Corporate report

Equality in UK Health Security Agency 2023: how UKHSA met the Public Sector Equality Duty in 2022 to 2023

Published 19 October 2023

Foreword by Dame Jenny Harries, Chief Executive Officer, UKHSA

The UK Health Security Agency’s (UKHSA’s) mission is to prepare for and respond to external hazards to our health and to build health security capacity at local, regional and national levels. These hazards include infectious diseases and pandemics, the health impacts of climate change and poor air quality, and radiological, chemical and nuclear exposures.

External health hazards are not experienced equally by everyone. Stark differences exist between communities and population groups in the risk of exposure to an external health hazard, susceptibility to poor outcomes, and the ability of an individual or community to build resilience against external threats to health.

Reducing avoidable differences is essential to realising UKHSA’s ambitions to provide health security for the nation, reducing the burden on our public services and protecting our economy. For this reason, achieving equitable outcomes in our work on health security is a cross-cutting priority for UKHSA.

To deliver against this priority, we also need to attract and nurture a diverse workforce who can create effective, innovative solutions to meet the needs of different communities and population groups. 

This first UKHSA Public Sector Equality Duty (PSED) report sets out our early progress as a new organisation against these ambitions.  We will review our PSED objectives to ensure we build on this foundation and continuously improve our ability to consider the needs of all individuals in our work.

Introduction

UKHSA was established on 1 April 2021, as part of a reform of the public health system in England. It became fully operational on 1 October 2021, with the transfer of health protection functions from Public Health England (PHE) and of NHS Test and Trace responsibilities from Department of Health and Social Care (DHSC).

This is UKHSA’s first annual report on its approach to meeting its duties under the PSED. The objectives and activity over 2022 to 2023 reflect UKHSA’s position as a new organisation that is still establishing its organisational approach to embedding consideration of equalities and health equity (HE). This report aims to give a sense of the action UKHSA has taken over the reporting period and is not intended to cover all areas of work. 

We use learning from our past equality impact assessments to inform how we develop and deliver our work on reducing health inequalities and have rolled out a toolkit, training and other resources to support colleagues in considering the potential impact on inequalities in their work.  

We have included examples of our work on the NHS COVID-19 app, the mpox (monkeypox) outbreak and winter preparedness below to show how UKHSA has delivered with a focus on reducing health inequalities as a central principle.

From our inception as a new organisation, we have continued to build a truly diverse workforce and a culture of openness and inclusivity, where difference drives innovation to meet the needs of our workforce and communities we serve. We have developed and shared data on staff diversity, promoted inclusive recruitment practices, grown the staff networks and have championed these at the highest level in UKHSA.

Equality Act 2010

The PSED in section 149 of the Equality Act 2010 applies to public bodies and others that carry out public functions. It ensures that public bodies consider the needs of all individuals in their day-to-day work in shaping policy, in delivering services and in relation to their own employees.

The PSED has 3 constituent parts. It requires public bodies such as UKHSA to have due regard to the need to:

• eliminate unlawful discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010
• advance equality of opportunity between people who share a protected characteristic and people who do not share it
• foster good relations between people who share a protected characteristic and people who do not share it

The protected characteristics covered by the equality duty are:

• age
• disability
• gender reassignment
• marriage and civil partnership (but only in respect of eliminating unlawful discrimination)
• pregnancy and maternity
• race – this includes ethnic or national origins, colour or nationality
• religion or belief – this includes lack of belief
• sex
• sexual orientation

The general equality duty is supported by 2 specific duties that require public bodies such as UKHSA to:

• publish information to show their compliance with the Equality Duty
• set and publish equality objectives, at least every 4 years

UKHSA’s objectives for 2022 to 2023 were published on 30 August 2022 at UKHSA equality objectives 2022 to 2023. These are priority objectives for UKHSA as a new organisation. They clearly distinguish between those related to staff and those related to the wider health system. They focus on ensuring that equality considerations are built into any processes, practices and ways of working and that they are implemented as fairly and transparently as possible.

Health Inequalities Duty (Health and Social Care Act 2012)

In addition to the PSED, the Health and Social Care Act 2012 introduced specific legal duties on health inequalities for the Secretary of State for Health.

Under the framework document between the DHSC and UKHSA, UKHSA is required to address health inequalities in relation to performing its role on health protection.  

UKHSA’s equality objectives for 2022 to 2023 and actions in support of them

UKHSA published UKHSA equality objectives 2022 to 2023 in August 2022, against which our performance has been measured in our first full year of operation. They reflect early goals to be achieved as a new organisation.

