Corporate report

UKHSA Advisory Board: minutes of 31 January 2024

Updated 12 March 2024

Date: 31 January 2024

Present at the meeting were:

• Ian Peters – Chair of UKHSA Advisory Board

• Dame Jennifer Dixon – Non-executive member

• Jon Friedland – Non-executive member

• Marie Gabriel – Associate non-executive member

• Dame Jenny Harries – Chief Executive

• Graham Hart – Non-executive member

• Susan Hopkins – Chief Medical Advisor

• Mark Lloyd – Non-executive member

• Raj Long – Associate non-executive member

• Scott McPherson – Director General, Strategy, Policy and Programmes

• Andrew Sanderson – Chief Financial Officer

Observers at the meeting were:

• Lee Bailey – Director of Communications

• Oliver Munn – Director General, Health Protection Operations

• Steven Riley – Director General, Data, Analytics and Surveillance

• Sir Gregor Smith – Chief Medical Officer (Scotland)

• Clara Swinson – Director General, Global Public Health (Senior Departmental Sponsor)

• Jac Gardner – Chief People Officer

In attendance at the meeting were:

• Richard Gleave – Director, Scientific Strategy and Development

Five attendees had their name and title redacted.

Apologies were received from:

• Sir Frank Atherton – Chief Medical Officer (Wales)

• Simon Blagden – Associate non-executive member

• Sir Gordon Messenger – Non-executive member

• Sir Michael McBride – Chief Medical Officer Northern (Ireland)

• Isabel Oliver – Director General, Science and Research

• Cindy Rampersaud – Non-executive member

• Thom Waite – Deputy Chief Medical Officer (England)

• Sir Chris Whitty – Chief Medical Officer (England)

1. Announcements, apologies, and declarations of interest

24/001 The Chair welcomed participants to the meeting and noted apologies. Congratulations were given to Dr Jennifer Dixon on her recent damehood. 

24/002 The public discussion was shorter than usual due to the commercial and people sensitivity of several topics moved to the closed discussion. This was seen as an exceptional circumstance with the Advisory Board committed to continuing to conduct as much of its business as possible in public. 

24/003 Following the recent interest in the appointment processes and declarations of interest for non-executive members of the Advisory Board, members were in the process of updating their declarations of interest, adopting a wider approach to disclosure than standard government policy. The updated disclosures would be published on the UKHSA gov.uk page. It was confirmed that there were no conflicts of interest from received declarations.

(Action: Governance team)

2. Minutes of the previous meeting and matters arising

24/004 The Advisory Board agreed the minutes of the meeting held on 30 November 2023 (enclosure AB/24/001) as an accurate record.

24/005 The Advisory Board noted the list of actions from the previous meeting (enclosure AB/24/002).

3. Chief Executive’s update

24/006 The Advisory Board noted the update from the Chief Executive (enclosure AB/24/003). The Advisory Board thanked those colleagues who had continued to provide operational support throughout the holiday period.

24/007 The Chief Executive reported on the main areas of activity:

UKHSA had accepted the disclaimer of opinion from the National Audit Office (NAO) to ensure the Annual Report and Accounts from 2022 to 2023 were laid in Parliament before the statutory deadline. It was acknowledged that significant progress had been made through the financial year to improve processes in the context of accepting additional responsibilities including the Covid Vaccine Unit. UKHSA would continue to implement outputs from the Finance and Control Improvement Programme to accelerate this progress.

Identifying opportunities for delivery of vaccine preventable disease programmes and anticipating learning for the health system from the COVID-19 Inquiry.

Engaging with industry and academia including a round table with the Pandemic Science Institute and an academic day to build upon the industry day launching the Vaccine Development and Evaluation Centre. The focus on academia was welcomed with support offered to facilitate engagement.

Modernising frontline operations such as the launch of electronic notification for infectious diseases which would drive efficiency in UKHSA’s services.

Conversations enabling the conclusion of the current Spending Review period to ensure the effective delivery of the health protection system.

Working with the NHS on the catch-up campaign for measles, mumps and rubella vaccines. Thanks were noted to the West Midlands team for recent work in addressing a rapid increase in measles cases. UKHSA was committed to harnessing the NHS Vaccine Strategy and delivery through the NHS to take advantage of early insights into vaccine preventable diseases.

Publishing UKHSA’s Genomics Strategy which would build upon key capability established during the COVID-19 pandemic, alongside setting direction for investment in and use of pathogen genomics.

24/008 Discussion followed on the disclaimed audit opinion. It was noted that key factors contributing to the outcomes were the inherited position from the disclaimer of opinion for 2021 to 2022 and increased responsibilities. The context of auditing Covid Vaccine Unit budgets included increased materiality relative to UKHSA accounts, changing guidance on COVID-19 vaccines and a change in forecasting model. UKHSA was committed to the ensuring NAO concerns were addressed and retaining flexibility to respond to epidemiology guidance for future health threats.

4. Financial report

24/009 The Advisory Board noted the financial update to end of December 2023 (enclosure AB/24/004). Further to earlier discussion on the Annual Report and Accounts for 2022 to 2023, the positive underlying progress for accounts was reiterated. 

