Corporate report

UKHSA Advisory Board: Chief Executive's Report

Updated 11 September 2025

1. Purpose of the paper

The purpose of the paper is to provide a brief overview of the recent operational and response status in 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

Since the Advisory Board last met, the most significant development for the Agency has been the recruitment to important senior leadership roles. This is my first Advisory Board as Chief Executive Officer (CEO) of UKHSA, and I am honoured to step into this role with a deep commitment to our mission – protecting people’s health and security, quietly, consistently and expertly. I will begin as CEO this month, and my immediate focus is to listen to senior leaders and staff from across the Agency to hear their priorities and their challenges. This will enable me and the new executive team to determine our future strategic priorities and optimise effective cross-agency working.

As an interim measure, I will appoint a director within the Chief Medical Adviser (CMA) group to cover CMA responsibilities until a permanent appointment is made.

The agency has appointed Professor Robin May as the Chief Scientific Officer for a one-year appointment. He will start on 22 September though engagement meetings have already commenced. Robin currently serves as Chief Scientific Adviser at the Food Standards Agency, where he works closely with other departmental Chief Scientific Advisers and the Government Chief Scientific Adviser on broader policy issues—experience that will be invaluable in his new role at UKHSA.

Finally on recruitment, we have completed the permanent recruitment of our Director of Finance, Performance, Risk and Assurance. Luke Heath has been appointed following a fair and open process. Luke has established relationships having been seconded from DHSC in an interim capacity for the last 12 months. Luke will continue to work closely with you, especially with Cindy Rampersaud and the Audit and Risk Committee (ARC).

In July, the Secretary of State for Health and Social Care announced plans 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 network and serve as UKHSA’s future headquarters. We expect the site to begin operations in the mid-2030s, with full completion anticipated by 2038. The majority of UKHSA staff will be based at this new facility. The campus will include the UK’s highest containment level laboratories – unique and vital capabilities that enable the safe study of the most dangerous pathogens. By strengthening the UK’s resilience to biological threats, the headquarters will enhance national security, one of the core pillars of the Government’s Plan for Change, and deliver world leading health protection and health security capabilities. The programme is now remobilising the design team and developing the programme business case. Further decisions on governance and oversight will be made with DHSC, Cabinet Office and HMT in coming months.

As you will be aware, we are in the final stages of producing our 2024 to 2025 Annual Report and Accounts (ARA). ARC has completed its review and the National Audit Office review is underway meaning we are on track to publish in November. The ARA marks a significant milestone in the Agency’s development, demonstrating the progress we have made, the Agency’s growing maturity, and the successful reform of our leadership structure. These changes have clarified roles and responsibilities across the Agency and enabled faster, more effective decision-making.

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 important assessment principles that the Government set out. There have been no changes to this since the last update. I will provide an update in the next Advisory Board meeting.

4. Update on Operational and Response Activities

This month, UKHSA will commence participation in Exercise Pegasus, following several months of planning and preparedness activity. The first live play Incident Management Team (IMT) will be held on 15 September with establishment of response structures to address a novel pathogen. Further meetings, and a Strategic Response Group meeting, are planned and the IMT will lead on responding to commissions from Cabinet Office Briefing Rooms following the first anchor day on 18 September. The exercise will cycle through simulation of the early phases of a pandemic to test decision making and lessons identified from Covid-19 and runs to 5 November 2025. A full evaluation report will be published in 2026.

The public hearings for Module 6 (Adult Social Care) of the Covid-19 Public Inquiry concluded at the end of July, I provided written and oral evidence as the UKHSA witness to the module. Dame Jenny Harries work provided written and oral evidence from her Deputy Chief Medical Officer role. Work is now underway on UKHSA’s written closing statement, which will address issues raised during the hearings and support the Inquiry’s consideration of potential recommendations. UKHSA’s corporate statement for Module 8 (Children and Young People) is being finalised, and Dr Shona Arora, Director for Health Equity and Clinical Governance, will be invited to give evidence at the public hearings in October.

As part of our goal to improve action on health security through data and insights, we have stood up the Enterprise Data and Analytics Platform (EDAP). The EDAP platform will enhance our ability to predict, respond to and manage public health threats through data-driven insights. The EDAP platform was launched in June 2023, and we have since worked on continuously improving and enhancing the data and the capability available. EDAP now contains the important datasets and capability required to progress with the ongoing transition of work from legacy infrastructure onto this new platform (such as the transition of on-premise platforms and the work on shared platforms with the DHSC). As more work is migrated, we will monitor the benefits enabled and the efficiencies delivered; such as new insights generated, time saved accessing and analysing data as all data is now in once place, increased transparency to our data providers on how this data is used and more targeted benefits such as how greater data access within a single platform contributes to our Health Equity outcomes.