Objective 1

We will embed understanding and promote awareness of the PSED and HE issues in everything we do, using these insights to improve the way we design and deliver our functions and products, and procure and commission from others, working with partners to ensure services are equitable and reduce health inequalities for everyone we serve. We will start this programme of work in 2022 to 2023 by:

• improving understanding of the PSED across UKHSA through refreshing our PSED and HE toolkit, developing training and promoting their use across the organisation
• monitoring the uptake and use of the toolkits, measuring the proportion of the people trained in their use and assuring the quality of impact assessments to identify areas requiring improvement
• developing our organisational approach to engaging with communities and stakeholders to understand how health hazards impact differently on different population groups and ensure services, products and policies are designed with user experience and needs in mind, starting with a review and gap analysis of current activity

Achieving more equitable health security outcomes is a cross-cutting goal for UKHSA. Targeting our health protection efforts on the people and places most at risk is fundamental to delivering our mission as an organisation. More detail on UKHSA’s role and approach to HE was published in a blog post in October 2022: Health equity and the UK Health Security Agency.

To build on the existing approach and deliver on our cross-cutting goal, UKHSA has developed an internal HE strategy to inform our work. The strategy was developed by UKHSA’s dedicated HE function, looking across our programmes, policies and processes. This sets out an approach to identify and target people and places at most risk to reduce avoidable harm and improve health security outcomes for all. This includes strengthening our organisational capability to prevent or mitigate the disproportionate impact experienced by people and places at highest risk and improving how we respond to health security incidents in a way that enables vulnerability to be identified and addressed.

The strategy outlines 4 areas of focus to create an enabling environment:

• building scientific and data knowledge and capability
• taking a ‘people and place’ approach
• advancing equitable health security through partnership approaches
• creating a culture where our workforce understands our legal responsibilities and has the capacity and capability to achieve more equitable health security outcomes

As part of our strategic approach and to support alignment with the wider health protection system, UKHSA has adopted NHS England’s Core20PLUS framework to identify the populations we will routinely consider in our work. This includes people with a protected characteristic, as well as the 20% of the population who are most deprived, people experiencing geographic inequalities, and inclusion health groups.

UKHSA’s Health Equity Strategy will inform its PSED objectives for 2023 to 2026.

Improving understanding of the PSED across UKHSA

UKHSA has sought to build on the approaches taken by PHE and NHS Test and Trace, as well as best practice from other parts of government, to improve understanding of and capability in discharging the PSED and HE across the organisation. 

Toolkit

The toolkit of support includes guidance on meeting the PSED, along with Equality Impact Assessment templates, the Health Equity Assessment Tool (HEAT) template which is designed for the public health system and healthcare professionals, as well as an assessment to consider the relevance of PSED at the start of a new project or proposal. These have been reviewed to ensure they met the range of needs across UKHSA.

Health equity hub

A new HE hub has been developed to make it easier for all staff to access guidance and templates through the UKHSA intranet. The hub also includes information on relevant blog posts and upcoming training. It will be expanded over time to act as a more comprehensive toolkit with signposting to guidance and expertise to support equalities assessments, for example data and insights on protected characteristics. 

Training

Induction training for all new joiners to UKHSA includes references to the PSED and signposting to the other support, training and resources available.

Training specifically on the PSED was developed for NHS Test and Trace. This has been reviewed and updated to meet UKHSA’s needs. The updated training offer has been developed to increase awareness and understanding across UKHSA of:

• HE and its importance for UKHSA’s work
• the PSED and staff’s role in meeting this
• when and how to carry out an equalities assessment

The training has been piloted and continuously reviewed with a view to rolling it out more widely across UKHSA through regular online sessions. Recordings are also available on the UKHSA intranet.

Tailored sessions were run to support Black History Month and Lesbian, Gay, Bisexual and Transgender Plus (LGBT+) History Month, which included examples from our organisation of where impacts relevant to protected characteristics have been or might be identified and mitigated.

Records are also kept of every training session delivered, including how many people attended from each group across UKHSA. In 2022 to 2023, 21 training sessions were held, with 383 attendees in total.

Further work is planned for 2023 to 2024 to promote the use of tools and training. This activity began in April 2023 with a session on HE at an all-staff event, which included an overview of the PSED and the tools, guidance and support available.

