Health Protection Agency

Health Protection Agency
Agency overview
Formed	2003
Preceding agencies	Public Health Laboratory Service; Microbiological Research Authority; National Focus for Chemical Incidents; National Radiological Protection Board (2005); National Institute for Biological Standards and Control (2009);
Dissolved	2013
Superseding agencies	Public Health England ; (2013–2021); UK Health Security Agency; (2021–Present);
Jurisdiction	England
Headquarters	London SW1
Employees	3,155 (2,831 at HPA and 324 NRPB)
Annual budget	£244.7 million (2008–2009)
Minister responsible	Secretary of State for Health;
Parent agency	Department of Health
Website	www.hpa.org.uk

The Health Protection Agency (HPA) was a non-departmental public body in England.^[1] It was set up by the UK government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards.^[2]

The HPA's role was to provide an integrated approach to protecting public health in the UK. It did this by providing advice and information to the general public, health professionals and local government, and by providing emergency services, support and advice to the National Health Service (NHS) and the Department of Health. The HPA also played a lead role in helping prepare for new and emerging health threats, such as bioterrorism or emerging virulent disease strains. A practical application of this role occurred during the 2009 H1N1 pandemic, where the agency moved beyond advisory functions to lead the UK’s frontline response, managing the transition from initial containment to nationwide treatment strategies.^[3]

There were four HPA centres – at Porton Down in Salisbury, Chilton in Oxfordshire, South Mimms in Hertfordshire, and Colindale in NW London. In addition, the HPA had regional laboratories across England and administrative headquarters in Central London. On 1 April 2013, the HPA minus the South Mimms site became part of Public Health England, a new executive agency of the Department of Health (DoH). The National Institute for Biological Standards and Control (NIBSC) located in South Mimms was merged with the Medicines and Healthcare products Regulatory Agency (MHRA).

History

The Health Protection Agency (HPA) was originally established as an NHS special health authority in 2003. On 1 April 2005, the Agency became a non-departmental public body, with the National Radiological Protection Board (NRPB) being merged into the organisation at the same time.

The origins of the HPA's largest facility in Porton Down can be traced back to 1940, when Porton had a highly secret and independent 'Biology Department' under the Ministry of Defence to study biological warfare and defence against it. By 1946 it was called the 'Microbiological Research Department', and from 1951 the 'Microbiological Research Establishment', with research becoming increasingly defensive and civilian in nature. Total civilian control was established by moving biological defence work to the Chemical Defence Establishment (now dstl), and renaming the facility from 1 April 1979 as the Centre for Applied Microbiology and Research (CAMR) within the Public Health Laboratory Service (PHLS). In April 1994, CAMR moved from PHLS centre to the Microbiological Research Authority (MRA), reporting to the Department of Health and continuing the programme in civil microbiological research started in 1979.

Microbiology Services remained the biggest of the four Divisions within the HPA with 1800 staff, consisting of laboratory groups from the Centre for Emergency Preparedness and Response, the Centre for Infections, eight regional microbiology laboratories and 37 collaborating hospital laboratories. Together, these laboratories provided frontline diagnostic and public health microbiology services to NHS trusts and HPA health protection units. Its remit included infectious disease surveillance, providing specialist and reference microbiology and microbial epidemiology, coordinating the investigation and cause of national and uncommon outbreaks, helping advise government on the risks posed by various infections and responding to international health alerts. In addition, both basic and applied research was undertaken to understand infectious diseases, and the group manufactured a number of healthcare products including vaccines and therapeutics. For instance, the HPA was the sole licensed manufacturer of anthrax vaccine in the UK.^[4]

In 2008, the agency further extended its operational scope by coordinating a comprehensive assessment of public health capacities across 25 European overseas countries and territories. Commissioned by the ECDC, this initiative required the HPA to lead a consortium of health institutes from France, the Netherlands, and Denmark. This role effectively positioned the agency as a technical bridge, harmonizing infectious disease surveillance and response strategies across remote jurisdictions in the Caribbean, Pacific, and Atlantic regions.^[5]

After dissolution

On 1 April 2013, the Health Protection Agency was merged into Public Health England (PHE), an executive agency of the Department of Health.

In August 2020, the UK Government announced that PHE would be replaced by a new organisation, the UK Health Security Agency (UKHSA), which formally launched on 1 April 2021. The health improvement functions of PHE were transferred to the Office for Health Improvement and Disparities (OHID), also within the Department of Health and Social Care.

Funding

HPA was accountable to the UK Secretary of State for Health, and was funded primarily by Government Grant in Aid. Other income was received from the NHS, commercial activities, grants, and other sources. HPA’s income for the fiscal year ending 31 March 2008, was £160.2 million from Revenue Government financing plus £109.2 million total operating income.^[6] Total average staff numbers for that year, including secondments and agency staff, were 3,394 staff.