The Cabinet Office Integrated Security Fund, which aims to deliver transformational projects for UK biosecurity, has awarded 2 projects to UKHSA. One focuses on securing onshore manufacture of Lateral Flow Devices (LFDs) in the UK at rapidly expandable scale for outbreak response, this would secure supply chain resilience in the UK and avoid the need to stockpile large numbers of LFDs which would be discarded if not used within their shelf life. The second focuses on wastewater surveillance builds on UKHSA’s wastewater monitoring programme for COVID-19 and ongoing polio wastewater surveillance to develop capability and capacity, providing robust methods for wastewater analysis in the UK for public health and biosecurity purposes.

We are implementing The Trust Programme to strengthen our data protection and cyber security. This transformation programme will ensure UKHSA meets the Data Security and Protection Toolkit requirements – the national standard for organisations that process NHS patient data. The programme focuses on 4 main areas:

• updating our policies
• strengthening governance arrangements
• improving technology systems
• enhancing security controls

We’re working with teams across the agency to make sure we meet regulatory standards and can respond effectively to emerging threats. We are currently procuring a delivery partner to support this work, with implementation planned to begin in November 2025.

Through the UKHSA work to control an outbreak of infections related to Burkholderia stabilis, UKHSA determined that non-sterile wipes were contaminated. Working with the Medicines and Healthcare products Regulatory Agency (MHRA), we advised the public to stop using certain non-sterile alcohol-free wipes and to dispose of them. UKHSA issued a safety alert to health professionals about recent infections potentially linked to contaminated non-sterile wipes and to reinforce existing infection prevention and control guidance.

4.1 Measles

We published our latest data on 31 July regarding measles cases in England. The data shows that outbreaks are continuing, with 674 confirmed cases since January 2025, including 145 cases reported between 3 and 31 July. Year to date, 48% (322 of 674) of these cases have been in London, 16% (111 of 674) in the North West, and 10% (65 of 674) in the East of England. Most cases in the UK have occurred in unvaccinated children aged 10 years and under. Globally, there has also been an increase in measles cases over the past year, including across Europe. UKHSA continues to work with the NHS to ensure the ongoing delivery of measles, mumps and rubella vaccines to protect the public.

4.2 Botulism

We issued a public warning to raise awareness about the signs and symptoms of botulism, following a small number of individuals presenting to NHS healthcare settings with adverse reactions after receiving cosmetic procedures involving botulinum toxin. The number of clinically confirmed cases of iatrogenic botulism reported between 4 June and 6 August 2025 was 41. The practitioners involved in this incident have ceased performing the procedure and are cooperating fully with the investigation. UKHSA has issued national advice to clinicians, advising them to remain vigilant for signs of botulism in individuals who may have recently undergone aesthetic procedures. Prompt recognition is essential to ensure appropriate treatment, including the administration of botulinum anti-toxin; UKHSA is ensuring that sufficient anti-toxin is available for treatment of severe cases. UKHSA also urges the public to take precautions when seeking aesthetic treatments, including verifying whether the product being used is licensed for use in the UK.

4.3 Respiratory Syncytial Virus (RSV) vaccines

A new UKHSA study—conducted in partnership with Nottingham University Hospitals and other NHS trusts—examined the effectiveness of RSV vaccines in preventing RSV-associated hospitalisation among adults aged 75 to 79 years in England. The findings show that the vaccine provides strong protection for older people, with an estimated effectiveness of around 82% in preventing hospital admissions due to RSV infection. The study also found that the vaccine is highly effective in reducing hospitalisation risk among older adults with chronic respiratory conditions and those living with immunosuppression.

4.4 Amber heat-health alert (HHA)

On 11 August, alongside the Met Office, we issued an amber HHA for 5 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.