Improving the quality of equality assessment

In addition to online resources, UKHSA’s central team answers queries in relation to meeting the PSED and Health Inequalities Duty, offering to review equalities assessments and act as a critical friend to ensure that they:

• are based on relevant evidence and data
• consider the full range of potential impacts for each protected characteristic
• consider mitigations as well as risks and draw on previous experience and best practice to identify potential mitigations

Where assessments relate to internal staff-facing proposals, the team facilitates appropriate engagement with staff network leads.

Equalities assessments require sign-off by a named senior level proposal owner, to ensure accountability.

In 2022 to 2023, 35 equalities assessments were reviewed by the central team.

A repository of equalities assessments is kept. Using this resource, UKHSA has reviewed over 100 past assessments to generate insights on best practice, common issues and mitigations to increase the quality of future assessments through training, support and guidance. 

Ensuring our functions and products are equitable and reduce health inequalities

UKHSA has developed a number of processes and approaches to ensure that user needs, and in particular equality considerations, are considered when developing and making changes to our products and services. The case study below demonstrates how we ensured that the impact of those with protected characteristics were considered through the continual adaptation of the COVID-19 app and its supporting guidance.

Case study 1: NHS COVID-19 app

Over 2022 to 2023, the NHS COVID-19 app and its supporting guidance was continually adapted to meet the needs of its users and of UKHSA. Any potential impacts of these changes on those with protected characteristics have been assessed and documented. UKHSA:

• considered equalities, information governance and accessibility aspects from the early stages of any feature’s development, adapting the design to ensure the app was relevant and sensitive to all users – each change suggested for the app went through a governance process that included assessment of the equality impact and consideration of the accessibility of new features under development
• reviewed the app’s accessibility and considered new solutions to make the app more accessible
• engaged with users across different groups to listen, learn and improve the app, including undertaking regular user research for every proposed new feature, most recently our decommissioning approach which was extensively tested with users including those who considered themselves vulnerable to COVID-19
• kept a specific focus on inclusivity and accessibility which included working with Open Inclusion, a specialised service that ensures products work for those with different ability concerns – these suppliers most recently provided an expert review for the self-declared test entry feature
• ensured every update to the app and supporting website was available in 12 languages at the same time – these languages were chosen using census data and information about which languages are spoken in communities most disproportionately impacted by COVID-19

Tailoring our communications to reach those with protected characteristics

UKHSA’s work with Core20PLUS communities and populations includes partnering with relevant community groups to develop culturally sensitive and language-appropriate communication materials in response to disease outbreaks, or to support prevention activity. 

The winter vaccination programme is a good example of the need to target activity at specific cohorts with protected characteristics and the approach we took to do this.

Case study 2: winter vaccinations 

In October 2022, UKHSA launched a winter vaccine marketing campaign, urging millions of eligible people to get their flu and COVID-19 booster vaccines. The campaign particularly aimed to reach all eligible cohorts, with specific activity targeted at people with long term health conditions, pregnant women and ethnic minority communities, with a particular focus on those with low vaccine confidence.

To tailor the campaign to these groups, UKHSA carried out a range of targeted activity including:

• roundtable events with faith leaders setting out key messages and providing them with assets such as posters and leaflets to pass on to their communities
• street teams in 21 locations around the country where vaccine take up for flu and COVID-19 was low, to dispel myths and encourage take-up
• translating assets into over 30 languages
• TV adverts across 15 community channels in different languages including Bengali, Panjabi and Hindi
• print partnerships in all national and regional titles and major community titles such as Eastern Eye, African Voice and Asian Express – achieving 241 pieces of media coverage with a reach of 9.6m
• partnering with a charity coalition made up of 17 charities that focus on people with long term health conditions, creating over 60 bespoke pieces of content and reaching 2.21 million people
• partnering with others, including working with Numed, Slimming World, Together TV to engage people with long term health conditions which helped us reach a total of over 13.1 million vulnerable people

Engaging with communities and stakeholders

UKHSA engages with a wide range of communities and stakeholders, particularly those representing under-served groups, to inform our work and ensure we meet their needs. To support this work, UKHSA makes use of a number of networks, including:

• the Health and Wellbeing Alliance, which is jointly managed by the DHSC, UKHSA and NHS England and NHS Improvement and is made up of 18 voluntary, community and social enterprise (VCSE) members that represent communities who share protected characteristics or that experience health inequalities – UKHSA has worked with alliance members through a series of workshops to create and build its health equity strategy and has also supported alliance members to co-create, produce and publish digital accessibility guidance and training products for other voluntary and community sector (VCS) organisations
• Health Equity Leads’ Network – each UKHSA Regional Health Protection Team (HPT) is represented on the Health Equity Leads’ Network, and over the reporting year this network has taken forward a range of activity to improve HPTs’ approach to engagement, including delivery of a qualitative analysis to understand current HE activities and structures within HPTs (1) and to propose future HPT-led HE activities

The response to mpox illustrates how UKHSA works with communities and stakeholders to understand and address inequalities. The focus of UKHSA’s response to mpox was to suppress transmission and aim for elimination by targeting public health measures to those at highest risk. Mpox disproportionately impacted gay, bisexual and men who have sex with men (GBMSM). We worked with different sexual health charities and LGBT+ organisations from the outset to ensure that our approach was tailored the LGBT+ communities’ needs. 

