Letter from Maggie Throup to Professor Dame Jenny Harries, UKHSA chief executive – GOV.UK

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Published 12 August 2022

© Crown copyright 2022
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This publication is available at https://www.gov.uk/government/publications/ukhsa-priorities-in-2022-to-2023/letter-from-maggie-throup-to-professor-dame-jenny-harries-ukhsa-chief-executive
The office of Maggie Throup
Parliamentary Under Secretary of State for Vaccines and Public Health
39 Victoria Street

Professor Dame Jenny Harries
Chief Executive
UK Health Security Agency
Nobel House
17 Smith Square

Dear Jenny,
This letter sets out the government’s priorities for the United Kingdom Health Security Agency (UKHSA) for the period April 2022 to March 2023. Given the urgent work on the Omicron response and the implications for the spending review, which were agreed in late March, I acknowledge with thanks your work in the last 4 months before this letter has been issued.
UKHSA has brought together staff and capabilities of NHS Test and Trace, the health protection elements of Public Health England, the Joint Biosecurity Centre and, since April 2022, the Managed Quarantine Service to strengthen health protection capability across the UK.
I would like to thank all UKHSA’s staff for their:
UKHSA is our permanent standing capacity to prepare for, prevent and respond to threats to health. Its responsibilities are for England, across the UK on reserved health matters, and in partnership with lead agencies in Scotland, Wales and Northern Ireland on devolved issues where relevant.
Since its creation, UKHSA has necessarily dedicated a significant proportion of its time and expertise towards responding to COVID-19. The agency’s capacity to continue to respond to resurgences and new COVID-19 variants is being maintained in line with the government’s COVID-19 Response: Living with COVID-19 strategy, and this capacity to respond is scalable within funding limits. This is enabling UKHSA to continue the response to COVID-19 alongside focusing on a broader range of health security priorities during the year ahead.
As agreed in principle, the transfer of responsibilities of the Vaccine Taskforce (VTF) from September 2022 to UKHSA provides an opportunity for UKHSA to harness the strengths of the VTF, including its:
Once responsibilities have been moved to UKHSA, progress will be assessed at an agreed point in the year.
The Department of Health and Social Care (DHSC) delivers its responsibilities on behalf of the Secretary of State for Health and Social Care through UKHSA and other delivery partners, and is accountable to Parliament for effective delivery of their remit and services.
As an executive agency of the DHSC with operational autonomy, UKHSA will:
UKHSA will develop its global-to-local reach, working with international and domestic partners, and combining robust science and analytics, insightful planning and responsive operational excellence, to keep the nation’s health secure.
As the nation’s expert dedicated health security agency, UKHSA will:
UKHSA will be expected to align with and, wherever applicable, input to relevant cross-system work including:
UKHSA will co-ordinate closely with the Office for Life Sciences to support delivery of the government’s Life Sciences Vision including the healthcare missions, and with DHSC on global health security policy. Research will be a high priority, including through collaborative programmes with academia and industry, particularly playing an important role in signalling to research funders key priorities for research.
UKHSA will be proactive in its approach to infection control and collaborate effectively across the public health system in order to prepare for, respond to and recover from all health hazards. This will involve building and sustaining strong, impactful relationships across local and national government, including with agencies in Scotland, Wales, Northern Ireland, the Crown dependencies, local authorities and other system partners across the UK to ensure threats are effectively identified, mitigated and addressed at home and abroad.
The agency will work alongside DHSC – including the Office for Health Improvement and Disparities (OHID), NHS England (NHSE) and NHS public health teams – on priority programmes.
UKHSA will also set out how it will work with tripartite partners (DHSC and NHSE) to plan for and respond to health emergencies, including infectious diseases and other health hazards.
UKHSA will work closely with the Chief Medical Officer (CMO), who is the UK’s most senior medical adviser and head of the public health profession. The CMO will be:
The CMO will co-ordinate closely with UKHSA in support of the agency’s global health remit.
Additionally, UKHSA will be a trusted source of public health advice and scientific expertise to government, and will also work closely with CMOs for Scotland, Wales and Northern Ireland. UKHSA will synthesise its multiple areas of expertise into an organisational view, which can be used to advise the system, CMOs and relevant ministers.
