Corporate report

UKHSA Advisory Board: Board and Committee Effectiveness Review

Updated 12 May 2025

1. 1. Purpose of the paper

The purpose of the paper is to present the results of the UKHSA Advisory Board Effectiveness Review for 2024 / 2025 and proposed recommendations for implementation in 2025 / 2026.

2. 2. Recommendations

The Advisory Board is asked to:

• comment on the findings of the UKHSA Advisory Board Effectiveness Review.
• note that recommendations will be implemented in line with the government’s review of all arm’s length bodies which is due to complete in late May.

3. 3. Background

The Advisory Board continued to mature in 2024 / 2025 within the context of a change in Government and new priorities for UKHSA.

Alongside standard reports from the Chief Executive, Finance and its Committees at every meeting, the Advisory Board considered specific issues during 2024 / 2025:

• UKHSA’s role in optimising the immunisation schedule
• Understanding the scope of the National Biosurveillance Network
• Reviewing UKHSA’s approach to the adoption of artificial intelligence
• Activity to address antimicrobial resistance
• An update on UKHSA’s strategic approach to technology and cyber capabilities
• Core preparedness for vector borne diseases and infectious diseases
• Publication of the first annual Science Review
• UKHSA’s use of health economics to support strategic growth in the UK
• UKHSA’s strategic use of public health communications
• Implementation of the Heath Equity Strategy
• UKHSA’s draft annual report and accounts
• Development of UKHSA’s leadership capabilities
• Early lessons from the Covid-19 pandemic
• Progress of internal audits
• Continuing development of the Health Security Risk Assessment
• UKHSA’s core preparedness on chemical, radiological and nuclear threats
• Reviewing UKHSA’s Income Generation opportunities
• Oversight on progress of the Money and People Services programme
• Progressing UKHSA’s approach to surging during future incident response

The Advisory Board is supported by four committees:

• Audit and Risk Committee (Chair – Cindy Rampersaud)
• Equalities, Ethics and Communities Committee (Chair – Graham Hart)
• People and Culture Committee (Chair – Sir Gordon Messenger)
• Science and Research Committee (Chair – Jon Friedland)

4. 4. Effectiveness Review Findings

4.1 Process

An online survey was shared with members of the Advisory Board and additional short surveys with members of each committee.  The number of participants across the executive and non-executive decreased from 18 to 15 reflecting a period of substantial change in the senior leadership.  The outcomes show that across the 8 dimensions: 3 improved and 5 decreased slightly with small movements possibly reflecting the change in respondents.  As an average of the dimensions, the rating remained steady at 4.3 out of 5.

A 360-feedback exercise on the Chair, Ian Peters, was also undertaken by Cindy Rampersaud and fed back to the Senior Departmental Sponsor as part of the Chair’s annual appraisal process.   These responses showed similar outcomes across the 18 dimensions: 8 improved, 5 remained flat and 5 decreased slightly.  The average rating remained the same at 4.6 out of 5.

4.2 Previous recommendations

A board software solution was rolled out in 2024 / 2025 to improve security and increase ease of accessing material and communications between members.

A number of workshop sessions were held with the board during 2024 / 2025 enabling open and constructive on subject specific areas.

4.3 Findings

Feedback indicated a matured state for the Board and continued change in UKHSA’s context including an organisational restructure. Positive feedback included:

• the role of the Advisory Board was clear with interest in how to evolve this role in the matured state of UKHSA;
• the Board provided strong support and constructive challenge;
• the rating of the dynamic between members decreased slightly but remained strong at 4.4 out of 5, with informal interaction supporting formal meeting processes;
• meetings were well chaired with all members able to contribute;
• the relationship between the Board and is Committees was strong.

4.4 Possible areas for improvement included:

• the rating for how UKHSA engaged with external parties improved from the previous year, although remains the lowest rated question. The Board should consider whether there is more that could and should be done, recognising that non executive’s time is scare and voluntary.
• increased delegation to committees, especially in the development of subject specific strategies;
• opportunity to increase oversight of risk and strategic input in a budget constrained environment with the change in CEO, Chief Scientific Officer and Chief Operating Officer. The corporate strategy development process will need clear timelines and an agreed process on when to engage Board advice;
• selective deeper dive discussions were welcomed over shorter updates where appropriate.
• there continues to be a range of views on the degree of challenge brought by the non executives and external attendees, particularly in the public meetings.  In a similar vein, there is a broad spectrum on the extent to which that group should play a more active role in overseeing performance and delivery.  Both topics relate to the advisory rather than assurance / fiduciary nature of the Board.

5. 5. Next Steps

An action plan will be developed following Board discussion and will reflect any changes arising from the Arm’s Length Bodies review, discussions with the new Permanent Secretary, Departmental Sponsor and new CEO.  A detailed report will be presented to each Committee to take forward any specific actions.  The review of the four committees concluded that they are all working well, with overall scores upwards of 4.  There were some common themes around risk, deep dives and a willingness to review and learn from underperforming or unsuccessful initiatives which the Committee chairs will pick up.

As required by Government, the board effectiveness review for 2025 / 2026 will need to be conducted by an independent external reviewer.  The Board will be advised on the Terms of Reference, cost and reviewer in due course.