UK Health Security Agency

Executive agency in UK health system

UK Health Security Agency

Agency overview
Formed| 1 April 2021
Preceding agency|

* Public Health England

Jurisdiction| England
Minister responsible|

* Neil O'Brien, Parliamentary Under-Secretary of State for Primary Care and Public Health

Agency executives|

* Dame Jenny Harries, Chief executive
* Ian Peters, Chair

Parent department| Department of Health and Social Care
Child agencies|

* NHS Test and Trace
* Joint Biosecurity Centre

Website| www.gov.uk/government/organisations/uk-health-security-agency

The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability and replacing Public Health England. It is an executive agency of the Department of Health and Social Care (DHSC).

The formation of the UKHSA essentially transferred Public Health England's health improvement functions to DHSC, while its health protection elements form part of the new government agency.[1] Staff and systems were moved into the new organisation in 2021.[2] PHE continued to have a shadow existence until September 2021.[3] UKHSA became fully operational on 1 October 2021.[4]

## Formation[edit]

A new organisation, initially to be called the Centre for Health Protection, was proposed by Matt Hancock, the Secretary of State for Health and Social Care, in July 2020 to combine NHS Test and Trace, the Joint Biosecurity Centre and the health protection functions of Public Health England (PHE).[5] Under the name of the National Institute for Health Protection (NIHP), the organisation was established by Hancock on 18 August 2020 as a single leadership structure bringing together NHS Test and Trace, the Joint Biosecurity Centre and all of PHE.[6] Due to the ongoing COVID-19 pandemic, the new organisation was not formally established until 1 April 2021,[6] by which time it was called the UK Health Security Agency. It reports directly to the Secretary of State for Health and Social Care.[6]

Baroness Harding was the interim executive chair of the new organisation from 18 August 2020 to 7 May 2021.[7][8][5] In 2022, the High Court found that her appointment to the position broke equalities legislation.[9] She had been the chair of NHS Improvement since 2017, and at the time was head of the NHS Test and Trace programme, established in May 2020. She was a former chief executive of the TalkTalk Group[10][11] who sits in the House of Lords as a member of the Conservative Party and is married to Conservative Party Member of Parliament John Penrose.[12] During questioning by the Science and Technology Committee of the House of Commons, Harding said she held the interim leadership while a full application process was carried out.[13]

In August 2020, Health Secretary Matt Hancock said that the NIHP would learn from South Korea and from Germany's Robert Koch Institute "where their health protection agencies have a huge, primary, focus on pandemic response".[11][8]

The Telegraph first leaked news of the plans for the new agency on 16 August 2020. They claimed that Public Health England was to be "scrapped" and replaced by a single body combining it with NHS Test and Trace, in response to the COVID-19 pandemic.[14] A leaked memo to staff written by the head of Public Health England, Duncan Selbie, said that the aim of the new body was to boost expertise with "much needed new investment".[15][16] Selbie apologised to staff that the news of the organisation's demise was briefed to The Telegraph before they were told.[17]

In February 2021, Harding said that the new body would not be "fully staffed and up and running" until October 2021.[18]

On 24 March 2021, Hancock announced that the organisation would be formally established on 1 April 2021 under the new name of the UK Health Security Agency, with Dr Jenny Harries stepping down as England's Deputy Chief Medical Officer to become chief executive, and Ian Peters to be chair. Hancock also confirmed that Harries would take over from Harding as lead of England's test, trace and isolate programme.[19] Harries assumed these roles following a hand-over period which lasted until Harding departed on 7 May 2021.[5]

## Role[edit]

The responsibilities of the UKHSA include:

* The health protection functions of Public Health England[2]
* Planning and executing the response to external health threats such as pandemics[20]
* The Joint Biosecurity Centre[21]
* NHS Test and Trace[21]
* Regulation of Coronavirus diagnostic devices [22]

UKHSA collaborates with Public Health Scotland, Public Health Wales and Northern Ireland's Public Health Agency.[2]

## Response[edit]

A 2020 BMJ editorial described the creation of the agency as "extremely foolhardy". It characterised the National Institute for Health Protection as "seem[ing] remarkably similar to the Health Protection Agency abolished in 2013."[23] An August 2020 editorial in The Spectator welcomed the return to an organisation similar in remit to that agency; it criticised Public Health England's focus on health improvement topics such as obesity and binge drinking, arguing that these should be tackled by local NHS health teams.[24] In August 2020 The Telegraph welcomed the change, characterising PHE as the quango "responsible for many critical failures over the course of this [COVID-19] pandemic" that had to be scrapped.[25]

On 2 September 2020, more than 70 health organisations wrote to the government to express concern about the future of health improvement work under these changes.[26]

The appointment of Lady Harding as interim executive chair of the new body was criticised by health experts as she did not have a background in health, and because of her political position.[10][27][28] The Guardian quoted allies of hers who, in response, said that she had quickly learned after being appointed chair of NHS Improvement in 2017 and that she had a record of "getting things done" while working in business.[10]