UKHSA will need to develop a culture that invests in its people and nurtures talent, enabling it to attract and retain highly talented individuals in public health. To empower and enable its workforce to succeed, UKHSA will create a working environment where innovation, collaboration and continuous improvement are at the heart of everything it does. Underpinning this are UKHSA’s values of being impactful, insightful and inclusive, which are fundamental to achieving this goal. UKHSA will strive to improve its capability to ensure that UKHSA’s future workforce is equipped to deal with health hazards.
UKHSA will develop and agree specific deliverables, and ensure that the agency operates at optimal effectiveness and efficiency, and provides value for money. UKHSA will plan to use its resources in an affordable and sustainable manner, and within agreed limits as set out in the framework document between DHSC and UKHSA, and in accordance with its obligations to the DHSC with regard to financial management, forecasting and reporting. UKHSA will look to take advantage of any income generation streams that may arise from assets such as UKHSA’s laboratory network.
UKHSA will prepare comprehensively for the UK COVID-19 Inquiry and communicate transparently with DHSC. UKHSA will fully engage with the inquiry, including responding to evidence requests as required and providing appropriate support to any witnesses to the inquiry for whom UKHSA are responsible.
The detailed priorities are attached at Annex A. In summary, organised in 3 areas, during 2022 to 2023, the government expects UKHSA to:
1. Reduce harm from infectious disease and other health security hazards, and achieve more equitable outcomes.
UKHSA will look to reduce the harm from threats to health, including COVID-19, by ensuring effective emergency preparedness, resilience, response and the ability to flex capacity where required in response to health emergencies, including infectious diseases and other health hazards.
UKHSA will:
2. Prepare for future health security hazards so that our health, society, public services and economy are less impacted.
UKHSA will strengthen pandemic preparedness to ensure that it becomes embedded within national security structures so that the country is well positioned to respond to all threats to health. UKHSA will learn lessons from and build on the legacy of the response to COVID-19, while delivering a resilient and scalable infrastructure to protect against future pandemics, and health threats, including waves of COVID-19.
UKHSA will:
3. Strengthen health security capability to improve the effectiveness of our local, national and global response.
UKHSA will look to deepen the UK’s role in global health security through playing a leading role on the global stage and fulfilling international responsibilities.
UKHSA will:
Much of UKHSA’s work outlined during 2022 to 2023 is vital core activity that is central to the function and capabilities of the agency, and that it should be carrying out on a continuous basis year to year. This remit letter distinguishes this core activity from the specific actions for the year. Going forward, core activity will not be formally re-commissioned each year for the remit letter, streamlining the process.
UKHSA is still in a development phase. Notwithstanding this, UKHSA will undertake an efficient, effective and robust transition of the agency’s functions in line with the Response COVID-19: Living with COVID-19 strategy and the spending review settlement, through a staged process of reorientation, transformation and re-design of internal structures.
DHSC and UKHSA will take the necessary time to develop and agree pragmatic and specific deliverables aligned to this remit letter.
As a category 1 responder under the Civil Contingencies Act 2004, UKHSA will work with DHSC and NHSE to provide effective emergency preparedness, resilience and response to all public health emergencies. This includes surveillance, analysis, risk assessment, and management of and response to infectious disease incidents and outbreaks, building on the advice from its expert advisory committees where appropriate.
As part of its core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will provide expertise to the National Resilience Strategy and Civil Contingencies Act 2004: post implementation review.
UKHSA will support a joined-up and UK-mindful approach to health security and health protection, embedding UK governance and engagement across all UK-wide programmes by building on collaborative action already in train, and drawing on lessons and experiences as appropriate.
As part of its core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will:
From autumn 2022, UKHSA will take on responsibility for COVID-19 vaccine supply from the VTF, and ensure we build on the VTF’s legacy by retaining many elements of its structure, approach and culture, including through close engagement with suppliers, utilising technical and commercial expertise, and centralised procurement. This will cover existing and future contracts for vaccine supply including the recently announced Heads of Terms with Moderna. This includes:
UKHSA will contribute to improving our childhood and adult immunisation programmes, and drive maximum uptake, and aid in regaining the UK’s measles elimination status, and the sustaining of our rubella and polio status.
