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45-652: 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

90-515: A chief nursing officer . The chief medical officer is a qualified medical doctor whose medical speciality traditionally was public health medicine, and whose work focused on the health of communities rather than health of individuals. More recently, some appointees have been senior clinicians without training in public health medicine. In the UK, the CMO is one of the chief professional officers who advise

135-543: A PHE director, wrote that the method established in April was designed to avoid undercounting, and that PHE always intended to review the approach as the pandemic progressed. On 2 October 2020, it was realised that almost 16,000 COVID-19 test results received by PHE from commercial laboratories since 25 September had not been loaded into dashboards or passed to the outsourced Test and Trace operation (notifications of test results to individuals were not affected). PHE retrieved

180-429: A background in health, and because of her political position. 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. The timing of the reorganisation, during the ongoing pandemic response, was criticised by various health experts and other bodies, including

225-492: A hand-over period which lasted until Harding departed on 7 May 2021. The responsibilities of the UKHSA include: UKHSA collaborates with Public Health Scotland , Public Health Wales and Northern Ireland's Public Health Agency . 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

270-461: A huge, primary, focus on pandemic response". Over time UKHSA has built a relationship with Korea Disease Control and Prevention Agency , signing a Memorandum of understanding and various visits between the two organisations. 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

315-423: A significant risk to public health remains valid", was asserted in advance of the results having been obtained from a study commissioned by Public Health England to answer the question whether municipal waste incinerators did, in fact, constitute a significant risk to public health. Chief Medical Officers (United Kingdom) Each CMO is assisted by one or more deputy chief medical officers, and complemented by

360-584: A specific and sensitive laboratory test, the availability of which continues to increase. The statement said "the need to have a national, coordinated response remains" and added "this is being met by the government's COVID-19 response ". This meant cases of COVID-19 were no longer managed by HCID treatment centres only. PHE began publishing a weekly COVID-19 epidemiology surveillance summary each Thursday from 23 April, combining community, primary care, secondary care, virology and mortality surveillance data to support national and regional planning in relation to

405-458: The Centre for Evidence-Based Medicine and others – that PHE's figures were over-estimates, since they included anyone who had a positive COVID-19 test, no matter how long ago. On 12 August it was agreed to publish the numbers of deaths within 28 days of a positive test, as was already done by other UK administrations. The cumulative total was recalculated as 41,329, a 12% decrease. John Newton ,

450-554: The Health Protection Agency abolished in 2013." 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. In August 2020 The Telegraph welcomed the change, characterising PHE as

495-563: The Joint Biosecurity Centre and the health protection functions of Public Health England (PHE). 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. Due to the ongoing COVID-19 pandemic , the new organisation

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540-642: The National Treatment Agency for Substance Misuse and a number of other health bodies. It was an executive agency of the Department of Health and Social Care , and a distinct delivery organisation with operational autonomy. On 29 March 2021, the UK Government announced that PHE would be disbanded and that its public health functions would be transferred, in proposals to reform public health structures. From 1 October 2021, PHE's health protection functions were formally transferred into

585-566: The Office for Health Improvement and Disparities . PHE's mission was "to protect and improve the nation's health and to address inequalities". It employed approximately 5,000 staff (full-time equivalent), who were mostly scientists, researchers and public health professionals. It announced plans to move its headquarters and 2,750 staff to Harlow on a former GlaxoSmithKline site in 2017. PHE laboratories provided an extensive range of microbiological diagnostic tests. The Secretary of State set

630-819: The Public Health Observatories , the cancer registries , the National Cancer Intelligence Network , and the UK National Screening Committee together with its screening programmes. The Department of Health and Social Care set out PHE's remit and priorities in a letter to its chief executive. The last of such letters, published in July 2021, included tasks to implement the transition to the UK Health Security Agency and

675-640: The Royal College of Psychiatrists , commenting on the plan to create PHE, stated its concern that there appeared to be "few, or no, commitments or resources within either the Department of Health or Public Health England to take the public mental health agenda forward". The agency was criticised by Professor Martin McKee in January 2014. He said that continuing health inequalities among London boroughs

720-581: The UK Health Security Agency (UKHSA), while its health improvement functions were transferred to the Office for Health Improvement and Disparities ( DHSC ), NHS England , and NHS Digital . Proposals for reorganising the National Health Service were published in the early months of the Cameron–Clegg coalition , in a July 2010 white paper from the Department of Health (under Andrew Lansley ) titled "Equity and excellence: Liberating

765-417: The quango "responsible for many critical failures over the course of this [COVID-19] pandemic" that had to be scrapped. 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. The appointment of Lady Harding as interim executive chair of the new body was criticised by health experts as she did not have

