UK Health Security Agency Strategic Plan 2023 to 2026

Objectives

The UK Health Security Agency (UKHSA) seeks to prepare for, prevent and respond to health security threats, save lives, reduce harm and protect livelihoods, public services and the economy.[1][2]Its three strategic goals are to respond effectively to health emergencies, prepare for and prevent future hazards, and build the United Kingdom’s health security capacity.[3]The 2023 to 2026 strategy is organised around six priorities: reduce infectious diseases and antimicrobial resistance; protect health from environmental threats; prepare for all hazards; improve health outcomes through vaccines; improve public health action through data and insight; and develop UKHSA as a high-performing agency.[3]

• Strengthen resilience against infectious diseases, emerging and high-consequence pathogens, antimicrobial resistance, pandemics, environmental hazards, and chemical, biological, radiological and nuclear incidents.[4]
• Prevent and mitigate hazards through surveillance, risk understanding, appropriate countermeasures, tested plans, specialist expertise, infrastructure and scalable response capabilities.[3]
• Improve vaccine uptake, optimise routine immunisation, reduce inequalities in coverage, support measles and rubella elimination, and sustain progress towards polio eradication and containment.[5][6]
• Reduce the burden of COVID-19, antimicrobial resistance, blood-borne viruses and tuberculosis, while supporting World Health Organization elimination goals for hepatitis B, hepatitis C, human immunodeficiency virus and tuberculosis.[7][8]
• Protect people from climate-related, environmental, chemical, radiological and nuclear risks, and apply a One Health approach linking human, animal, plant and environmental health to identify and mitigate zoonotic threats.[4][9]
• Embed health equity by improving understanding, data and action for vulnerable, deprived and high-risk communities and settings, with the aim of reducing health inequalities over the plan’s lifetime.[1][10]
• Strengthen health protection science, genomics, diagnostics, data, analytics, innovation and life-sciences capability to support timely, evidence-based and equitable decisions.[11][12]

Implementation

UKHSA is an executive agency sponsored by the Department of Health and Social Care (DHSC), operating principally in England while undertaking specified United Kingdom-wide responsibilities and collaborating with devolved governments on cross-border threats.[13][14]It combines scientific, clinical, public health, data, policy and operational capabilities with national leadership, regional delivery and locally informed action.[15][3]Delivery is intended to be partnership-based, scalable to the severity of each threat, and supported by annual business plans that translate the three-year strategy into yearly deliverables.[16][17]

• Coordinate preparedness, prevention and response with DHSC, the National Health Service, local authorities, Directors of Public Health, Integrated Care Boards, devolved governments, academia, industry, voluntary-sector organisations, communities and international partners.[11][4][18]
• Lead regional incident responses through nine regional teams that advise local partners, investigate cases and outbreaks, operate surveillance and alert systems, and contribute to emergency planning, resilience and mutual support.[3][18]
• Detect and assess threats through horizon scanning, systematic surveillance, epidemiology, specialist diagnostics, laboratory testing, pathogen genomics, modelling, behavioural science and advanced analytics.[10][16]
• Maintain specialist laboratory and research capacity, including level 4 containment facilities, to detect and respond to high-risk human and animal pathogens and support development of diagnostics, vaccines and therapeutics.[19]
• Develop and exercise contingency arrangements for varied hazards and transmission scenarios, drawing on learning from previous incidents and the UK COVID-19 Inquiry.[4]
• Scale operational capability through pre-arranged commercial contracts, flexible procurement, academic collaboration and national and local partnerships.[4]
• Support vaccine development, procurement, storage, distribution, schedule design, clinical guidance, workforce training, public information and real-world impact analysis, working with the Medicines and Healthcare products Regulatory Agency, NHS bodies, providers and communities.[5][6]
• Modernise data, technology, laboratories and critical infrastructure, including an enterprise data and analytics platform, genomic surveillance and a cross-government National Biosurveillance Network.[20][12]
• Build a skilled, diverse and flexible workforce across scientific, clinical, public health, data, logistics, commercial, policy and corporate functions, supported by investment in facilities, technology and stakeholder relationships.[21][22]
• Govern through ministerial and parliamentary accountability, a Chief Executive Officer, senior leadership team and non-executive advisory board, with governance arrangements set out in a framework document.[23][22]
• Monitor delivery through progress against strategic priorities and annual business-plan deliverables, reporting monthly to the executive team, quarterly to DHSC and annually through published reports and accounts.[17]