Organisation

Following consultation during April 2010, the HPA was organised into four groups: Microbiology Services, Health Protection Services, Biological Standards and Control, and the Centre for Radiation, Chemical and Environmental Hazards.

Microbiology Services

The Division included laboratory groups from the Centre for Infections, Centre for Emergency Preparedness and Response, the Regional Microbiology Network and their associated supports. The remit of the Centre included infectious disease surveillance, providing specialist and reference microbiology and microbial epidemiology, coordinating the investigation and cause of national and uncommon outbreaks, helping advise government on the risks posed by various infections and responding to international health alerts. During the early stages of the 2009 flu outbreak, these services implemented rigorous diagnostic algorithms across the agency's regional laboratory network. This involved extensive nose and throat swab testing to precisely map transmission chains within localized clusters, such as schools and social groups.^[3]

The Centre for Emergency Preparedness and Response prepared for and coordinated responses to potential healthcare emergencies, including possible acts of deliberate release. In addition, both basic and applied research were undertaken into understanding infectious diseases and the Centre manufactured a number of healthcare products, including vaccines and therapeutics. Internationally recognised as a world leader in microbiology research and testing, HPA's Porton Down Centre worked with foreign governments, international biotechnology and pharmaceutical corporations, and start-up and spin-out companies. The strategic goal of the Centre was "to build on and develop the intellectual assets of the organisation in partnership with industry." Areas of expertise include: bacterial vaccines, toxin therapeutics, Good Laboratory Practice (GLP) and in-vivo testing of compounds, biodefence and biosafety testing, diagnostics, and the provision of cell cultures.

The agency’s microbiology expertise was instrumental in identifying systemic vulnerabilities within remote health systems. Through its leadership in the 2008 assessment, the HPA documented significant limitations in laboratory infrastructure and human resource availability across various territories. By flagging these deficiencies, the agency helped establish a roadmap for strengthening early detection and surveillance frameworks, ensuring that isolated populations could better align with international health standards.^[5]

The Regional Microbiology Network was composed of eight regional microbiology laboratories. In addition, 37 hospital microbiology laboratories participated as HPA collaborating laboratories. Together, these laboratories provided frontline diagnostic and public health microbiology services to NHS trusts and HPA health protection units.

Research conducted by agency specialists during field investigations also contributed to global epidemiological data. For instance, studies into the 2009 pandemic revealed that attack rates were significantly higher in prolonged indoor settings, like classrooms, compared to transient environments such as public transport, helping to refine international models for respiratory pathogen transmission.^[3]

In the field of epidemiological methodology, the HPA utilized the case-cohort study design for its outbreak investigations. This approach was implemented to address the time and resource constraints often encountered during field research. By adopting this design, the agency was able to obtain direct risk ratio estimates, which are particularly relevant for assessing vaccine effectiveness and point-source outbreaks. This framework allowed for the investigation of multiple health outcomes using a single control group, a practice that was applied in various scenarios, including the investigation of concurrent gastrointestinal outbreaks.^[7]

Health Protection Services

This Division comprised two nationally organised services, each with their own head: LaRS and a new National Epidemiology Service. Combining these services into one grouping was intended to facilitate and reinforce close team working among those with skills relevant to delivering effective and consistent responses to significant health protection threats. LaRS provided support to the front line response by coordinating services at the regional and local level. It was a source of specialist advice and operational support, and it contributed actively to policy making and implementation in partnership with other HPA divisions and with the NHS, local authorities and other agencies. This partnership was vital during the H1N1 containment phase, where HPA-led risk assessments guided local authorities in the temporary closure of educational institutions and the targeted distribution of antiviral prophylaxis.^[3]

The agency’s role as a regional coordinator culminated in October 2009, when the HPA hosted a major stakeholder summit in London. This meeting focused on synthesizing epidemiological data and addressing the specific health needs of diverse territories. By integrating local syndromic surveillance with international health regulations, the HPA facilitated a more cohesive response to infectious disease threats across the EU-associated territories.^[5]

Centre for Radiation, Chemical and Environmental Hazards (CRCE)

The Centre for Radiation, Chemical and Environmental Hazards comprised the Radiation Protection Division (formerly the National Radiological Protection Board) and the Chemical Hazards and Poisons Division. The base for the Centre was in Chilton, Oxfordshire.

National Institute for Biological Standards and Control (NIBSC)

The National Institute for Biological Standards and Control's (NIBSC) mission was to assure the quality of biological medicines. At the heart of the work was the preparation, storage and worldwide distribution of World Health Organization international standards and reference materials to provide benchmarks for product quality. In addition NIBSC provided testing services as the UK's Official Medicines Control Laboratory to ensure compliance with product specifications. These activities and advice provided by NIBSC were underpinned by leading edge scientific research covering a wide range of scientific disciplines. In April 2013, the NIBSC left the HPA and was merged with the UK's Medicines and Healthcare products Regulatory Agency.