24/010 The following points were raised in respect to the current financial year:

• UKHSA had transferred responsibility and relevant budget to NHS for COVID-19 testing from 1 April 2024

• over optimistic forecasts continued on spending and delivery in quarter four, so mitigations had been agreed

• capital spend was forecast to accelerate in quarter four which was consistent with historic delivery

24/011 The budget for 2024/25 was expected to be confirmed in March 2024. A key focus was identifying activity in the currently separate COVID-19 budget that would need to endure and prioritising against other core funded activities. It was expected that reduced COVID-19 related spending would decrease the materiality noted during the audit of Annual Report and Accounts.

5. Core preparedness for response to infectious disease threats

24/012 The Chief Medical Adviser presented the update on UKHSA activities to support preparedness for infectious diseases (enclosure AB/24/005).

24/013 The Advisory Board noted the update with main highlights and challenges including:

• increased rates of mycoplasma, above seasonal levels of winter respiratory infections (including COVID-19), changing migration patters affecting tuberculosis rates

• attention would be focused on imported vector borne diseases which remained a risk area

• mixed rates of sexually transmitted diseases which disproportionally affected vulnerable people and often arose from other health inequalities

24/014 The report included national statistics produced by UKHSA on a weekly basis and an important tool to inform behaviour and public health communications. Discussion noted that multiple sets of data used different reporting methods which could present a challenge for to greater public understanding on the health messages. There was opportunity to move towards consistency of products from analytical pipelines. A more detailed item was on the forward look to discuss public health communications which would include these areas of consideration.

(Action: Lee Bailey)

24/015 Future areas of work included:

• shifting thinking around global health to assess threats against the changing patterns of migration

• providing clarity on future risks that require additional capacity and supportive working relationships – UKHSA is dependent on other parts of the health system for delivery

• building upon pathogen genomics and diagnostics opportunities with industry

• streamlining digital and contact communication platforms within health protection operations

• enabling the workforce with the skills needed – UKHSA continued building staff levels, with vacancies in some areas below pre-pandemic capability; below-market remuneration remains a material constraint

• approaching preparedness work from a syndemic perspective with aims to address combining effects of access to education, inequalities and deprivation

24/016 There was interest in the opportunities to leverage interest of further education students in UKHSA’s work and improving the development of the clinical curriculum. It was confirmed that UKHSA had continued engagement to develop this, including regular communication with the Presidents of relevant Royal Colleges.

24/017 The preparedness paper would remain a critical annual update for the Advisory Board. Discussion on system leadership and coordination would continue with partners in other fora.

(Action: Susan Hopkins)

6. Leadership update

24/018 The Chief People Officer and Deputy Director, People presented the update on leadership in UKHSA (enclosure AB/24/006). UKHSA had taken a holistic approaching to defining and developing leaders that set the culture and tone for the organisation.

24/019 The Advisory Board noted the report. When considering whether the current training was bespoke enough, it was accepted that the Future, Engage, Deliver course had been introduced across a wide cadre of staff to provide a baseline for leadership development in UKHSA. Tailoring for specific groups would then build on this foundation.  The recent Civil Service People Survey had shown positive trends including increased confidence in the clear vision set by senior leaders. 

24/020 The following points were raised during the discussion:

• the importance of considering generational differences in working practices

• hybrid working presented challenges for the majority of organisations – this would be a continuing focus for UKHSA to ensure positive impacts on performance management and wellbeing

• expanding the Accelerate Programme was part of the broader development framework to address inclusive talent management

• fundamental skills for first time line managers would be a priority in the next year

• the approach to promotion could be strengthened beyond current focus on enabling experience and evidence base for individuals to prepare ahead of promotion

• it was important to consider UKHSA’s ability to influence leaders within the wider health system

24/021 An update would be added to the Advisory Board forward look in twelve months with the People and Culture Committee to pick up further discussion on the following key topics:

• hybrid working

• influencing leadership beyond the boundaries of UKHSA

• development for first-time line managers

7. Advisory board committees

7.1 Audit and Risk Committee

24/022 The Advisory Board noted the minutes of the Audit and Risk Committee meetings on 17 November 2023 (enclosure AB/24/007) and 5 December 2023 (enclosure AB/24/008). The meetings since November had been focused on Annual Report and Accounts. In addition, the meeting on 5 December also discussed the Finance and Control Improvement Programme, engagement with internal audit actions and clinical quality and governance. Jon Friedland was welcomed to the Committee to provide scientific expertise.

7.2 Equalities, Ethics and Communities Committee

24/023 The Advisory Board noted the minutes of the Equalities, Ethics and Communities Committee meeting on 10 October 2023 (enclosure AB/24/009). Roundtables on vaccination and social care involving external representatives were a positive approach used in latest meetings. The forward look for Committee had progressed well, and it was recognised that further work was needed to fulfil the ethics aspect of the remit.

24/024 It was suggested that an Advisory Board meeting may want to pick up discussion on the social care sector including partnerships and leadership within this setting.

8. Questions from members of the public

24/025 No questions were received from members of the public.

9. Forward look

24/026 The Advisory Board noted the topics for future meetings (enclosure AB/24/010).

10. Any other business and close

24/027 There being no other business, the meeting closed at 11:29am.