Working to make government more effective

Explainer

UK Health Security Agency

What is the UK Health Security Agency (UKSHA)? What does it do? How is it organised?

Three Covid-19 tests
UKHSA was responsible for responding to the Omicron variant, which involved distributing 1.1 billion tests in six months in 2022.

What is the UK Health Security Agency?

The UK Health Security Agency (UKHSA) is the government agency charged with protecting public health against external threats such as infectious disease or biological and chemical hazards. It is an executive agency of the Department of Health and Social Care (DHSC).

What does the UKHSA do?

The UKHSA prepares for, prevents and responds to infectious diseases and chemical, biological, nuclear and environmental hazards. 73 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 26 January 2023, page 11. It does so through research, data collection, providing advice to other government agencies and acting to contain outbreaks. The inclusion of ‘security’ in its name refers to its role in reducing the country’s vulnerability to public health emergencies. 74 HM Government, ‘Public Health Protection and Health Security Framework Outline Agreement’, HH Associates Ltd. on behalf of the Controller of Her Majesty’s Stationery Office, October 2021, p. 3.

The UKHSA primarily operates in England. It also has responsibilities across the UK in specialist roles such as responding to radiation, and represents the UK on international public health matters, but responsibility for the majority of health security and protection in Scotland, Wales and Northern Ireland sits with the devolved governments through their own agencies. 75 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 26 January 2023, page 11.

How is the UKHSA organised?

Since its establishment in April 2021, UKHSA has been led by its chief executive, Dr Jenny Harries. 76 Department of Health and Social Care and the UK Health Security Agency ‘Work begins for UK Health Security Agency to protect the nation’, press release, 1 April 2021, retrieved 8 March 2023, www.gov.uk/government/news/work-begins-for-uk-health-security-agency-to-protect-the-nation She is accountable for her performance to the health secretary, who has the ability to set objectives for UKHSA though an annual remit letter, and to the UKHSA board, whose chair and non-executive board members are appointed by the health secretary. 77 Department of Health and Social Care and UK Health Security Agency, ‘Framework document between the Department of Health and Social Care and the UK Health Security Agency’, 27 January 2022, retrieved 16 March 2023, www.gov.uk/government/publications/framework-document-between-the-department-of-health-and-social-care-and-the-uk-health-security-agency/framework-do… UKHSA is headquartered in London but also has a network of laboratories as well as nine regional teams, which support local government in its statutory public health functions. 78 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 26 January 2023, page 15.

How and why was the UKHSA formed?

The UKHSA was formed following the abolition of Public Health England (PHE) in 2021 79 UK Health Security Agency ‘UK Health Security Agency launches with a relentless focus on keeping the nation safe’, press release, 1 October 2021, retrieved 8 March 2023, www.gov.uk/government/news/uk-health-security-agency-launches-with-a-relentless-focus-on-keeping-the-nation-safe , merging PHE’s health protection functions with NHS Test and Trace and the Joint Biosecurity Centre. Due to the perceived failings of Public Health England during the Covid-19 pandemic, then health secretary Matt Hancock decided to create an agency focused solely on health security, integrating scientific expertise and research with the infrastructure and operational capacity needed to respond to threats, 80 Department of Health and Social Care, ‘Transforming the public health system: reforming the public health system for the challenges of our times’, 29 March 2021, retrieved 9 March 2023, www.gov.uk/government/publications/transforming-the-public-health-system/transforming-the-public-health-system-reforming-the-public-health-system-for… originally to be called the National Institute for Health Protection. 81 Department of Health and Social Care and Matt Hancock ‘Government creates new National Institute for Health Protection, press release, 18 August 2020, retrieved 9 March 2023, www.gov.uk/government/news/government-creates-new-national-institute-for-health-protection This became the UKHSA.

What has the UKHSA done since being established?