Case study 3: mpox and sexual health outreach

The National LGBT Survey has highlighted the difficulties that LGBT individuals, particularly marginalised groups, face when accessing sexual health services. To address some of these challenges, in December 2022, UKHSA – with the support of the Cabinet Office Equality Hub – launched a grant programme. This aimed to increase uptake of the mpox vaccination, improve knowledge and understanding, and improve access to sexually transmitted infection (STI) and HIV testing, HIV pre-exposure prophylaxis (PrEP), and other preventative interventions.

The Mpox and Sexual Health Outreach and Engagement Fund has enabled VCS organisations, which are best placed in communities to engage marginalised LGBT groups, to develop projects aimed at encouraging uptake of the mpox vaccine and wider engagement with sexual health services. The fund provided £200,000 across 14 VCS and community-based organisations to deliver their projects.

Examples of projects include:

• promoting sexual health and mpox vaccination, by delivering a series of tailored community-based mpox and STI screening clinics in accessible, non-clinical settings, such as Pride festivals and music venues
• raising awareness about mpox within the migrant community in Nottingham, by working in partnership with the African Institute for Social Development to run a multilingual digital communications campaign, translating key information about mpox and the vaccine into different languages and sharing it through social media

Review and gap analysis of engagement activity

In August 2022, UKHSA’s Executive Committee commissioned a review of UKHSA’s approach to engaging the public, recognising that if we are to deliver more equitable health security outcomes for the population, then effective public and community engagement was essential. The review considered the effectiveness of existing engagement arrangements and sought to identify best practice and opportunities for improvement. The review concluded in February 2023 and established that across the organisation there is very real and active engagement with the public and identified opportunities to go even further. To increase the impact and breadth of our activity, work in 2023 to 2024 will focus on defining a co-ordinated and consistent approach to engagement across the organisation and to create an operating model that enables learning and insights to be more effectively and systematically shared across the organisation. 

Objective 2

We recognise that a workforce that reflects the diverse nature of our population is more likely to enable UKHSA to succeed in its ambitions. We aim to nurture and sustain an inclusive and respectful culture and working environment, which values and respects diversity, where everyone can thrive, achieve their potential, and advance their careers. We will continue to invest in a talented workforce that represents the diversity of the working population. In 2022 to 2023 we will:

• continue to strengthen the completion, collation and monitoring of diversity information about our staff
• by driving up declaration rates, enhance our evidence base and insights, and use this information to develop our future strategic priorities and action plans
• set and monitor key performance indicators to enable us to track progress and show improvement

Dashboard

UKHSA launched its diversity dashboard prototype in November 2022. The overall dashboard presents an entire workforce profile (employees only), and the workforce composition of each group, disaggregated by age, ethnicity, disability, gender, and sexual orientation. The dashboard is updated and published quarterly and is shared with key stakeholders to initiate helpful conversations, which seek to identify useful next steps to address observable imbalances and/or drive action.

Key performance indicators (KPIs) are aligned to the 4 strategic priorities for 2022 to 2023:

KPI 1. Inclusive culture – to maintain (within 2% points) the People Survey responses to “I think that my organisation respects individual difference (for example culture, working styles, background)”. The 2022 results for KPI 1 maintained 75% points.

KPI 2. Inclusive recruitment – to deliver at least 4 targeted positive action campaigns in recruitment and/or development where there is data-backed evidence to support. We delivered one pilot in development and one pilot in inclusive recruitment.

KPI 3. Data and governance – to increase our current declaration rates in each of the 4 data categories (ethnicity, disability, LGB and religion). Declaration rates have continued to fluctuate since we started reporting in March 2022. Between March 2022 and March 2023, we saw a 3 percentage points increase in declaration rates. In the last 12 months we have seen the following changes in our representation:

• disability up 1.8pp from 8.0% to 9.8%
• ethnic minority down 1.3pp from 26.8% to 25.5%
• LGB down 0.6pp from 7.0% to 6.4%
• women down 2.2pp from 67.3% to 65.0%

Through a series of declaration campaigns, we will continue to encourage all staff to declare their diversity data.