5. Strategic Forward Look

This is a period of change for the agency. Our current strategic plan finishes in 2026; we are in the process of agreeing funding with DHSC; we are learning from the COVID-19 public inquiry, the ALB review and Exercise Pegasus; and we are responding to a changing health system at home and overseas. We need to identify our strategic direction, our future priorities and how we wish to build our capabilities whilst also identifying clear savings, efficiency and productivity opportunities and respond to an emerging context. In June, the Chancellor announced the outcomes of Phase 2 of the Spending Review (SR). In DHSC’s overall budget, day-to-day spending will increase from £202 billion in 2025 to 2026 (as of the Spring Statement 2025) to £232 billion in 2028-29. Adjusted for inflation, this is a real terms annual increase of 2.8%. Capital spending (longer term investment) will increase from £13.6 billion in 2025-26 to £14.6 billion 2029 to 2030. This means the overall real terms value will remain the same across the period.

As part of wider thinking about our strategic direction, we have been working closely with DHSC to confirm the UKHSA settlement for each of the next 3 financial years within this allocation. While DHSC have confirmed the RDEL outcomes for our additional funding bids relating to chemical, biological, radiological and nuclear activity, pandemic preparedness capabilities and the Harlow estate, the core agency RDEL and CDEL (capital departmental expenditure limit) remains in flux. The core settlement is important to ensure that we continue to maintain and build the capacity and capabilities to prevent, detect and respond to all hazards.

The Executive Committee has initiated an internal process to identify UKHSA’s priorities and options for our core resource funding, which will be presented to the Department as part of the negotiations. Formal advice on the core RDEL settlement will be submitted to Ministers ahead of the start of Conference Recess on 16 September, with a final decision expected shortly after. Core capital funding proposals for the next 4 financial years have been submitted with final advice on allocations as part of DHSC wide capital advice for ministers.

The advice to Ministers on our resource funding will begin to set out our intended strategic direction for the next 3 years, which we will expand upon and articulate our ambition through the development of our 2026 to 2029 strategic plan, which we plan to publish by March 2026. We have time booked at the November Advisory Board meeting to have a fuller discussion on the development of the strategic plan and our emerging priorities. The spending review and strategic plan discussions will also inform the development of our organisational transformation, strategic workforce planning, and business planning, ensuring we deliver maximum value and impact within the agreed financial envelope and align our strategic processes throughout the coming year.

We were delighted to welcome Chris Lewis, who joined UKHSA on 1 September as our new Director for Global Health Protection. Chris joined us from the Foreign, Commonwealth and Development Office, bringing a wealth of experience in international strategy, partnerships, and global health security. As part of his new role, Chris will be leading a review of UKHSA’s global approach, ensuring our work is coherent, impactful, and closely aligned with wider HMG global health priorities. This review will draw on the expertise of groups across UKHSA already delivering important contributions to our global priorities, helping to shape a more joined-up and strategic approach for the future. This is an important opportunity to strengthen our partnerships and ensure UKHSA continues to play a leading role in protecting the UK and contributing to health security worldwide. Both flagship Official Development Assistance (ODA)-funded projects, International Health Regulations Strengthening Project and UK-Public Health Rapid Support Team (UK-PHRST), have received confirmation that, following the Spending Review and DHSC’s revised ODA settlement, they will continue to receive funding from April 2026 through March 2029. In addition, the DHSC-National Institute for Health and Care Research re-tender for the UK-PHRST’s academic partner—currently UKHSA and the London School of Hygiene and Tropical Medicine—is live.

UKHSA has contracted with PricewaterhourCoopers to undertake a review of public health microbiology that is addressing 5 main strategic areas. Phase 1 of the review will conclude in September with a “baseline or situational assessment” report including international comparisons, information from interviews from across UKHSA and an analysis of performance, finance or activity data. This will feed into Phase 2 which will focus on value for money assessments, assessment of further income generating opportunities, and an assessment of opportunities for technology and informatics systems. This work will link with the wider UKHSA work on operating models, Science Hub development, surge/pandemic preparedness diagnostics and clinical risk in Public Health Microbiology.

The vaccine system is potentially impacted by the planned organisational and system changes, notably the merger of DHSC with NHSE, delegation to Integrated Care Boards and local system restructures. UKHSA is working closely with colleagues across the tripartite to help shape the future system, achieve clear accountabilities across the vaccine life cycle, and support the optimisation of programme delivery. This includes UKHSA’s leadership of the 10-year Moderna-UK Strategic Partnership, where Moderna this year have completed the build of their mRNA vaccine manufacturing facility and R&D labs at Harwell, alongside their commitment to invest over a £1 billion in the UK.

Professor Susan Hopkins

Chief Executive

September 2025