As part of these core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will be prepared to contribute to the development of a future vaccine strategy
UKHSA will collaborate with partners on the design, development and implementation of a future operating model for COVID-19 and influenza vaccination programmes. It will drive COVID-19 awareness, engagement and take-up of vaccinations, and support maintenance and supply of antivirals to ensure continued deployment of life-saving treatments for COVID-19.
As part of these core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will support the transition of testing for treatment to primary care (NHSE-led) from UKHSA.
UKHSA will continue work on surveillance and response to a range of health hazards, in particular the main transmission disease routes (gastrointestinal, respiratory, sexual, touch, vector-borne and blood-borne) as well as CBRN and big event disasters.
UKHSA will review and assess the public health risks, set out the appropriate mitigation and contingencies, and review the appropriate levels of preparedness against these to establish our enhanced response capability.
UKHSA will lead in developing a strategic system-wide approach to health surveillance and data use to inform action at national and local level. This should cover communicable and non-communicable diseases, including measurable action on disparities.
FAIR (findability, accessibility, interoperability and reusability) principles should be at the heart of UKHSA’s data strategy.
As part of its core activities, UKHSA will:
UKHSA will collaborate with regional OHID and NHS public health teams on the delivery of the Tuberculosis (TB): action plan for England (2021 to 2026) with the aim to achieve a year-on-year reduction in TB incidence and in-UK TB transmission, and enable the UK to meet its commitment to the WHO elimination targets by 2035.
UKHSA will provide advice and support, working with policy makers, local authorities and wider sectoral partners and stakeholders to protect adult social care settings and populations from new and existing threats.
In 2022 to 2023, UKHSA will
Support delivery of the DHSC’s approach to health disparities, co-ordinating with partners to ensure all members of the community are, as far as possible, equally protected from health threats.
As part of its core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will support the development and delivery of an effective and proportionate COVID-19 testing regime within vulnerable settings, incorporating the different risk levels relative to the wider population
UKHSA will enhance the resilience and scalability of national and local public health systems, including by incorporating lessons learned from COVID-19. As part of these core activities, it will strengthen resilience of national and local public health systems through the Future of the Local Health Protection programme. In addition, in 2022 to 2033, UKHSA will deliver a strategy and framework on future local health protection system by early 2023.
UKHSA will support the government’s vision goal to contain, control and reduce harms from the spread of antimicrobial resistance (AMR) through delivery of UKHSA’s commitments in the UK 5-year action plan for antimicrobial resistance 2019 to 2024 and supporting DHSC’s work to develop the next 5-year national action plan.
Additionally, UKHSA will support and lead, where necessary, the delivery of international commitments, providing technical expertise in relevant work packages of the Transatlantic Taskforce on AMR (TATFAR) and technical support as needed on effectiveness of international efforts to combat AMR, including advice on potential new international commitments to be agreed at the UN High-level Meeting on AMR in 2024.
Build towards the goal of zero transmissions of HIV in England by 2030 by providing scientific and analytic expertise in the detection, prevention and control of sexually transmitted infections and HIV through agreed commitments and future strategies.
As part of its core activities, UKHSA will support local authorities and NHS commissioning of sexual health, HIV and hepatitis service delivery in England, including through monitoring the impacts of disparities.
In addition, in 2022 to 2023, UKHSA will contribute to the development and implementation of the government’s Sexual and Reproductive Health Action Plan for England. It will also support the commitment to eliminate HIV transmission by 2030 and implementation of the Towards Zero: the HIV Action Plan for England – 2022 to 2025 jointly developed by OHID and UKHSA.
UKHSA will ensure that DHSC, other government departments, the public and other stakeholders have up-to-date information on the health impacts of air pollution to encourage behaviour change at every level, and the actions to take to mitigate against health impacts, including health inequalities.