KPI 4. Value and invest – to increase current staff network memberships by over 10% over the next 12 months. Network membership has increased by over 10% and between them we saw a 499% increase since March 2022.

Our work on inclusion

Diversity and Inclusion (D and I) is embedded into UKHSA organisational policies, practices and work areas across the organisation including human resources (HR) corporate services, learning and development, recruitment, pay and pensions. Several initiatives have been developed to drive and further enhance D and I in UKHSA.

D and I strategic priorities

A strategic goal for UKHSA is to improve HE across the UK. To do that effectively we are committed to attracting, retaining, and investing in a talented workforce that represents the diversity of our population.

We continue to build a diverse workforce and a culture of openness and inclusivity. We celebrate difference and appreciate the value it brings to meet the needs of our workforce and communities, so we can serve them better. We see a person’s background as an asset and welcome diversity of thought to improve our business and refine our approach.

We take an evidence-led and data-driven approach to D and I to help drive innovation and change. We have used the diversity dashboard to identify areas for improvement and monitor progress to ensure that we continue to make UKHSA a great place to work.

Our commitment is set out in our D and I Strategic Priorities that we developed in consultation with staff networks. Through listening to staff, we identified 4 strategic priorities for 2022 to 2023: inclusive culture, value and invest, inclusive recruitment, and data and governance.

Inclusive culture

Inclusion is one of our organisational values. Therefore, we continue to build an organisation where everyone is welcome and feels they belong and where we treat each other with respect and tolerance. The D and I Team collaborate across the People Group and the wider business to ensure that D and I is embedded in all our workforce and people practices. We support our leaders to role model inclusion so that diversity of thought and alternative perspectives can benefit the organisation and the communities we serve.

Value and invest

We value and invest in all our staff and work with our staff networks to support awareness campaigns, inclusion and learning events. We work in partnership with our networks and D and I champions and encourage their involvement at a cross-government level, ensuring we continue to learn and respond as an organisation. We refreshed our approach to diversity schemes and programmes and continue to explore how we can best maximise these in line with our business purpose.

Inclusive recruitment

We know from data and insight that we can do more to ensure that all groups progress through the recruitment process equitably. Supported by evidence, we piloted positive action initiatives in line with the Equality Act 2010. These included launching a development programme aimed at Grade 6 to 7 (or equivalent) staff who identify as an ethnic minority and/or have a disability and an inclusive recruitment checklist for hiring managers. We have a diversity statement in all adverts and reviewed the essential criteria for D and I in job descriptions.

Data and governance

We take a data-driven, evidence-led and delivery focussed approach on everything that we do. To support our leaders in delivering against their D and I objectives we developed a D and I dashboard and KPIs to chart and narrate our progress as an organisation and report openly in line with our governance process for D and I. We ensure we uphold our PSED and report and progress work in relation to the gender pay gap.

Leadership and governance

UKHSA directors are accountable to Jenny Harries, Chief Executive Officer, for the subsequent actions taken by their leadership teams in tackling any identified inequalities. All SCS have a mandatory D and I objective and our Executive Committee publishes its D and I objectives on the UKHSA staff intranet.

All staff networks have an executive committee champion who provides sponsorship to staff networks. The champions act to provide senior accountability for the delivery of network action plans aligned to the D and I strategy and are instrumental in supporting D and I activities.

The D and I team meet monthly with network chairs and report 6 monthly with the People Board and Executive Committee.

Staff networks

UKHSA is proud to have 12 staff networks including sub networks and over the course of the year have increased network membership and activity. The networks have played an active part in creating and developing our culture and have facilitated collective learning and development opportunities, holding events attracting high profile speakers, in addition to engaging positively with their members across UKHSA.

Networks play a key role in essential programmes of work such as raising awareness about World Aids Day by co-hosting an internal event to promote the HIV action plan, supporting the equality impact assessment for the science hub programme, and assisting the working group for the move to Canary Wharf.

