Correspondence

Letter from Dame Diana Johnson MP to Professor Susan Hopkins, UKHSA Chief Executive

Published 24 September 2026

From:

The Rt Hon Dame Diana Johnson DBE MP
Minister of State for Public Health and Patient Safety
Department of Health and Social Care
39 Victoria Street
London
SW1H 0EU

To:

Professor Susan Hopkins
Chief Executive
UK Health Security Agency
10 South Colonnade
Canary Wharf
London
E14 4PU

Dear Susan,

I am writing to set out my priorities for the UK Health Security Agency (UKHSA) for the financial year 2026 to 2027.

In our 10 Year Health Plan for England: fit for the future, we have set out 3 shifts for transforming our health and care systems to ensure they remain fit for the future. You have a vital role to play in:

• implementing the shift from sickness to prevention
• reducing the overall burden of ill health
• achieving more equitable health outcomes for the whole population

Purpose and strategy

UKHSA’s purpose is to protect people from health threats - preventing and reducing the harm to health caused by:

• infectious diseases
• chemicals
• radiation
• climate change
• a range of environmental hazards including air quality

The UKHSA Strategy 2026 to 2029 describes the core services you provide through your work, and the foundations and capabilities that make that work possible. These include the following essential functions UKHSA needs to be able to carry out to fulfil its mission:

• health protection surveillance and risk assessment
• emergency preparedness, resilience and response (EPRR)
• laboratory and diagnostic services
• vaccination and immunisation - end-to-end operational support
• health intelligence and risk communication
• health protection response and incident management
• clinical countermeasures and strategic stockpile management
• scientific research, modelling and advisory functions
• international health protection and international health regulation compliance

The functions above are described in more detail in the annex to this letter.

This year marks the start of implementation of UKHSA’s strategy. During 2026 to 2027, UKHSA must:

• start to implement the changes set out in its strategy
• implement the outcome of the spending review settlement
• continue to meet its statutory responsibilities and provide a high-quality service to the public

UKHSA will also contribute to government priorities on health and economic growth, with a particular focus on the following areas.

Understand

UKHSA should prioritise the following activities in 2026 to 2027 to:

• achieve its ambition of being the nation’s trusted authority for fast and reliable intelligence on health threats
• provide clear insight to others that guides action and prevents harm

Public health laboratory capability

Deploy and refresh high-throughput automation and advanced testing across the public health laboratory network to:

• enhance pathogen and antimicrobial resistance detection
• strengthen surge and outbreak response

Complete the assessment of clinical network laboratories’ future locations.

Pathogen genomics and metagenomics

Continue to build the infrastructure, partnerships and analytical capabilities to expand and embed the use of genomics and metagenomics across UKHSA and NHS systems. This will strengthen rapid and accurate genomic surveillance for pathogen detection and response.

Surveillance, early warning and decision making

Increase use of advanced analytics (including epidemiological methods, modelling, intelligence assessment and artificial intelligence) to:

• improve the timeliness and quality of surveillance, epidemiological insights, forecasting, health threat detection and analysis
• enhance outbreak and incident preparedness
• support faster, more consistent evidence-based decisions using local, national and global data

This will be supported by strengthened digital and data capabilities, including improved management of vital data sets within secure, integrated environments, such as UKHSA’s Enterprise Data and Analytics Platform, to enable safer and more efficient insight generation.

Health equity in health protection

Strengthen the evidence base on inequalities that affect high-priority health risks and what works to reduce them. Use this to develop and implement more targeted, trusted and effective interventions through strong community engagement.

Prevent

UKHSA’s ambition is to move the focus of the health protection system towards prevention by reducing the severity and frequency of cases, incidents and outbreaks through:

• better foresight, insight and preventative action
• an emphasis on improving the effectiveness of the UK’s vaccination programmes

To achieve its ambition, UKHSA should focus on the following high-priority activities in 2026 to 2027.

Vaccine uptake

Support expansion of immunisation programmes, including implementation of:

• respiratory syncytial virus (RSV), flu and pneumococcal programmes
• the catch-up programme for measles, mumps, rubella and varicella (MMRV)
• a one-year meningitis programme for teenagers in school year 13

This will be supported by an integrated communications and marketing approach for routine and seasonal immunisation, with an explicit focus on improving uptake in underserved communities.

Supply chain resilience

Complete a comprehensive review of vaccine and countermeasure supply chains. Implement priority improvements to ensure a resilient, reliable and scalable supply of vaccines, diagnostics and medical countermeasures across routine and incident response.

