Corporate report

UKHSA Advisory Board: Chief Executive's Report

Updated 20 November 2025

1. Purpose of the paper

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

2. Recommendations

The Advisory Board is asked to note the update.

3. Organisational Highlights

It has been a couple of months since I started as Chief Executive Officer (CEO) of UKHSA. My immediate focus has been on listening to senior leaders and staff from across the Agency to understand their priorities and challenges. This has enabled me and the new executive team to determine our future strategic priorities which we discussed in an ExCo and Directors Away Day on 3rd November.

Since the Advisory Board last met, Exercise Pegasus has concluded its main phases, having cycled through the emergence of a novel infectious disease, containment and mitigation phases. This tested our capabilities to respond, decision making across government through COBR (Cabinet Office Briefing Rooms) such as consideration of public health & social measures, impacts of different demographics from the novel virus, how we would manage cases, contacts, settings, testing, surveillance and more; against a background of difficult fiscal and economic risk.  As an agency, whilst learning much from the testing of our severe incident response for the first time since Covid-19, we performed effectively throughout the Exercise demonstrating our expertise and pandemic capabilities; in addition to our contribution in designing and delivering the Exercise. A full evaluation report will be published in 2026.

As noted in my last report, the Secretary of State for Health and Social Care announced plans in July to proceed with the development of new, state-of-the-art scientific facilities in Harlow, Essex. The Harlow site will form part of the Government’s National Biosecurity Centre (NBC) network and serve as UKHSA’s future headquarters and will open in full by 2038. The Harlow Programme Team continues to remobilise the programme and is working on a comprehensive Programme Business Case with approval by HMT due in summer 2026. UKHSA’s Executive Committee has held all-staff briefings at our affected sites, engaging with over 2000 staff, and has also issued a survey to staff to get views on the move and how the Agency can support staff over the coming years. A comprehensive engagement plan is in development. The Programme is also working closely with the Science Group on the laboratory design in particular with a view to sharing the initial plans with staff next year.

The National Audit Office (NAO) audit of the 2024-25 Annual Report and Accounts (ARA) was due for signature by the Comptroller & Auditor General on 13th November and laid before parliament on 17th November. Unfortunately, due to an unavoidable resourcing issue within the NAO this was not possible.  An alternate plan has been agreed with the NAO, which will mean the ARA is laid around the 11th December. The quality of the ARA continues to improve, we expect no new audit opinion limitations, reflecting the growth and maturity of the Agency. Planning for the 2025-26 ARA is underway, however the delays in the current year’s schedule is likely to result in a post-Summer Recess laying for the account.

This year’s Civil Service People Survey closed on 21 October, and our final response rate was 68%. We will review the responses when we get the results in December, before discussing them at our People and Culture Committee and progressing necessary actions. We also invited staff to vote for the final winners of the ‘We are UKHSA Awards 2025’, across all award categories, to celebrate and share the achievements of our people. The Advisory Board is invited to attend the UKHSA Awards Ceremony in London on Wednesday 3 December, where the winners will be announced.

4. Update on Operational and Response Activities

UKHSA provided a written closing statement to the UK Covid-19 Public Inquiry for Module 6 (Adult Social Care) following the conclusion of public hearings at the end of July. For Module 8 (Children and Young People) UKHSA provided a corporate written statement and UKHSA’s Chief Medical Adviser, Dr Shona Arora gave oral evidence at the public hearings in October for the module 8 related to Children and Young People.  There is a paper for this month’s Advisory Board to highlight the commitments UKHSA has made as part of the evidence provided to the inquiry, and how these are being fed-in to the UKHSA’s strategic planning. UKHSA is preparing for the publication of the final reports from Module 2 (Core UK decision-making and political governance) of the COVID-19 inquiry (due 20 Nov), and the Dawn Sturges Inquiry (due 4 Dec). UKHSA has also been asked for a statement related to the Manston Inquiry.

In October, Marc Merel and I opened the Project Amplify laboratory - our new high-throughput PCR (Polymerase Chain Reaction) testing laboratory at Porton Down, built and installed in under eight months, re-purposing COVID-19 laboratory equipment and built through exceptional cross-disciplinary collaboration, on time and under-budget. The facility enhances UKHSA’s emergency response and pandemic preparedness by providing in-house testing capacity of up to 24,000 PCR tests per day. This gives us the potential to step up testing much earlier than alternative contingency arrangements and provides excellent value for money compared to alternative arrangements with external delivery partners. The lab is now with the Porton Down testing and diagnostics team for validation and will support surveillance, diagnostic development, and staff training, enhancing scientific capability and ensuring increased preparedness for the country.