The timing of the reorganisation, during the ongoing pandemic response, was criticised by various health experts and other bodies,[29] including the editorial in the BMJ,[23] the Institute for Government,[30] the King's Fund,[31] and Christina Marriott, the chief executive of the Royal Society for Public Health.[11] An editorial in The Guardian compared it to "reorganising a fire brigade as it tries to put out a blaze" and said the decision had been made without proper consultation or scrutiny.[32]

## References[edit]

1. ^ Serle, Jack (24 March 2021). "PHE staff to be split between DHSC and new health security agency". Health Service Journal. Retrieved 2 April 2021.
2. ^ a b c "Transforming the public health system". GOV.UK. 29 March 2021. Retrieved 2 April 2021.
3. ^ "Covid: Health security body gives UK 'protective shield'". BBC News. 24 March 2021.
4. ^ "UK Health Security Agency launches with a relentless focus on keeping the nation safe". GOV.UK.
5. ^ a b c [2022] EWHC 298 (Admin)
6. ^ a b c "Government creates new National Institute for Health Protection". GOV.UK. Retrieved 18 August 2020.
7. ^ Hughes, Laura (17 August 2020). "Dido Harding to lead new pandemic agency for England". Financial Times. Retrieved 17 August 2020.
8. ^ a b "Health Secretary axes public health body". BBC News. 18 August 2020.
9. ^ "Dido Harding's appointment by Matt Hancock in Covid response 'broke equalities law'". 15 February 2022.
10. ^ a b c Campbell, Denis (18 August 2020). "Dido Harding: confident, loyal – but with precious little relevant experience". The Guardian.
11. ^ a b c "Matt Hancock confirms Public Health England axed with Test and Trace boss Baroness Harding to lead replacement body". Politics Home. 18 August 2020.
12. ^ Walker, Jonathan (18 August 2020). "Anger as Tory politician put in charge of health body leading Covid fight". BirminghamLive.
13. ^ Allegretti, Aubrey (17 September 2020). "Coronavirus: Head of Test and Trace says rise in demand for COVID tests wasn't expected". Sky News. Retrieved 19 September 2020.
14. ^ "Public Health England to be scrapped and replaced by new body". The Telegraph. 15 August 2020. Retrieved 15 August 2020 - via Reuters.
15. ^ "Coronavirus: Public Health England 'to be replaced'". BBC News. 17 August 2020. Retrieved 17 August 2020.
16. ^ "Selbie: 'I am sorry beyond words'". HSJ. 17 August 2020. Retrieved 18 August 2020.
17. ^ "Boss 'sorry beyond words' after details on Public Health England's future leaked". ITV News. 17 August 2020.
18. ^ Manthorpe, Rowland (26 February 2021). "Revealed: How ministers are planning to seize control of policy from Public Health England". Sky News. Retrieved 27 February 2021.
19. ^ "Britain to launch new health security agency to battle pandemics". Reuters. 24 March 2021. Retrieved 24 March 2021.
20. ^ "About us". GOV.UK. UK Health Security Agency. Retrieved 2 April 2021.
21. ^ a b "New UK Health Security Agency to lead response to future health threats". GOV.UK. Retrieved 2 April 2021.
22. ^ "Two UK COVID test makers pull devices due to new review". Reuters. 2 November 2021.
23. ^ a b Scally, Gabriel (2020). "The demise of Public Health England". BMJ. 370: m3263. doi:10.1136/bmj.m3263. PMID 32816779. S2CID 221177869.
24. ^ Christopher Snowdon (19 August 2020). "Farewell, Public Health England". The Spectator.
25. ^ View, Telegraph (19 August 2020). "Public Health England had to be scrapped". The Telegraph.
26. ^ Campbell, Denis (2 September 2020). "Health leaders warn Boris Johnson over axing of Public Health England". the Guardian. Retrieved 27 February 2021.
27. ^ Cruse, Ellena (20 August 2020). "Matt Hancock defends appointment of Dido Harding as National Institute for Health Protection head". Evening Standard. Retrieved 22 August 2020.
28. ^ "Britain's new health boss sparks cries of cronyism". Politico. 23 August 2020.
29. ^ Iacobucci, Gareth (2020). "Public Health England is axed in favour of new health protection agency". BMJ. 370: m3257. doi:10.1136/bmj.m3257. PMID 32816824. S2CID 221159280.
30. ^ Nickson, Sarah (19 August 2020). "Getting rid of Public Health England will not make dealing with the coronavirus pandemic easier". Institute for Government. Retrieved 27 February 2021.
31. ^ Timmins, Nicholas (20 August 2020). "Strengthening health protection: right idea, wrong time". The King's Fund. Retrieved 30 August 2020.
32. ^ "The Guardian view on scrapping Public Health England: not just wrong but highly risky". The Guardian. 18 August 2020. Retrieved 19 August 2020.

## External links[edit]

* September 2020 UK Government Policy Paper setting out the responsibilities of the NIHP
* Establishing the National Institute for Health Protection – House of Commons Library, February 2021

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