810-540: The COVID-19 pandemic. 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". Selbie apologised to staff that the news of the organisation's demise was briefed to The Telegraph before they were told. In February 2021, Harding said that the new body would not be "fully staffed and up and running" until October 2021. The Institute for Government said that

855-913: The NHS". This was followed by a more detailed paper "Healthy Lives, Healthy People: Our strategy for public health in England" in November. The bill to implement the proposals was introduced to the House of Commons in January 2011, and was the subject of a report by the Health Select Committee in October. Responding to criticism, the government published "Healthy Lives, Healthy People: Update and way forward" in July. The Health and Social Care Act gained royal assent in March 2012, with all elements of

900-633: The UKHSA faced financial uncertainty and big cuts in its first year, frustrating recruitment, even at board level. Staff turnover and a requirement to use a new accounting system contributed to a qualified audit opinion from the National Audit Office . It drew the conclusion that, when a public body is set up, the right premises, staff, budgets and systems are needed at the outset, when swift and successful delivery can be essential to earning public trust – even if resources will need to be scaled back later. On 24 March 2021, Hancock announced that

945-483: The Wellcome Trust, criticised the move to abolish PHE during an ongoing pandemic, with Richard Murray, Chief Executive of The King's Fund, stating that PHE "appears to have been found guilty without a trial" and it is "unclear what problem government are hoping to solve". In response, Hancock said the move was needed to bring together disparate leadership to strengthen the UK's response to the pandemic, and that

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990-544: The annual directive from the Department of Health and Social Care included coordination of the response to public health emergencies under a heading "Leaving the EU". In addition, an "integrated surveillance system" and "investigation and management of outbreaks of infectious diseases" were listed in an annex. PHE carried out contact tracing in the early stages of the COVID-19 pandemic , but this ceased on 12 March 2020 in view of

1035-650: The authority's public health functions including responding to emergencies. As of 2020 there were 134 of these posts. A reorganisation of public health protection in England was announced by the then Secretary of State for Health and Social Care , Matt Hancock , in August 2020. The move was in response to mistakes in decision making during the COVID-19 pandemic, including issues with the supply of personal protective equipment for healthcare workers, low community testing capabilities, and insufficient data resourcing. Several health experts, including Jeremy Farrar, Director of

1080-707: The chair of NHS Improvement since 2017, and at the time was head of the NHS Test and Trace programme, established in May 2020. 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. 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

1125-525: The change would not result in disruption. PHE would be combined with NHS Test and Trace to form a National Institute for Health Protection, under a new leadership structure headed by Conservative peer Dido Harding as interim CEO. Her appointment was later found to be unlawful. Michael Brodie, current CEO of the NHS Business Services Authority , was appointed as interim PHE CEO, replacing Duncan Selbie . In March 2021, it

1170-464: The decision made in March 2021 that these functions would move to "new homes within the health system" including the creation of an Office for Health Protection within the Department for Health and Social Care . This was subsequently re-named the Office for Health Improvement and Disparities and launched 1 October 2021. A few PHE staff moved to NHS England / Improvement or to NHS Digital . While it

1215-692: The editorial in the BMJ , the Institute for Government , the King's Fund , and Christina Marriott, the chief executive of the Royal Society for Public Health . 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. Public Health England Public Health England ( PHE )

1260-494: The government in their respective health and social care disciplines. The CMO has independent statutory authority, first established in the 19th century, to issue reports without requiring government approval. The historic post was created in Victorian times to help to prevent cholera and other epidemics. In 1969, the post of Chief Medical Officer for Wales was created, and prior to this both England and Wales were covered by

1305-711: The major conclusion and message of its report" ... this "raises serious questions not only about the conclusions of the PHE report, but also about the quality of the agency's peer review process." Authors of the PHE report subsequently published a document clarifying that their endorsement of the 95% claim did not stand on the single study criticised in The Lancet , but on their broad review of toxicological evidence. The agency has also been criticised for "serious questions about transparency and conflicts of interest" regarding this review, that PHE's response "did not even begin to address

1350-661: The missing results after determining that the cause was ill-thought-out use of Microsoft's Excel software. Matt Hancock , Health Secretary, said in Parliament that the error "should never have happened". The following month, economists at the University of Warwick estimated that the delayed contact tracing led to more than 125,000 additional infections and 1,500 deaths, although PHE disputed their findings. Public Health England has been criticised for downplaying mental health within its overall resourcing and agenda; in 2011

