Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committee minutes

Updated 12 May 2025

1. 1. Recommendation

The Advisory Board is asked to note the minutes of 28 January 2025 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 8 April 2025.

2. 2. Minutes (confirmed), UKHSA Equalities, Ethics and Communities Committee, 28 January 2025

Present at the meeting were:

• Graham Hart – Non-Executive Member of UKHSA Advisory Board (Chair)
• Shona Arora – Director, Health Equity and Clinical Governance
• Susan Hopkins – Chief Medical Advisor (Executive Lead)
• Mark Lloyd – Non-Executive Member of UKHSA Advisory Board
• Hannah Taylor – Director, Policy
• 1 member had their name and title redacted

In attendance were:

• 7 attendees had their names and titles redacted

Apologies:

• Marie Gabriel – Associate non-executive member
• Raj Long – Associate Non-Executive Member of UKHSA Advisory Board

3. 3. Welcome, apologies and declarations of interest

25/001 The Chair welcomed participants to the meeting, noted apologies, and confirmed that there were no declarations of interest.

25/002 Marie Gabriel was congratulated on her Damehood awarded in the New Year’s Honours.

4. 4. Minutes of the previous meeting and actions

25/003 The Equalities, Ethics and Communities Committee agreed the minutes of the 8 October 2024 meeting (enclosure EEC/25/001) and noted the action log (enclosure EEC/25/002).

25/004 Verbal updates were provided on:

• Government priorities – teams were building the evidence base to support future Spending Review conversations and support for health inequalities. Additionally, teams were consulting on health protection implications which may arise from the move to mayoral devolution;
• Vaccine uptake – UKHSA staff met with the NHS Race and Health Observatory to discuss the agency’s role in vaccine uptake;
• Impact of early prison release scheme – health protection input into the early prison release scheme focused on continuity of care (especially substance misuse), mental health provisioning and minimizing numbers of prisoners releasing without contact address for health concerns. It was noted that support to these cohorts from local authorities could face increased pressure from the redesign of local government.

5. 5. Genomics

25/005 [Title redacted] presented the paper on ethics and ethical use of data in the Pathogen Genomics Programme (enclosure EEC/25/003). There was an increasing use of pathogen genomics for diagnostics and surveillance purposes.

25/006 Metagenomics (sequencing all genomic material in a sample providing pathogen-agnostic test) enabled valuable data insights. UKHSA teams were working with policy colleagues to strengthen the legal and ethical framework on the use of data in this new area. The genomics programme board had engaged widely across the landscape of clinical and academic pathogen genomics in the UK to support these discussions.

25/007 The Equalities, Ethics and Communities Committee noted the ethical issues encountered during development of the programme, and the approach taken by the programme.

25/008 The discussion noted:

• UKHSA was learning from challenges faced by partners in community engagement (e.g. Genomics England and vaccine hesitancy);
• there was a distinction between human genomics and pathogen genomics with the aim to remove as much human data as possible and find an approach that future proofed the increasing data available on human genomes;
• it was important to consider historic underrepresentation of inclusion health groups while acknowledging hesitancy in these communities;
• rapid change in pathogen genomes should be expected;
• UKHSA planned to work closely with health protection research units to address the substantial public engagement needed in metagenomics;
• the challenge around consent for metagenomics was secondary processing for routine diagnostics and outbreaks rather than research projects;
• education of clinicians processing routine blood samples was important;
• internal communications to UKHSA staff would support greater understanding of metagenomics and its potential.

25/009 The Committee welcomed further discussion of Pathogen Genomics with a focus on the equity aspect.

6. 6. Health Protection Research Units (HPRUs)

25/010 [Titles redacted] jointly presented the paper on HPRUs which are funded through the National Institute for Health and Care Research (NIHR) and are partnerships between UKHSA and universities in multi-disciplinary health protection research (enclosure EEC/25/004).

25/011 UKHSA supported the design of the HPRUs and contributed to guidance for applications, including detail on expectations for health equity and inclusion.

25/012 The Equalities, Ethics and Communities Committee noted the update on the NIHR HPRUs funding competition within the context of Health Equity and Inclusion Health.

25/013 The Committee encouraged the aspiration to foster learning across HPRUs in the space of health equity and inclusion. Activities included:

• mapping health equity priority areas against the HPRU topics;
• a panel session on the HPRUs chaired by NIHR and core strand on equity at the UKHSA Conference in March.

25/014 The Committee encouraged a holistic approach to embedding health equity considerations through the HPRU process. It would enable alignment with wider goals of UKHSA and a proactive approach to health equity beyond the focus on Patient and Public Involvement Engagement (PPIE). Discussion noted the following comments:

• there should be a stronger focus on needs of specific communities and populations over focus on single pathogens;
• highlighted the importance of proposing the inclusion health equity as a topic in the upcoming first HPRU 3 directors’ meeting that would ensure its consideration throughout the award lifecycle;
• clear articulation from NIHR of the outcomes wanted would support investment in the right areas;
• proposal for the HPRU oversight group to enabled supportive conversations on opportunities in the health equity space and ability to influence the annual report of HPRUs;
• utilising learning from the previous years and planning ahead to influence the health equity impact wanted over a longer timeframe;
• support for establishing a Health Equity Network across HPRUs as part of a proposed UKHSA Health Equity Analysis Research and Data (HEARD) Knowledge Mobilisation Hub initiative, which would ensure a stronger strategic approach to health equity insights.

25/015 The Committee noted interest in the impact of HEARD. It was agreed to provide an update in six-month time or circulate in correspondence between meetings.

7. 7. Inclusion Health

25/016 [Titles redated] presented the update on Inclusion Health activities (enclosure EEC/25/005). The framework sought to improve inclusion health outcomes focused on evidence to support population needs, engagement with affected communities and partnership. The framework valued lived experience, accessibility, building trust with communities and integrating services.

25/017 The Equalities, Ethics and Communities Committee noted the progress of Inclusion Health engagement over the past year. Activities included the mpox response, development of inclusion health surveillance and contributing to other team activities (such as the tuberculosis taskforce, maintaining hepatitis C elimination, the synthetic opioid taskforce, pandemic planning and homeless guidance.

25/018 The Committee praised the framework of evidence, engagement and partnership, encouraging a focused approach for the next stage of work. Feedback noted:

• the value to communities of specialist outreach services should be promoted through the Spending Review;
• measuring impact from one part of system was difficult, noting variability of provision across the country;
• a systems approach could provide clarity but was challenging given pressures on other partners. There was value in targeting inclusion groups to reduce other health system pressures (e.g. use of emergency department resources and impact of infectious disease)
• while successful in the health and justice space, other partners should be encouraged as enablers of inclusion health outcomes;
• engagement through Integrated Care Boards or mayors would enable targeting of known inequalities in local areas.

25/019 The Committee recommended identifying two key priorities in coming year to persuade stronger support from partners. These priority areas should balance feasibility and deliverability.

8. 8. Forward look and topics for future meetings

25/020 The Equalities, Ethics and Communities Committee noted the Forward Look (enclosure EEC/25/006). The following topics were suggested for future meetings:

• the impact of HEARD in approximately six months’ time;
• linking the locations strategy for UKSHA employees with impact of health equity in regions;
• chemicals/radiation and the environmental impact on inclusion health groups;
• an update on migrant and asylum seeker health.

9. 9. Any other business and close

25/021 The Committee noted the exceptions report from the Health Equity Board which ensured oversight of equity work across the organisation (enclosure EEC/25/007).

25/022 The meeting closed at 3:50pm.