UK Health Security Agency Strategic Plan 2023 to 2026

Objectives

UK Health Security Agency (UKHSA) is a three-year strategic plan for 2023 to 2026 that aims to prevent, prepare for and respond to infectious diseases and environmental, chemical, radiological and nuclear hazards, saving lives and protecting livelihoods.[1][2]Its overarching ambition is a safer, more resilient and equitable population, society and economy that is less disrupted by health security threats.[3][4]

• Strengthen all-hazards preparedness, prevention, surveillance and rapid response for threats ranging from local outbreaks to pandemics, natural disasters and major public health incidents.[5][6]
• Protect communities, public services, the National Health Service and economic resilience through scientific and operational leadership.[7][8]
• Reduce health inequalities by improving understanding of risks affecting deprived, vulnerable and high-risk groups and tailoring health protection policy, communications and interventions accordingly.[3][9][6]
• Advance infectious disease control through targeted COVID-19 testing, vaccination and surveillance; antimicrobial resistance action; and progress towards World Health Organization disease-elimination goals, including measles, rubella and tuberculosis.[10][11]
• Optimise vaccination by increasing uptake, reducing disparities, strengthening the full vaccine pathway and supporting development of vaccines, therapeutics and diagnostics for unknown threats within 100 days of identification.[12][13]
• Apply a One Health approach linking human, animal, plant and environmental health, while strengthening evidence and interventions for climate-related and environmental health risks.[8][14][6]
• Develop accessible, timely and ethically managed data, surveillance, genomics, diagnostics, analytics and research capabilities to identify threats, inform decisions and improve equitable population health outcomes.[15][16]
• Build a high-performing, sustainable organisation through investment in people, infrastructure, technology, science, partnerships, operational excellence and value for money.[16][17][18]

Implementation

UKHSA delivers the strategy as the nation’s expert health security body and a category 1 responder, combining clinical, public health, scientific, data, analytical, policy and operational capabilities.[4][9]Annual business plans translate the three-year strategy into yearly actions and deliverables, with progress reported monthly to the executive team, quarterly to the Department of Health and Social Care, and annually through published reports and accounts.[3][1]

• Coordinate national and local delivery through nine regional teams that lead or support surveillance, incident management, outbreak control, emergency planning, resilience and mutual aid with local authorities, Directors of Public Health, the National Health Service and other partners.[14][19]
• Scale response capacity proportionately to threat severity and community need, using pre-arranged commercial contracts, specialist deployment, academic collaboration and national surge capability for exceptional demands.[20][5][6]
• Maintain specialist assets including public health microbiology and rare pathogen services, high-containment laboratories, genomic sequencing, diagnostic evaluation, environmental monitoring, radiation protection and chemical-response capability.[8][14]
• Use surveillance, horizon scanning, epidemiology, modelling, genomic sequencing, diagnostics and advanced analytics to detect hazards, assess transmission and impact, identify priority groups, guide interventions and evaluate vaccine effectiveness.[9][14][15]
• Strengthen data infrastructure through a modern enterprise data and analytics platform, reduced data latency, rationalised legacy systems, information-risk management, cyber security and safe sharing of local, national and international surveillance data.[15][16]
• Work across central government, devolved governments, the National Health Service, local government, integrated care bodies, academia, industry, voluntary organisations, communities and international partners.[6][21][19]
• Support UK-wide coordination through the UK Health Protection Committee under the Common Framework on Public Health Protection and Health Security, alongside cooperation with public health agencies in Scotland, Wales and Northern Ireland.[6]
• Deliver international health security activity with the Foreign, Commonwealth and Development Office, World Health Organization and overseas partners, including compliance with the International Health Regulations (2005) and deployment through the UK Public Health Rapid Support Team.[1]
• Govern the agency as an executive agency sponsored by the Department of Health and Social Care, led by a Chief Executive Officer and senior leadership team, advised by a non-executive board, and accountable through ministers and Parliament.[22][18][21]
• Apply accountability, transparency, risk management, sound financial governance and value-for-money principles, while using commercial and business-development partnerships to secure capability, innovation and income in support of the core mission.[3][17][18]

