key assessment principles that the Government set out. I will provide an update in the next Advisory Board meeting.

4. Strategic Forward Look

Throughout the SR, we have given particular focus to the future of our laboratory estate, with our scientific facilities currently based at Porton and Colindale. Following the conclusion of the SR, the Government are yet to confirm whether to base these at Harlow in Essex, bringing together our existing functions from Colindale, Porton and 10 South Colonnade into a headquarters for UKHSA, or to upgrade our existing facilities in Porton and Colindale and not proceed with the Harlow site. Both options will represent a significant investment in our ageing laboratory infrastructure. I will provide an update in the next Advisory Board meeting.

Work continues on the COVID-19 Public Inquiry, in particular for modules 2 (Government Decision Making), 6 (Adult Social Care), 7 (Test, Trace and Isolate) and 8 (Children and Young People) at present, all concurrently requiring statements from UKHSA (and individuals employed by UKHSA).  UKHSA may also need to contribute to two new public inquiries, the Southport Inquiry, which is examining the attack at a children’s dance club in Southport on 24 July 2024 and the Manston Inquiry, which is examining the decisions and actions leading to conditions at Manston Short-Term Holding Facility between 1 June and 22 November 2022. A detailed overview is provided in the accompanying advisory board paper.

On 20 May UKHSA witnessed history at the 78th World Health Assembly in Geneva, Switzerland, when the World Health Organisation’s Member States formally adopted the world’s first Pandemic Agreement, following three years of negotiations in an increasingly complex geopolitical environment; most notably the absence of the United States in negotiations from late January 2025. UKHSA experts had provided technical input to these negotiations to help inform the UK position. Chief Medical Advisor Susan Hopkins attended the first two days of the Assembly as part of the UK delegation, alongside Minister Dalton, and met with many of our global partners. The Agreement will ensure that Member States, including the UK, take comprehensive collaborative action to better prevent, prepare, and respond to pandemics more equitably and effectively. It includes obligations on prevention; surveillance; workforce development; research and development; and takes a One Health approach (recognising the interdependence between animal, human, and environmental health). Negotiations are now underway on an annex to the Agreement to clarify details for a new Pathogen Access and Benefit Sharing system. The Agreement protects the sovereignty of Member States to make their own public health decisions in the event of a global health emergency. It will not be binding on the UK as a matter of international law until the UK Government has ratified it in accordance with our constitutional process.

5. Update on activities

Mpox – On 5 June 2025, the fourth meeting of the International Health Regulations Emergency Committee regarding the upsurge of mpox 2024 determined that the event continues to constitute a public health emergency of international concern.  Mpox clade IIb cases continue to be detected in low numbers in the UK; there is no evidence of sustained transmission of clade Ib.  As global situational monitoring, domestic surveillance, isolation, and vaccination procedures are in place, mpox will now return to business-as-usual management. An NHS England expanded vaccination programme for mpox, aimed at gay, bisexual and other men that have sex with men at highest risk of exposure is being launched on 1st August 2025, and delivered through sexual health services. This is a prospective routine programme building on the campaign rolled out during outbreak response.

Influenza A (H5N1) – Following completion of the Incident Management Team’s objectives, the H5N1 incident was stood down at the end of May to management within business-as-usual activity. Preparedness work is ongoing and being led by the Centre for Pandemic Preparedness, whilst Risk Assessment & Global Situational Awareness work continues to be led jointly by key teams across the Agency.

Measles – we published our monthly update on the 5th June on measles cases in England, which shows outbreaks continuing, with 109 cases confirmed in April and 86 so far in May. Cases have predominantly been in unvaccinated children aged 10 years and under. There has also been a global increase in measles cases including Europe over the last year and the Agency is concerned, that with travelling for holidays or to visit family this summer, there is a risk this could lead to another surge of measles cases in England. UKHSA continues to work with the NHS to ensure continued delivery of measles, mumps and rubella vaccines to protect the public.

Amber heat-health alert (HHA) – on 19 June, alongside the Met Office, we issued an amber HHA for all regions of England. Under UKHSA and the Met Office’s Weather-Health alerting system, an amber alert means that weather impacts are likely to be felt across the whole health service. At this level, we may begin to see some health impacts across the wider population. We may also see an increase in risk to health for individuals aged over 65 years or those with pre-existing health conditions, including respiratory and cardiovascular diseases. Our UKHSA data dashboard provides the latest details on HHAs currently in place and their duration.

Flu vaccines – data published in May by UKHSA show that the flu vaccine is estimated to have prevented around 96,000 to 120,200 people from being hospitalised in England last winter. The figures are encouraging, but many more could have been protected if more eligible people took up the free flu vaccine. UKHSA’s annual figures show contrasting influenza vaccine uptake rates for 2024/25 across eligible groups during a season of high flu levels. High flu vaccine uptake was seen once again in those aged 65 and over (74.9%) – just fractionally short of the World Health Organization 75% target. The number of frontline healthcare workers receiving a flu vaccine this season was 37.8%. Although this can’t be directly compared to previous seasons due different timings of this season’s occupational health offer, the previous season saw uptake of 43.1%. The initial rise in flu activity this season was driven by influenza A(H1N1) in children and later increased in elderly age groups. There was limited influenza A(H3N2) activity recorded. Influenza B activity started to increase in January 2025 in younger age groups and peaked across nations between mid-February and early March but with limited activity in elderly age groups.

Sexually Transmitted Infections – new data published in June shows that syphilis diagnoses in England continued to rise in 2024 compared to 2023. Overall, there were 9,535 diagnoses of early-stage syphilis diagnoses in 2024 compared to 9,375 diagnoses in 2023 – a 2% rise. Concerningly, the overall figure for syphilis, including late-stage syphilis or complications from the infection, increased 5% from 12,456 in 2023 to 13,030 in 2024. Encouragingly, there was a 16% drop in gonorrhoea cases, with 71,802 diagnoses of gonorrhoea in 2024, compared to 85,370 in 2023. The fall has been greatest in young people aged 15 to 24 years where there was a 36% reduction in diagnoses, but it is too soon to conclude whether this trend will continue. There has been a concerning acceleration in diagnoses of antibiotic-resistant gonorrhoea cases. While most gonorrhoea infections can be treated effectively, certain strains present significant treatment challenges due to antibiotic resistance. Ceftriaxone resistance is particularly concerning as this antibiotic serves as the primary treatment for gonorrhoea infections. Although numbers remain low, ceftriaxone-resistant gonorrhoea cases are being detected more frequently. There have now been 14 cases reported in the first 5 months of 2025, which is greater than the number of cases reported for the whole of 2024 (13 cases).  Six of the 14 cases in 2025 have been extensively drug-resistant cases, which means that they were resistant to ceftriaxone and to second-line treatment options. Most ceftriaxone resistant cases are associated with travel to or from the Asia-Pacific region, where the prevalence of ceftriaxone resistance is high.

Dyfed Alsop

Chief Operating Officer & Deputy Chief Executive

July 2025