Achievements

UKHSA is proud of its achievements since it was established, such as:

• a full suite of diversity networks, each backed by their own executive committee champion
• network membership increasing by over 10% since March 2022 and the networks publishing around 51 blogs, 29 articles and promoting 82 events for all staff
• all our SCS having a D and I objective, underpinned by a clear set of D and I standards, and each executive committee member publishing their personal D and I objectives on the intranet
• achieving Carer Confident Level 2 (Accomplished) status, with a carers passport, line manager toolkit and carers charter all launched in June as part of Carers Week activity
• an interactive D and I dashboard to chart progress across the organisation against our 4 D and I KPIs
• Accelerate, a pilot development programme for Grade 6 to 7 ethnic minority and/or staff with a disability, and gaining agreement from the Executive Committee to run it
• an inclusive recruitment checklist for hiring managers
• external recognition for social media coverage to celebrate achieving Carer Accreditation and UKHSA’s commitment for working families
• agreement to advertise all recruitment adverts flexible by default

Benchmarks

UKHSA partners with Working Families (and during November 2022 signed a public letter with other employers to agree to advertise all role flexible by default), and Business Disability Form to remove workplace barriers to inclusion. UKHSA is a Disability Confident Level 3 employer and has Level 2 Carer Confident Accreditation.

Disability

UKHSA is a Disability Confident Leader and is committed to retaining this status. The scheme supports the organisation to meet the needs of staff living and working with a disability.

UKHSA’s workplace adjustments passport and guides, help managers and staff identify workplace adjustments for mental and physical health conditions. The workplace adjustments passport captures an accurate record of an individual’s workplace adjustment that can be carried forward if they moved to another team or government department. UKHSA continues to promote the passport within the organisation such as through work to support International Day of Persons with Disabilities. This year UKHSA celebrated Neurodiversity Week and raised awareness of this topic through events and blogs.

Apprenticeships

UKHSA actively promotes a wide range of apprenticeships from new entry to master’s level, building opportunities for all employees to realise career aspirations, as well as diversifying UKHSA’s resourcing and filling of skills gaps.

Apprenticeships within UKHSA are regularly reviewed, we work across the business and with delivery partners to design offers mapped to specific professional career pathways. This enables clear evidence to be gathered on uptake and employee journeys.

Learning and development

UKHSA provides an inclusive learning environment, with active review of equity of opportunities – driven by an evidence-based approach and continuous evaluation of products and offers.

The Effective Manager Programme includes resources and interactive sessions on Freedom to Speak Up and the extensive staff networks and support available to all staff.

Performance management at senior levels is reviewed through the lens of D and I – with executive review of dashboard data to provide full understanding of performance and inclusion aspects at the most senior levels of performance in the organisation.

Senior performance management has this year defined most clearly expectations of our leaders in relation to D and I and the need to evidence proactive work and delivery across D and I.

The UKHSA Learning and Development (L and D) policy provides clarity on the equality of opportunity golden thread – ensuring that all staff have the opportunity to access L and D that will enable them to undertake their roles to the best of their ability.

The Learning and Capability team and D and I teams work collaboratively to ensure the intersection of development and inclusion features through all our offers and products.

UKHSA mandatory training requires all staff to undertake Expectations in the Civil Service (previously Inclusion in the Civil Service). Completion rates and activity in this training is driven by monthly reporting to D and I topic leads, senior leaders and human resources business partners (HRBPs) to continue to drive awareness and understanding in an organisation which is committed to inclusion.

UKHSA has invested in the creation of a human-centred design learning and development offer which includes a suite of bite-sized learning guides, self-help toolkit, and face-to-face learning modules which seek to build the organisations capability – mindset and skillset – in placing an understanding of people and communities lived experiences and needs at the centre of problem solving, policy making, and service and product design. Throughout financial year 2023 to 2024 we will seek to deploy a capability building programme to complement training on PSED and HE deployed this year.   

Talent

UKHSA is committed to building an inclusive environment for people development, investing, and building the talent of all employees. To ensure our approach is inclusive and aligns to our vision, we recognise everyone as talent, working in partnership with D and I colleagues, business areas and across government to enable individuals to grow and perform their best in UKHSA through a range of development and leadership programmes. As an organisation we take an evidence-based approach in identifying and developing the different types of talent, skills and experience to deliver the UKHSA remit and for the citizens we serve.

UKHSA’s focus on people development works to:

• develop a workforce that takes ownership of and is informed of choices, and is engaged in their its development, appreciating development is wider than promotion
• move away from the abstract concept of ‘potential’ towards enabling individuals to develop a range of experience and expertise
• equip line managers to hold talent management discussions (career conversations) and support their staff to effectively act on the outcomes
• use career conversations to identify, develop and harness individual strengths and skills to build UKHSA as a learning organisation
• build a data hub on employee development

Professional communities

UKHSA has an established head of profession network which is currently being reviewed and supported to provide the most effective approach to the diverse professional communities in UKHSA and the professional development all staff. There is proactive work in collaboration around career pathways, talent, performance, accreditation, professional registration, and development opportunities to ensure that UKHSA has a flourishing culture for all to develop professionally.