In its first years of existence UKHSA prioritised responding to the Covid-19 pandemic, within its wider remit of public health protection. 82 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 26 January 2023, page 11. It was responsible for responding to the Omicron variant, which involved distributing 1.1 billion tests in six months in 2022. 83 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 28 April 2022, page 16. In addition, from February 2022, the UKHSA worked to implement the government’s “Living with Covid” strategy, 84 Cabinet Office, ‘COVID-19 Response: Living with COVID-19’, Cabinet Office, 21 February 2022, www.gov.uk/government/publications/covid-19-response-living-with-covid-19 which meant reducing the number of staff and resources involved in testing. 85 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 28 April 2022. In its 2021/22 annual report, it outlined plans to cut staff numbers from around 11,000 to about 7,000 86 UK Health Security Agency, ‘Annual Report and Accounts 2021/22’, HM Stationery Office, 26 January 2023, page 14. , and up to 40% of staff in health protection teams. 87 Mason R, Stewart H and Campbell D, ‘UK health agency to cut 800 jobs and halt routine Covid testing’, The Guardian, 26 April 2022, www.theguardian.com/society/2022/apr/26/uk-health-agency-to-cut-40-of-jobs-and-suspend-routine-covid-testing

UKHSA has also tackled incidents and outbreaks beyond Covid-19, including monitoring and advising on the human health risks of avian influenza in 2021 and 2022. 88 UK Health Security Agency, ‘An update on avian flu’, GOV.UK, 17 November 2022, https://ukhsa.blog.gov.uk/2022/11/17/an-update-on-avian-flu/

What problems has the UKHSA experienced?

A month after its creation, the UKHSA had to urgently respond to the new Omicron variant of Covid-19, 89 Davis N, Sample I and Brooks L, ‘When did Omicron Covid variant arrive in UK and is it spreading?’, The Guardian, 1 December 2021, retrieved 8 March 2023, www.theguardian.com/world/2021/dec/01/when-did-omicron-variant-arrive-in-uk-and-is-it-spreading  alongside merging its three predecessor organisations with separate functions, teams, and cultures. 90 Harries J, ‘In Conversation with Dr Jenny Harries’, speech at the Institute for Government, 28 July 2022, www.instituteforgovernment.org.uk/event/online-event/conversation-dame-dr-jenny-harries-chief-executive-uk-health-security-agency In addition,  there were initial funding difficulties followed by large cuts after February 2022 91 UK Health Security Agency, Annual Report and Accounts 2021/22, 26 January 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131855/UKHSA_Annual_Report_21_22_FINAL.pdf, page 8. , problems with merging IT systems 92 Dalton G, Amos N and Gill M, How to abolish a public body: Ten lessons from previous restructures, Institute for Government, March 2023, www.instituteforgovernment.org.uk/publication/abolish-public-bodies, page 19. and very high levels of temporary staff. 93 UK Health Security Agency, Annual Report and Accounts 2021/22, 26 January 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131855/UKHSA_Annual_Report_21_22_FINAL.pdf, page 90. These operational challenges were described as “extraordinarily unusual” by the chair, Ian Peters. 94 UK Health Security Agency, Annual Report and Accounts 2021/22, 26 January 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131855/UKHSA_Annual_Report_21_22_FINAL.pdf, page 8.

In January 2023, the National Audit Office found “significant shortcomings in financial control and governance which are pervasive to UKHSA’s financial statements” and concluded that DHSC did not sufficiently support or oversee UKHSA’s administrative functions during its establishment. 95 UK Health Security Agency, Annual Report and Accounts 2021/22, 26 January 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131855/UKHSA_Annual_Report_21_22_FINAL.pdf, page 95 In its annual report, the UKHSA argued that this was caused by factors that “were to a large extent outside of the control of current management” and that the UKHSA “as it exists today is substantially different”. 96 UK Health Security Agency, Annual Report and Accounts 2021/22, 26 January 2023, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131855/UKHSA_Annual_Report_21_22_FINAL.pdf, page 8.

Keywords
Health
Publisher
Institute for Government

Related content

03 NOV 2023 Podcast

Boris Johnson's orgy of narcissism

The BBC’s health reporter Jim Reed joins the team to work out what we’ve learnt from the Covid Inquiry evidence sessions and WhatsApp messages.