Monitoring & Evaluation

UK Health Security Agency (UKHSA) combines operational surveillance, scientific evidence, data analytics, genomics, diagnostics, modelling and research to identify threats, guide preparedness and response, and support health-protection decisions.[15][11][12]Its accountability arrangements include oversight by ministers and Parliament, advice and challenge from a non-executive advisory board, and corporate governance assurance.[23][22]

• Monitor progress against strategic priorities and annual business-plan deliverables, with monthly reporting to the UKHSA executive team, quarterly reporting to the Department of Health and Social Care, and publication of an annual report and accounts.[17]
• Maintain local and national surveillance to detect infectious-disease outbreaks, rare and emerging infections, environmental hazards, healthcare-associated infections and other health-security incidents.[10][19][18]
• Use pathogen genomic sequencing to identify pathogens and drug resistance rapidly, track transmission and variants, assess vaccine effectiveness, and support targeted outbreak control.[15][3][8]
• Apply horizon scanning, systematic surveillance, laboratory testing, epidemiology, forecasts and advanced analytics to identify emerging risks and inform policy and operational decisions.[10][16][12]
• Evaluate health-protection interventions through clinical, epidemiological and public-health expertise, and provide analysis, evidence, guidance and intelligence to government and delivery partners.[11][16]
• Monitor vaccination coverage, uptake inequalities, infection outcomes and real-world vaccine impact, while maintaining measles whole-genome sequencing and surveillance of COVID-19 transmission and viral evolution.[5][6][24]
• Support progress towards World Health Organization certification and elimination targets for polio, measles and rubella, alongside disease-elimination work for hepatitis B, hepatitis C, human immunodeficiency virus and tuberculosis.[5][8]
• Assess differential impacts of hazards on communities, improve data and understanding for high-risk groups and settings, and use this evidence to support equitable responses and reduce health inequalities.[10][4]
• Build climate and environmental health evidence, including on air quality, high-risk populations and the effectiveness of interventions, supported by the Centre for Climate and Health Security.[4][9]
• Use contingency exercises and learning from previous incidents, including the UK COVID-19 Inquiry, to test and improve preparedness and response capability.[4]
• Strengthen information governance through an agency-wide data strategy, an information-risk programme, data-maturity assessment, secure sharing of surveillance information, and cyber-safety systems.[12]
• Publish science and guidance, share evidence with partners, and promote transparency, public accountability and robust financial governance.[21]

The source identifies surveillance, reporting, evidence generation and governance mechanisms, but does not specify a single consolidated indicator framework, quantified performance targets, independent evaluation methodology or universal reporting timetable for all six strategic priorities.[3][25][17]

Costing & Financing

The material presents prevention, preparedness, scientific capability and partnership working as sources of economic and public value, but does not provide a costed implementation plan, total budget, programme allocations, quantified funding gap or comprehensive financing strategy for the three-year plan.[2][14][17]

• Manage budgets responsibly and support income generation through corporate finance and business-development functions.[19][23]
• Use contracts and relationships with private, not-for-profit and public-sector partners, through which a significant portion of UKHSA’s budget is delivered, to access capability, resources and innovation.[14][18]
• Use pre-arranged commercial contracts, academic collaboration and flexible, value-focused procurement to scale capabilities and support vaccine development, procurement, storage and distribution.[4][5]
• Invest in workforce capacity, specialist laboratories, infrastructure, technology, data platforms, science, research, commercial capability and partnerships, without explicit monetary values.[10][16][21]
• Optimise taxpayer-funded spending and pursue value for money in operational delivery, procurement and organisational investment.[5][21]
• Recognise prevention as economically beneficial: research cited in the strategy found that higher measles, mumps and rubella vaccination uptake during the 2012 to 2013 outbreak could have averted the outbreak at 4% of the eventual cost of managing it.[13]
• Identify estimated savings to the National Health Service and the economy from UKHSA activities in 2022 as exceeding its core budget, while not providing a monetary estimate or methodology in the supplied material.[2]
• Link health-security investment to preventing ill health, reducing disruption to livelihoods and public services, lowering the burden of incidents, and supporting life-sciences growth.[13][2][11]

No explicit funding sources, funding commitments, expenditure totals, resource-mobilisation targets, economic assumptions or cost allocations are specified beyond partnership-based delivery, income generation and the limited comparative prevention-cost example.[16][9][17]