Flexible working

UKHSA is proud to offer all staff a ‘day one’ right to request to work flexibly. UKHSA’s approach to flexible working enables staff to balance their home and working lives. The approach incorporates a carers charter, carers passport and carers toolkit for managers. Staff can job share, change their hours, work from home and request shared parental leave. The Flexible Working, Parents and Carers Network continues to encourage flexible working through work to promote Carers Week and Carers Rights Day.

Gender pay gap (GPG) report

In November we published our first gender pay gap (GPG) report as part of the wider DHSC health family report. We reported a median pay gap of 10.4% and a mean pay gap of 12.9%.

This does not mean that all men are paid 12.9% more than women for doing the same work, but rather the difference in average pay between men and women. It reflects the complex make-up of UKHSA, where women account for two-thirds of the workforce (65%) but there are also many more women than men working at lower paid grades.

The percentage of men and women receiving a bonus was 2.1% for men and 3.3% for women. The UKHSA bonus figures represent a small number of in-year awards made in Public Health England (PHE) where payment could not be made prior to transition to UKHSA in October 2021.

The distribution of women through each pay quartile were:

• lower 71.8%
• lower middle 68.5%
• upper middle 65.4%
• upper 54.8%

Alongside the UKHSA equality objectives, we can potentially mitigate the risk of pay gap rises by continuing to focus on:

• ensuring the fairness and equality of recruitment
• promoting talent, progression and career paths
• using of effective pay strategies where we can
• policies focused on supporting inclusion for all in the workplace, including family-friendly policy
• building an inclusive culture

Our equality objectives for 2023 to 2026

To build on the work undertaken in its first full year of operation, UKHSA is reviewing its equality objectives to ensure they remain relevant and aligned with the priority areas identified through the development of the Health Equity for Health Security Strategy. These will be published in due course.

Annexe: UKHSA staff characteristics

Protected characteristics

This section presents data on protected characteristics among UKHSA staff. Figures are based on a total headcount of 5,768 (employees only) as of March 2023. Statistics are taken from the UKHSA Human Resources and Payroll system (also called MaPs). The next 2 tables present information on the proportion of staff on whom details of a particular protected characteristic is currently held.

Figure 1. Proportion UKHSA employees who have declared each of the protected characteristic, March 2023

Percentage	March 2022	June 2022	September 2022	December 2022	March 2023
Ethnicity	81%	85%	85%	81%	80%
Disability	65%	97%	94%	85%	78%
Religion and belief	70%	40%	73%	69%	67%
Sexual orientation	70%	72%	72%	68%	65%

Figure 2. Proportion UKHSA employees who have declared each of the protected characteristics (excluding ‘Prefer not to say’), March 2023

Percentage	March 2022	June 2022	September 2022	December 2022	March 2023
Ethnicity	75%	79%	79%	76%	73%
Disability	59%	59%	57%	53%	50%
Religion and belief	62%	40%	65%	62%	60%
Sexual orientation	61%	63%	63%	60%	65%

Gender

Women make up 65% of the UKHSA workforce, above the economically active population (47.7%) and civil service average (53.8%) (Figure 3).

Figure 3. Gender profile of UKHSA staff, March 2023

Gender	Percentage of staff
Female	65%
Male	35%

Age

Just over a quarter of UKHSA staff (26%) are aged 40 to 49 years. Under a quarter of UKHSA staff (21%) are aged 50 to 59, 6% are aged over 60 years and 18% of staff are aged under 30 in the UKHSA workforce (Figure 4).

Figure 4. Age profile of UKHSA staff, March 2023

Age	Percentage of staff
16 to 19	0%
20 to 29	18%
30 to 39	26%
40 to 49	26%
50 to 59	21%
60 to 64	6%
65 and over	4%

Note: Includes UKHSA employees only where characteristics are known.

Ethnicity

Figure 5 shows that 74% of UKHSA staff describe themselves as white. The next largest ethnic group is Asian or Asian British (13%), followed by black or black British (7%). These patterns are likely to vary across regions reflecting local population profiles by ethnic group, from which the UKHSA workforce is drawn (Figure 5).

Figure 5. Distribution of UKHSA staff by ethnic group, March 2023

Ethnic group	Percentage of staff
White	74%
Asian	13%
Black	7%
Chinese	1%
Mixed	3%
Other	1%

Note: Includes UKHSA employees only where characteristics are known.