1395-522: The new government agency. Staff and systems were moved into the new organisation in 2021. PHE continued to have a shadow existence until September 2021. UKHSA became fully operational on 1 October 2021. 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 ,

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1440-404: The new system to be operative by April 2013. The Act established Public Health England as an executive body accountable to the Secretary of State for Health . It took over public health activity from the department and from the regional strategic health authorities (which were abolished), and all activities of the Health Protection Agency , the National Treatment Agency for Substance Misuse ,

1485-490: 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. Harries assumed these roles following

1530-447: The pandemic. From 29 April, PHE collated daily reporting of the number of deaths of people in England with a positive COVID-19 test; the numbers published each day by the UK government had previously only counted deaths in hospital. By July, as the number of deaths continued to fall, PHE reported significantly more deaths than those collated weekly by the Office for National Statistics from death certificates. Concerns were raised – by

1575-784: The post of Chief Medical Officer of England and Wales. Through various reorganisations, the CMOs for Scotland has been the chief medical officer in the Local Government Board for Scotland , Scottish Board of Health, Department of Health for Scotland, the Scottish Home and Health Department, the Scottish Executive Health Department and now the Scottish Government : The Welsh post was created in 1969. Prior to this there

1620-409: The total budget for public health, and determined how it was allocated between PHE and local authorities. The 2012 Act, which established PHE as a national body, also returned the responsibility for a range of community and public health services to local authorities. Each upper tier local authority was required to appoint a director of public health, an officer of the authority who was responsible for

1665-464: The various relationships and funding connections" in question, and that this "adds to questions about the credibility of the organisation's advice". Scientific evidence accumulated since has cast further doubt on PHE's claim. A 2017 question in the House of Lords revealed that a position underpinning UK Government policy, namely "that well run and regulated modern municipal waste incinerators are not

1710-476: The wide spread of infection in the population. From 19 March, consistent with the opinion of the Advisory Committee on Dangerous Pathogens , PHE no longer classified COVID-19 as a "high consequence infectious disease" (HCID). This reversed an interim recommendation made in January 2020, due to more information about the disease confirming low overall mortality rates, greater clinical awareness, and

1755-407: Was a scandal, and claimed coalition reforms had left it unclear who was supposed to analyse health data and tackle the problems highlighted. The agency was criticised by The Lancet for allegedly using weak evidence in a review of electronic cigarettes to endorse an estimate that e-cigarette use is 95% less hazardous than smoking: "it is on this extraordinarily flimsy foundation that PHE based

1800-590: Was an executive agency of the Department of Health and Social Care in England which began operating on 1 April 2013 to protect and improve health and wellbeing and reduce health inequalities. Its formation came as a result of the reorganisation of the National Health Service (NHS) in England outlined in the Health and Social Care Act 2012 . It took on the role of the Health Protection Agency ,

1845-455: Was announced that the new agency would instead be called the UK Health Security Agency , commencing on 1 April and led by Jenny Harries (formerly a regional director at PHE and Deputy Chief Medical Officer for England ). The new UKHSA would focus on infectious disease control, particularly the ongoing COVID-19 pandemic . Options for PHE's other roles, such as preventing ill health and reducing health inequalities, were to be discussed, with

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1890-409: Was created in the Health and Social Care Act 2012 . Campaigns have been run on lung cancer, bowel cancer, oesophago-gastric and kidney & bladder cancer. PHE was also responsible for Change4Life and ACT FAST. In January 2014 it launched a campaign against smoking called 'Health Harms' on television and billboards across England. The bullet points setting out PHE's priorities for 2019/20 in

1935-465: Was not formally established until 1 April 2021, by which time it was called the UK Health Security Agency. It reports directly to the Secretary of State for Health and Social Care . Baroness Harding was the interim executive chair of the new organisation from 18 August 2020 to 7 May 2021. In 2022, the High Court found that her appointment to the position broke equalities legislation. She had been

1980-417: Was originally announced that PHE would be wound up on 31 March 2021, the body continued to have a 'shadow existence' until 1 October 2021, to support the transition of responsibilities to its successor organisations. The PHE name and employment contracts remained until 1 October. PHE had the following public-facing divisions: Duncan Selbie was the chief executive of PHE from its formation until 2020; he

2025-424: Was previously chief executive of Brighton and Sussex University Hospitals NHS Trust . In the reorganisation announced in August 2020, Michael Brodie was appointed as interim CEO. Brodie was finance director at PHE from its formation until 2019, when he became CEO of the NHS Business Services Authority . Other senior personnel include: PHE took over the responsibility for 'Be Clear on Cancer' campaigns after it

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