Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committee minutes

Updated 2 February 2023

Date: Tuesday 24 January 2023

Sponsor: Graham Hart

Purpose of the paper

The purpose of the paper is to provide the Advisory Board with minutes of the 6 October 2022 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 12 January 2023 .

Recommendation

The Advisory Board is asked to note the minutes of 6 October 2022 meeting of the Equalities, Ethics and Communities Committee.

Minutes

Title of meeting: UKHSA Equalities, Ethics and Communities Committee

Date: Thursday 6 October 2022

Present were:

• Graham Hart — Non-executive Chair
• Shona Arora – Director Health Equity and Clinical Governance
• Andrew Cooper – Deputy Director, Inclusion Policy and Reward
• Jennifer Dixon – Non-executive member
• Marie Gabriel – Associate non-executive member
• Susan Hopkins – Chief Medical Adviser (executive lead)
• Linda Kennedy – Director of Health Protection Policy
• Mark Lloyd – Non-executive member
• Raj Long – Associate non-executive member
• Scott McPherson – Director General, Strategy, Policy and Programmes
• Oliver Munn – Director General, Health Protection Operations and Chief Operating Officer (Testing)

In attendance:

• Consultant Medical Epidemiologist
• Head of workplace, community, universal offer, private market and evaluations
• Policy Manager
• Clinical Fellow
• Deputy Director of Health Equity
• Board Secretary
• Deputy Director of Equality and Place Based Policy
• Deputy Director, Policy
• Deputy Director of Blood-borne and STI
• Head of Office and Senior Private Secretary
• Interim Director of Regions
• Head of Risk Communications and Emergency

Welcome, apologies and declarations of interest

22/001 The Chair welcomed all participants to the meeting.

Introductions

22/002 Each member of the committee introduced themselves.

Terms of Reference

22/003 The Chair introduced the terms of reference (enclosure EEC/22/001) for the committee and thanked the non-executive directors for their input into the terms of reference.

22/004 Discussion noted that the terms of reference should consider:

• inviting members of diverse communities to join the committee
• rotationally inviting members of the Health Equity Board and inclusion networks
• seeking expert ethical advice on ethical issues that arise in future meetings

22/005 Additionally the Committee was expected to maintain close links with other Committees in UKHSA including the Science and Research Committee and People and Culture Committee.

22/006 Committee members were asked to send any potential changes to the terms of reference to the Chair, Chief Medical Advisor or Board Secretary.

Policy context

22/007 Director of UKHSA Policy updated the Equalities, Ethics and Communities Committee on the implications of policy on the UKHSA’s health equity strategy.

22/008 Discussion noted that the committee should consider:

• framing the narrative around the valid epidemiological reason to address health protection needs in high-risk groups
• the committee must focus on the long-term strategy whilst also focusing on the immediate short-term
• risk-based analysis may be the best approach in the current political climate

Health equity strategy

22/009 The Deputy Director of Health Equity and Deputy Director of Equality and Place Based Policy presented this item (enclosure EEC/22/002).

22/010 The committee commented on the health equity strategy’s vision, 5 key ambitions and 3 strategic focus areas.

22/011 Discussion noted that the health equity strategy should consider:

• that system leadership, one of the three strategic focus areas, could include system partnership as the UKHSA works with Office for Health Improvement and Disparities and NHSE, and that one of the 3 strategic focus areas, ‘people and pathogen’, should explicitly include ‘place’

• the strategy could include partnerships, not just with systems, but also with the communities we are trying to work with

• the strategy does not address how protecting the most vulnerable can help the rest of population and the economy. It was also raised that the strategy should consider the extent to which it can influence elements of non-health related policy

• the committee were interested in success measures and tangible goals

• the role of the UKHSA is not to reduce health inequalities but to reduce avoidable risks and improve health outcomes

• the UKHSA’s 2 big areas of challenge are data and surveillance and community engagement

Current health hazard responses

22/012 The Director of Health Equity and Clinical Governance and Interim Director of Regions provided an overview of assessing incident impact on existing or potential health inequalities.

22/013 Discussion noted that the committee should consider:

• further emphasis on the mitigations of dynamic risk assessments

• how we work with our data and surveillance teams to collect better data on specific groups, for example ethnic groups and sexuality

Deep dive on mpox (monkeypox) incident

22/014 The deep dive on the mpox incident covered:

1. Mpox epidemiology Overview of previous infections that have affected similar population groups.

2. Equality impact assessments

3. Dynamic risk assessments

It was commented that the committee should engage with data and surveillance teams to collect better data on specific groups.

4. The UK’s strategy

It was commented that the UKHSA should let partners know what we are doing and how we are working.

5. Communications and community engagement

It was suggested that the UKHSA should involve the groups themselves and take advice from staff networks to use the correct language

6. Systemwide action plan (England)

It was commented that working with sexual health services can be a challenge due to their limited funding.

7. Vaccine strategy and deployment

8. Challenges

22/015 It was commented that identification of eligible individuals was a challenge.

The discussion noted that the UKHSA’s health protection teams should consider:

• including and engaging the affected groups and to inform partners of what we are doing and how we are working.

• addressing how the UKHSA learn from incidents and how to further enhance after-incident analysis.

• have the UKHSA considered looking at how well other countries have managed mpox and is there anything we can learn?

Winter planning

22/016 To provide overview of winter contingency planning.

22/017 The Director General of Health Protection Operations provided an overview of key winter health hazards and their impact on disadvantaged groups.

22/018 It was noted that the cost-of-living crisis will have an impact on disadvantaged groups this winter, and that for influenza, COVID-19 and extreme weather the UK are quite resilient but do not have the same strength and depth with other health hazards.

22/019 It was suggested that the Director General of Health Protection Operations will present on winter pressures at the next committee meeting in January 2023, focusing on real-time data and exposures.

Forward look and topics for future meetings

22/020 It was agreed that committee members should send topics for future meetings to the Chair.

22/021 It was agreed that 2 hours is the correct time allocation for future meetings.

Any other business and close

22/022 Thanks were noted to all participants for their papers, contributions and organisation ahead of the meeting.

22/023 The meeting closed at 11:59am.

[name redacted]

October 2022