Our Radiation Protection Sciences Division delivered the 2025 European Radiation Protection Week conference, which was hosted by UKHSA in London from the 29th September–2nd October.  The event attracted some 250 participants from 40 countries. The programme consisted of five plenary sessions and fifteen parallel sessions covering a wide range of radiation protection issues, including patient protection, dosimetry in space and studies in deep underground mines with reduced natural background radiation. The conference was attended by the European Commission project officer for the Pianoforte European Partnership for radiation protection research who indicated enthusiasm within the Commission for extension of the co-funded partnership for two years with additional funding to around €15million to the Partnership of 58 organisations. Along with several satellite meetings, this was a great opportunity to strengthen UKHSA’s position on the European stage in relation to radiation protection research. Further opportunities for collaborative research were identified. One of our Senior Radiation Protection Scientists, Grainne O’Brien, was awarded the 2025 MELODI award (Multidisciplinary European Low Dose Initiative), recognising her significant achievements in advancing understanding of low dose radiation effects.

In September we hosted the Health and Safety Executive (HSE) for a planned intervention in relation to Industrial Automated Control Systems (IACS).  HSE had originally inspected our facilities at Porton Down in March 2022 and identified some key improvements needed to ensure compliance against operational standards. This resulted in UKHSA commencing a major programme of work to improve cyber security in relation to our control systems. This included the production and implementation of a cyber security management system, and a full assessment of cyber risks for our IACS related systems.  Over recent years the programme has delivered a broad range of system and IT upgrades to meet the requirements set out in the operational guidance. HSE were complementary at the progress made during the recent intervention and confirmed we had met expectations in terms of implementing the original improvements.  We received some helpful additional verbal advice, together with a requirement to provide our plans for the next phase of work we intend to deliver. This represents a major landmark in an ongoing programme to ensure our control systems are compliant with cyber guidelines. The work to continue to reduce risks will continue in future years and require ongoing investment.

The Trust Programme, to strengthen our cyber security and information management systems and processes has now been established. The approval for the procurement of delivery partners is nearing completion and we hope to begin to onboard the consultants from 14th November.   Alongside this, the Programme Director Robbie Kent has been in place since August and 16 out of 23 roles have been filled in the civil service programme team. The first Programme Board will sit at the end of November.

In September, the new Moderna Innovation and Technology Centre opened as the latest addition to the the UK’s £100 billion life sciences sector to come out of Moderna’s 10-year strategic partnership with the government. The partnership also includes an over £1 billion programme of investment in UK research and development being brought forward by the company, tapping into the UK’s deep skills base, world-class academic institutions, and the power of the NHS as an engine for research and innovation. The new facility will support around 150 highly-skilled jobs, while enabling groundbreaking work on the use of mRNA vaccine technology to tackle cancer and seasonal infections like flu, RSV and COVID-19, subject to the usual regulatory processes. In the event of a pandemic, where mRNA vaccines were effective, it will be utilised to produce up to 250 million vaccine doses a year, improving our national resilience to future health emergencies with domestic UK manufacturing capabilities.  I’m delighted that UKHSA leads the partnership on behalf of government with Sarah Collins as the Senior Responsible Officer. It is an exemplar on how we and government can work closely with industry to prepare and respond to emerging health threats.

We continue to urge the public to book their vaccinations against flu, COVID-19 and respiratory syncytial virus (RSV). COVID-19 rates are falling, however we are seeing flu circulate earlier than we would in a typical season. Currently,  A(H3N2) is the predominantly circulating strain which is usually associated with higher morbidity and mortality, particularly in the elderly and we are seeing a ‘drifted’ sub-strain of this circulate. UKHSA has published early analysis of vaccine effectiveness to understand how well the vaccine is performing, given drifted the strain, which suggests that this season’s vaccines are offering effective protection against severe flu – children are around 70 to 75% less likely to attend or be admitted to hospital with flu if vaccinated and adults are around 30 to 40% less likely to attend or be admitted. This is similar to what we see most years.

We are continuing to highlight the importance of taking up the free NHS offer as soon as you are invited for vaccination. Pregnant women and millions of children have already been able to get vaccinated, with appointments for most eligible groups available from 1 October. Vaccination offers the best protection against respiratory viruses such as flu, COVID-19 and RSV, and the NHS national booking system means it’s easier than ever to book your appointment and get protected. For the first time this year, in addition to other eligible groups, toddlers can also get their flu vaccination, which is given as a nasal spray, at community pharmacies. Uptake is broadly in line with the previous season.

Rabies vaccine demand increased significantly following media coverage of the recent death from rabies on 18 June 2025. In response, UKHSA procured additional vaccine stock, and is supporting the call taking function of the RIGS service with overtime.