Disability

We know the disability status of 78% of our workforce, of those, 10% have declared that they have a disability (Figure 6).

Figure 6. UKHSA staff by disability status, March 2023

Disability status	Percentage of staff
Disabled	10%
Not disabled	90%

Note: Includes UKHSA employees only where characteristics are known.

Religion and belief

Data on the religion and belief held by staff is shown in Figure 6. Christianity is the most reported religion among UKHSA staff (46%). The next largest group is those who report being Atheist (25%). There are small proportions of staff who report that they are Hindu (4%) or Muslim (7%). All other religions are reported by less than 1% of staff, while 10% have other faiths and 5% no faith (Figure 7).

Figure 7. Religion and belief profile reported by UKHSA staff, March 2023

Religion	Percentage of staff
Atheism	25%
Buddhism	1%
Christianity	46%
Hinduism	4%
Humanism	0%
Islam	7%
Jainism	0%
Judaism	1%
Sikhism	1%
Other	10%
No faith	5%

Note: Includes UKHSA employees only where characteristics are known.

Sexual orientation

Sexual orientation information for UKHSA staff is available for 60% of the workforce. Most staff declare themselves to be heterosexual (94%) and just over 6% of staff report being lesbian, gay, bisexual (LGB) (Figure 8).

Figure 8. Sexual orientation reported by UKHSA staff, March 2023

Sexual orientation	Percentage of staff
Heterosexual	94%
Gay or lesbian	3%
Bisexual	3%
Other	0%

Note: Includes UKHSA employees only where characteristics are known.

Workforce composition by grade

This section focuses on the workforce composition of each UKHSA group by grade and then gender, age and ethnicity as of March 2023.

Gender analysis

There are nearly twice as many women (65%) as men (35%) working within UKHSA. Figure 9 shows that the distribution of women is higher across the administrative, executive officer and middle manager grades. There is a slightly lower percentage of women staff at senior manager grade, which does not reflect the overall gender UKHSA workforce composition. Proportionately men are overrepresented at the senior manager, Senior Civil Servants (SCS) and equivalent level grades. Our SCS is 60% men (Figure 9).

Figure 9. UKHSA workforce gender profile by grade, March 2023

Grade	Female	Male
Administrative	70%	30%
Executive officer	74%	26%
Middle manager	68%	32%
Senior manager	59%	41%
Senior civil servant	37%	63%
Medical and dental	59%	41%

Note: Includes UKHSA employees only where characteristics are known.

Age analysis

Figure 10 illustrates that all age groups are represented up to SCS grades at UKHSA, except for Medical and Dental (M and D) where there are no staff under 30 years of age. Staff aged in the 40 to 49 age range are mainly represented at senior manager, SCS and M and D grades. The largest proportion of staff in middle management roles are in the 30 to 39 age range (29%). Within senior manager grades there is a low representation of staff under 30 (5%). Over half of SCS and M and D are over 50 which may have implications for succession and retirement planning (Figure 10).

Figure 10. UKHSA workforce age profile by grade, March 2023

Grade	Under 30	30 to 39	40 to 49	50 and over	Total
Administrative	33%	24%	15%	28%	100%
Executive officer	36%	25%	17%	23%	100%
Middle manager	23%	29%	24%	23%	100%
Senior manager	5%	24%	33%	38%	100%
Senior civil servant	1%	19%	31%	50%	100%
Medical and dental	0%	12%	33%	55%	100%

Note: Includes UKHSA employees only where characteristics are known.

Ethnicity

In UKHSA, 74% of the workforce is white, 26% are ethnic minority. Around 6% of people have said that they prefer not to disclose their ethnicity (6% of the declaration rates). UKHSA does not have ethnicity information for 27% of our staff. Figure 11 shows the ethnicities of staff at each grade as a percentage of all staff at that grade. This means that if there were similar representation at all grades, the bars for ethnic minority staff would all show as approximately 26%. The graph illustrates that although ethnic minority staff are represented at every grade, they are relatively overrepresented in the medical and dental grade (38%) and underrepresented at SCS and equivalent level grades (10%) (Figure 11).

Figure 11. UKHSA ethnicity workforce profile by grade

Grade	White	Ethnic minority
Administrative	69%	31%
Executive officer	64%	36%
Middle manager	73%	27%
Senior manager	83%	17%
Senior civil servant	90%	10%
Medical and dental	62%	38%

Note: Includes UKHSA employees only where characteristics are known.