As part of its core activities, UKHSA will:
In addition, in 2022 to 2023, UKHSA will contribute to the cross-government commitments made in the Clean Air Strategy and in response to a Prevention of Future Deaths Report. In particular, it will lead on the provision of the evidence base in response to commitments to reduce fine particulate matter (PM2.5) in London and the south-east, and to work with OHID in support of this public commitment.
UKHSA will support the UK’s COP26 commitments, which feed into building and bolstering a health system that is climate resilient.
As part of its core activities, UKHSA will provide expert scientific advice and support to DHSC, health and care system partners, and other government departments, to ensure the impact of climate change on public health, and on the delivery of health and care services, is considered as part of all system design.
In addition, in 2022 to 2023, UKHSA will:
UKHSA will support preparations and provide public health guidance to host the 2022 Commonwealth Games and other major national public events safely, and contribute to cross-government initiatives where DHSC leads for the health sector, such as the Yarrow programme.
UKHSA will continue to support local authorities to deliver public health activity, including at the border, seaports, airports and rail crossings, to aid the local detection and management of outbreaks and help prevent wider community transmission. This includes:
In 2022 to 2023, UKHSA will:
UKHSA will support progression of the Science Hub Programme business case, which carries a significant investment, to create the future UK infrastructure for public health scientific capabilities and capacity.
UKHSA will conduct research to inform delivery of its aims in partnership with universities through the National Institute for Health and Care Research (NIHR) Health Protection Research Units. It will also conduct additional research by securing funding through open competition, including from NIHR research programmes and UK Research and Innovation (UKRI), in partnership with academia and/or industry.
UKHSA will establish the Centre for Pandemic Preparedness (CPP) as a world-leading hub on all aspects of pandemic preparedness with a focus on securing the health of the UK population.
In 2022 to 2023, UKHSA will:
UKHSA will maintain a robust programme for the delivery of emergency clinical countermeasures. This includes the procurement, storage and deployment of countermeasures and stockpiled medicines, and the re-procurement of a pandemic-specific influenza vaccine advance purchase agreement.
In 2022 to 2023, UKHSA will:
UKHSA will provide proactive, timely and well-evidenced public health advice and scientific expertise to support decision-making to ensure a comprehensive operational response to health hazards, including CBRN.
As part of its core activities, UKHSA will:
Maintain a resilient system that can be scaled up as required to support the ongoing response to COVID-19 and other threats to health effectively.
In 2022 to 2023, UKHSA will:
UKHSA will broaden and deepen a security culture within appropriate aspects of public health, building on the experience of our COVID-19 response to strengthen our approach to future health security threats, and ensure better compliance, higher uptake and a more secure public health landscape through the following measures.
As part of its core activities, UKHSA will:
UKHSA will develop a robust health intelligence system that is accessible and integrated for the timely identification and prevention of public health threats reaching the UK.
As part of these core activities, UKHSA will:
Additionally, in 2022 to 2023, UKHSA will support DHSC to review and update the legal framework for health protection to best meet future health security needs. This includes any possible changes to the Public Health (Control of Disease) Act 1984 and relevant secondary legislation, as well as any non-legislative levers as appropriate. UKHSA is responsible for providing expert public health, operational delivery and policy advice to support decision-making and implementation of any changes.
UKHSA will deliver ongoing domestic health protection activity as the UK’s focal point on the international health regulations in collaboration with the WHO and the EU on incidents and outbreaks.
In 2022 to 2023, UKHSA will:
UKHSA will represent the UK in the global health security infrastructure and fulfil international responsibilities. It will:
UKHSA will assist the WHO in improving global surveillance, pandemic preparedness and response by providing expert input on public health issues.
In 2022 to 2023, UKHSA will:
UKHSA will deliver DHSC Official Development Assistance-funded projects to support low and middle-income countries in building capacity to prevent, detect and respond to health threats, including the International Health Regulations Strengthening (IHR-S) project and, working closely with the London School of Hygiene and Tropical Medicine’s UK Public Health Rapid Support Team (UK-PHRST).
In 2022 to 2023, UKHSA will:
UKHSA will continue to deliver on our health security commitments under the EUUK Trade and Co-operation Agreement.
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