In October 2025, clade Ib mpox cases were reported in the USA, Italy, Spain, the Netherlands and Portugal, without travel links to countries with known clade Ib mpox transmission, suggesting community transmission in these countries for the first time. Some of the new cases in these countries have been in gay, bisexual and other men who have sex with men (GBMSM); a group in which clade IIb mpox caused a global outbreak in 2022. We have now seen a small number of clade Ib mpox cases in the UK. All but one case  has been travel-associated to clade Ib mpox affected countries. There is no evidence of community transmission of clade Ib mpox in the UK. Whilst we expect the UK’s pre-exposure vaccination programme for eligible GBMSM to protect against a recurrence of 2022, further incursions of clade Ib mpox are expected. UKHSA continues to work with professional organisations and voluntary and community sector partners to provide appropriate information and ensure access to vaccination across the country.

5. Strategic Forward Look

Since the last Advisory Board, the Agency’s focus has remained on setting strategic direction and securing the budget settlement that will enable delivery of our priorities.

The Chancellor will make a Budget statement to the House on Wednesday 26 November. This will reflect a fiscal environment that remains challenging and will come as UKHSA reaches the end stages of work with DHSC to confirm the Agency’s settlement for the next three financial years as part of the overall health budget. UKHSA’s Core RDEL (Resource Delegated Expenditure Limit – for day-to-day resources and administration costs) and CDEL (Capital Delegated Expenditure Limit – for investment) are vital to the Agency’s ability to both maintain and expand its capabilities, and ultimately to deliver on its remit and goals.

Discussions with the department on the UKHSA Core RDEL and CDEL settlement are progressing. We have engaged Ministers on our plans, and they will take decisions through the DHSC group business planning process that will conclude in the coming weeks. These activities come at a time where the Agency is actively and visibly delivering on Government priorities including Exercise Pegasus, and as UKHSA continues to implement learnings from the COVID-19 Public Inquiry and Cabinet Office-led review of all public bodies.

Continued progress has been made on UKHSA’s Strategic Plan and we are working to define our direction, priorities and the capabilities the Agency will need amid a challenging economic climate. Delivering on our mission and working within our budget headroom will require a relentless focus on efficiency, productivity and demonstrating the value of every pound the Agency spends.

We are entering a critical phase in developing our new Strategic Plan, with publication targeted for March 2026. In the coming weeks, both ExCo and Directors will collaborate to shape the plan’s core pillars—focusing on where UKHSA can have the greatest impact. This includes considering the role of new funding for emergencies such as emerging infections and pandemics, chemical, biological, radiation and nuclear (CBRN) preparedness). This work will also explore how delivery is likely to be achieved in practice, particularly in the context of a changing health system both domestically and internationally. I will continue to update the Advisory Board in the coming months.

As we prepare to refresh our organisational strategy, I am launching a stakeholder survey this winter. The survey will be delivered by Savanta and the work includes quantitative surveys and qualitative interviews designed by UKHSA Communications and the Behavioural Insights and Science Unit. It builds on the baseline insights gathered in January 2024, which explored stakeholder awareness and attitudes towards UKHSA. All data will be anonymised in line with the Market Research Society Code of Conduct and securely stored under the Data Protection Act. The fieldwork has begun and initial results expected in December.

To ensure UKHSA continues to deliver high-impact global health protection, the Global Health Protection Directorate is undertaking a comprehensive review of UKHSA’s international portfolio. This strategic exercise is designed to enhance alignment between UKHSA’s global activities and the UK Government’s domestic and international priorities. The review will assess current programmes, partnerships, and resources across UKHSA’s international work, with a focus on identifying opportunities to maximise value, improve coherence, and ensure that UKHSA’s global health efforts are responsive to emerging threats and evolving geopolitical contexts. As part of its commitment to strengthening international partnerships, UKHSA is actively supporting the implementation of the EU-UK agreement on health security.

On 19 September, UKHSA was formally designated by DHSC as the UK’s new National IHR Authority (NIA), responsible for overseeing implementation across the UK of the 2024 amendments to the International Health Regulations. Also in September, a delegation from the European Centre for Disease Prevention and Control (ECDC), led by Pamela Rendi-Wagner (Director of ECDC), visited UKHSA. The delegation met with UKHSA’s Chief Executive and the Chief Medical Officer and discussion focussed on Exercise Pegasus, surveillance and threat detection. Additionally in October, UKHSA hosted European Radiation Protection Week in London and also hosted the fourth meeting of the World Health Organization European Region partnership on poison centres. On 6 October UKHSA welcomed the President of Italy’s National Public Health Institute, Istituto Superiore di Sanità, during which the two agencies signed a Data Sharing Agreement. UKHSA’s Chief Executive also had a successful introductory meeting with the Director General of Folkehelseinstituttet (FHI), the Norwegian Institute of Public Health.

Professor Susan Hopkins

Chief Executive

November 2025