Monitoring & Evaluation

Monitoring and accountability combine surveillance, scientific assessment, operational learning and formal corporate reporting to track delivery of the 2023 to 2026 strategy and its annual business-plan commitments. Progress is reported monthly to the UKHSA executive team and quarterly to the Department of Health and Social Care, with an annual report and accounts published on achievements against strategic priorities.[1]

• Use local, national and international surveillance, horizon scanning, epidemiological analysis, forecasting, threat assessment and data collection to detect emerging infectious, environmental, chemical, radiological and nuclear hazards and inform policy and operational decisions.[9][20][14][23]
• Strengthen pathogen genomics and sequencing to identify strains and variants, detect linked infection clusters, understand transmission and drug resistance, assess vaccine effectiveness, and support outbreak control and vaccine development.[24][14][11]
• Monitor vaccine coverage, infection outcomes, COVID-19 prevalence, variants, transmission and the effects of vaccines and treatments, using modelling, behavioural science, health service science and health economics to guide timely vaccination decisions.[12][10]
• Evaluate programmes and interventions through scientific evidence, modelling, expert advice and analysis of disease burden, including evaluation to support safe and effective vaccination programmes and antimicrobial resistance interventions.[20][6][10]
• Test preparedness through contingency exercises covering varied threats, transmission routes and scenarios, incorporating lessons from previous incidents and the UK COVID-19 Inquiry.[5]
• Share intelligence early and transparently with partners, including local responders, devolved governments and international surveillance networks, to improve situational awareness and coordinated response.[7][8][15]

Accountability is exercised through the UKHSA framework document, ministerial and parliamentary scrutiny, Department of Health and Social Care sponsorship, and Advisory Board challenge and assurance. Non-executive Advisory Board members contribute expertise from health, technology, local government, the military, media and third-sector organisations.[3][18][21]The strategy also emphasises good financial management, risk management, transparency, operational excellence and value for money as organisational accountability requirements.[3]

Performance is framed around rapid and effective responses, prevention or reduction of harm, improved population health outcomes, reduced inequalities and value for money.[4]Operational evidence includes responding to more than 25,000 health security incidents in the preceding year, although this is reported as an activity volume rather than a strategic target.[8]Regional teams contribute through disease surveillance and alerts, investigation and management of cases, incidents and outbreaks, and support to local authorities and the National Health Service.[14][19]

The strategy does not specify a consolidated indicator framework, quantified targets, formal evaluation methodology, independent evaluation arrangements or a comprehensive evaluation timetable.[24][4][11][1]

Costing & Financing

The strategy prioritises value for money, resilient capability and protection of livelihoods, the National Health Service and the wider economy, but does not provide a strategic-plan budget, detailed costings, funding-gap assessment or resource-mobilisation plan.[22][3][1]

• Invest in scientific, clinical, public health, analytical and operational capacity, including laboratories, data and technology platforms, surveillance, cyber security, workforce development and critical infrastructure.[7][8][15][17]
• Use pre-arranged commercial contracts, academic collaboration and public- and private-sector capability to scale rapidly during exceptional health security demands.[5][6]
• Procure vaccines for flexibility and best value for the taxpayer, supported by market engagement, partnerships, health economics capacity and access to multiple developers.[12][13]
• Strengthen commercial and business-development partnerships to generate income from UKHSA capabilities and assets and to access additional resources, capability and innovation.[18][19]
• Manage budgets responsibly through organisation-wide finance functions and pursue an income-generation strategy, although no monetary allocations or income targets are supplied.[20]

Economic value is presented principally through avoided harm: savings for the National Health Service and the economy from UKHSA activities in 2022 were estimated to exceed its core budget, excluding wider public-health benefits to individuals.[4]The source does not quantify either the savings or the core budget.[4]It also cites an illustrative vaccination finding that higher measles, mumps and rubella uptake could have averted the 2012 to 2013 measles outbreak at a cost equivalent to 4% of the final outbreak-management cost.[22]

The sources identify some non-monetised resources, including existing smallpox vaccine stock and additional doses procured for the 2022 mpox response, but do not provide their cost.[23]They do not specify total expenditure, allocations by programme, funding sources, financing gaps, procurement costs, economic assumptions, quantified savings or costing methodologies for the stated strategic priorities.[13][10][11][17]