Border health security

Optimise health protection capabilities at the border by developing a modern operational model with closer integration between:

• government departments
• local port health authorities
• NHS
• UKHSA

This will support more timely, high-quality and co-ordinated responses to health threats and disease outbreaks.

Priority health threats

Address significant health protection threats by:

• implementing high-priority actions from the UK 5-year action plan for antimicrobial resistance 2024 to 2029
• progressing disease elimination targets, including for hepatitis B, hepatitis C, human immunodeficiency virus (HIV) and tuberculosis (TB)

Enabling prevention by partners

Provide tailored, practical insights that apply UKHSA expertise to enable partners to take action to prevent or reduce the impact of health hazards, including:

• a thematic assessment report on heat resilience in UK hospitals
• implementation of the National contingency plan for West Nile Virus in England and National contingency plan for invasive Aedes mosquitoes in England
• an updated assessment on health impacts of per- and polyfluoroalkyl substances (PFAS), supporting the assessment of chemical and microbiological hazards in drinking water, sewage and bathing waters. This will inform national policy and local response

Respond

To achieve its ambition to become a core trusted national leader in responding to health threats ranging from local outbreaks through to global pandemics, UKHSA should prioritise the following activities.

Emergency preparedness and assurance

Complete the Exercise Pegasus evaluation, and report and embed a systematic approach to learning from incidents and public inquiries. This will be supported by a robust EPRR readiness and assurance framework to provide confidence in UKHSA’s ability to respond effectively.

Pandemic preparedness

Play a critical role in the implementation of the government’s 2026 Pandemic Preparedness Strategy: building our capabilities. This will include targeted improvements in:

• UKHSA capabilities in diagnostics, case, contact and outbreak management, and surveillance
• the underpinning evidence, expertise, systems and processes to rapidly mobilise an effective pandemic response

UKHSA will play a critical role in the development of pandemic response plans, including co-ordination with local system partners, and engagement with academia and industry to support a whole-of-society response.

Surge Response Service

To create the core infrastructure necessary for a whole-system response model:

• build the foundational capabilities required for scalable diagnostics and test management
• deploy early services in targeted live settings

Commence transition of the National Pandemic Flu Service to modernised configurable components

Chemical, biological, radiological and nuclear (CBRN) preparedness

Refresh chemical and radiological response plans, ensuring there is an end-to-end approach, including:

• exercising
• scalable surge capacity across all capabilities
• maintenance of a resilient supply and deployable stock levels of diagnostics and medical countermeasures (MCMs)

Emerging infectious disease preparedness and response

UKHSA will retain delegated responsibility from the Department of Health and Social Care as lead government department for emerging infectious disease policy and response.

Expertise and infrastructure

To achieve its ambition of having a future-ready workforce, which is supported by reliable and secure infrastructure and systems that allow it to have a positive impact and provide value for money, UKHSA should prioritise the following activities in 2026 to 2027.

Transforming UKHSA

Develop a future operating model to further improve impact, resilience and value for money.

User interaction transformation programme

Scope out the programme and minimum viable product for a unified, insight-driven system to manage all user interactions. Ensure the issue reaches the right expertise efficiently, while giving UKHSA a real-time view of demand, risk and performance.

Enhancing operational efficiency

This includes practical improvements to implementation and operations that increase productivity, strengthen performance and ensure value for money across core functions and frontline provision, including though the transformation of UKHSA’s Chief Operating Officer group.

Digital and data systems

Create a more integrated and resilient digital and data estate through implementation of a:

• digital blueprint and target architecture
• product-based operating model with clear ownership of priority services

Reduce fragmentation by:

• rationalising legacy systems
• improving interoperability across laboratory, surveillance and operational capabilities
• strengthening end-to-end service design

Build sustainable in-house capability, strengthen data governance and cyber security through compliance with the Cyber Assessment Framework (CAF)-aligned Data Security and Protection Toolkit (DSPT), and improve service performance and reliability in line with operational priorities.

Development of the UK Health Security Campus

This involves:

• programme business case approval and programme remobilisation
• initiation of long-term procurement activities for construction and professional services
• completion of RIBA stage 2 and 3 design for the high containment building, and RIBA stage 1 and 2 design for the main building

Leadership and collaboration

UKHSA’s ambition is to:

• build its position as a trusted leader protecting the nation’s health
• strengthen systems
• make effective, reciprocal partnerships

To achieve the above, UKHSA should prioritise the following activities in 2026 to 2027.

People, leadership and culture

Establish a comprehensive review of UKHSA’s current organisational environment, which will inform targeted interventions to foster a culture where:

• leaders can lead with clarity and accountability
• the diverse workforce feels a strong sense of belonging

This will enable people and teams to thrive, collaborate effectively and achieve high-impact outcomes.

Global health security

Meet international public health commitments and fulfil health security and disaster risk reduction functions, working with global partners to strengthen global health security and protect the UK population.

System leadership

Continue to provide effective health protection leadership across the wider health system, supporting co-ordinated action at national, regional and local levels. Lead policy on areas including emerging infectious disease and health protection incident response.

Partnerships

Continue to establish and strengthen partnerships across the health system, including with industry partners in critical sectors, to support effective health protection and preparedness.

Conclusion

UKHSA’s performance framework should set out clearly how the agency will achieve these expectations over the year ahead, including how progress will be monitored.

In addition, UKHSA will continue to be a trusted source of public health advice and scientific expertise, and work closely with the Chief Medical Officer (CMO), the UK’s most senior medical adviser and head of the public health profession. The CMO will be:

• the ultimate arbiter for advice on scientific and clinical matters
• formally consulted by UKHSA on wider health protection strategy
• the professional lead for UKHSA’s most senior medical professionals

The CMO will co-ordinate closely with UKHSA in support of the agency’s global health remit. UKHSA will also work closely with the CMOs for Scotland, Wales and Northern Ireland.

I look forward to our continued close working relationship as UKHSA progresses this important work.

Annex A: UKHSA’s essential functions

This list of UKHSA’s essential functions was developed to support the implementation of business continuity, cybersecurity and data governance compliance, in line with DSPT-CAF guidance.

Health protection surveillance and risk assessment

UKHSA is responsible for:

• continuous (24/7) surveillance and risk assessment of infectious diseases, environmental hazards and other public health threats
• detection and analysis of emerging risks through syndromic surveillance, laboratory reports and international alerts

EPRR

UKHSA is responsible for:

• maintaining UKHSA’s 24/7 incident co-ordination function (including out-of-hours on-call services)
• interface with the Scientific Advisory Group for Emergencies (SAGE), the Cabinet Office Briefing Rooms (COBR) and local responders during major incidents
• national co-ordination of infectious disease outbreaks, CBRN incidents and health security emergencies

Laboratory and diagnostic services

UKHSA is responsible for:

• provision of reference laboratory testing
• operation of high-containment laboratories (such as containment levels 3 or 4 (CL3 or CL4), in vitro and in vivo laboratories, and associated animal services
• provision of microbiological and virological diagnostic services to the NHS
• provision of genome sequencing services to the NHS and public health system

Vaccination and immunisation - end-to-end operational support

UKHSA is responsible for:

• procurement of vaccines and immunoglobulins for national immunisation programmes and emergency stockpiles
• logistics and distribution to NHS organisations and vaccination sites, including those within the secure, temperature-controlled supply chain
• public health expertise, evidence generation and clinical advice to design and support the optimal immunisation programme

Health intelligence and risk communication

UKHSA is responsible for:

• generation and dissemination of official health protection advice to the public, government, NHS and other stakeholders
• technical briefings and data dashboards to support national decision making
• co-ordinated media and risk communication during outbreaks and health emergencies

Health protection response and incident management

UKHSA is responsible for:

• on-the-ground advice to local authorities, integrated care boards and NHS providers
• regional health protection teams (HPTs) responding to outbreaks and incidents in communities, healthcare and institutional settings
• clinical and health protection management of notifiable disease cases and their contacts (for example, TB, sexually transmitted infections, healthcare-associated infections and environmental health threats)

Clinical countermeasures and strategic stockpile managements

UKHSA is responsible for:

• oversight and deployment of national stockpiles of vaccines, antivirals and immunoglobulins for emergency use
• technical and logistics planning for rapid deployment during pandemics, terrorist incidents or cross-border outbreaks

Scientific research, modelling and advisory functions

UKHSA is responsible for:

• partnership and secure data capture, analysis and modelling with academia and National Institute for Health and Care Research health protection research units (HPRUs)
• operation of the joint modelling team and scientific input to advisory groups (such as the Joint Committee on Vaccination and Immunisation (JCVI) and SAGE)

International health protection and international health regulation compliance

UKHSA is responsible for monitoring global threats and co-ordination with the World Health Organization, European Centre for Disease Prevention and Control, and other international partners.