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UK Vaccine Taskforce
RUNNING THE UK’S VACCINE TASKFORCE
Nick Elliott provides his account of leading the government’s programme to urgently secure and deliver COVID-19 vaccines
It was in March 2020 that the UK’s chief scientific advisor Sir Patrick Vallance decided to act on a thought that vaccines might provide the only way out of the coronavirus pandemic. The focus of government at that time was on providing the correct PPE and getting Test and Trace sorted out. Sir Patrick thought we needed to start thinking about vaccines as the medium- to long-term solution, so he brought together a vaccine expert advisory panel of academics, clinical specialists and industry experts.
At the same time, the BioIndustry Association formed a manufacturing group in support of the advisory panel. This was an important moment, as Steve Bates, its CEO, assembled his members to conduct an audit of vaccine manufacturing capacity in the UK, which became the baseline manufacturing benchmark for the Vaccine Taskforce (VTF), enabling us to identify gaps, what capacity we needed to secure quickly and what we needed to invest in.
This was the genesis of what became the VTF. In April 2020, Kate Bingham, a member of that expert advisory panel, was asked by the prime minister to become the chair of a nascent VTF. At the same time, I was asked to move from my role as deputy chief executive of Defence Equipment & Support in the Ministry of Defence to take on the role of director general (DG) of the VTF and senior responsible owner of the vaccine programme.
Three big, audacious goals
The VTF had three goals. The first was to secure access to a promising COVID-19 vaccine or vaccines for the UK population as quickly as possible. That was about selecting the right vaccines to pursue, making sure the manufacturing capability was in place to deliver them and doing the right commercial deals. Most importantly, it was doing all of that at a rapid pace – we knew we needed to do this as quickly as possible.
The second goal was to make provision for the international distribution of vaccines, as we recognised that getting a solution for the UK was only part of the plan. The third was a legacy goal to support UK industrial strategy by establishing a long-term vaccine strategy to prepare the UK for future pandemics, especially in terms of manufacturing in the UK.
One of the things we needed to do if we were going to be successful was to navigate government processes as quickly and efficiently as possible. We needed to set up an organisation from scratch in an incredibly short period of time, and we needed to create an empowered team capable of delivering those challenging goals. Making that happen was my key responsibility, and the only way to achieve it was to set out from the start a clear vision of what success looked like and to be absolutely focused on delivering that outcome.
Our goal to secure access to a promising vaccine as quickly as possible meant we had to get a team of genuine experts together. It wasn’t a traditional team; it was a ‘rainbow’ team of scientific and industry experts, civil servants, military planners and a few consultants, hosted by government. We brought in a whole host of different people over the next few months, building a team of around 200. We were based in the Department for Business, Energy and Industrial Strategy (BEIS) and we had to go through all of the government
processes, procedures and approvals to get anything done.
Following process was important to ensure accountability of how we were spending taxpayers’ money. However, speed of action was mission critical, so we needed to navigate that process in a way that allowed us to operate at the pace we needed. We needed to focus on outcomes rather than procedure and to do this at speed. The answer was to design bespoke governance and to build trust and confidence with the key decision-makers across all of government, but especially in the Treasury, Cabinet Office and Number 10, and it was about making sure we had an absolutely robust and focused plan against which success could be measured.
Agility through necessity
We found lots of ways to be agile. For example, we had to get approval from four different departments to spend any money, even after we had our portfolio budget approved by the Treasury. We needed sign-off from business secretary Alok Sharma, health secretary Matt Hancock, Lord Theodore Agnew from the Cabinet Office and chief secretary to the Treasury Steve Barclay.
Normally, going through those four different departments and all their teams and briefers would take considerable time and effort, so we got them to agree to come together in a single ministerial panel: the four of them together with one set of papers – and we could call them together at 24 hours’ notice. They were fantastically flexible. That meant that – in one example – we closed a negotiation late at night on a Monday. We put it through BEIS’s internal approvals process by the Thursday, we called the panel together on the Friday evening and by Saturday we had signed the contract.
Four-and-a-half days from the completion of contract negotiation to signing is unheard of in government – that’s the sort of agility we were able to bring. Of course, the imperative of the COVID-19 crisis helped us to achieve this, but there is no reason why the principles can’t be adopted in more normal times. It means putting much greater value on time and speed of decision-making focused on outcomes rather than process.
Nick is now a director at Turner & Townsend
Placing bets
There were more than 200 potential COVID-19 vaccines undergoing some form of development, so how did we decide where to place our bets? It was hugely important that we undertook rigorous expert assessment, but equally important that we used the right selection criteria to pick our portfolio. The criteria we used ensured that we had a selection of different vaccine types, from the traditional inactivated whole virus vaccines to the new and novel mRNA vaccines. But the most important criterion was time – was the vaccine already in the clinic, could it get to human trials quickly and could it be manufactured at pace to ensure it would be available if and when proved safe and effective and approved for use? Not only did we need to decide which vaccines to back, but also where to invest at risk on trials capacity and manufacture. There was a worldwide shortage of manufacturing capacity, so putting this into place for the UK without knowing at that stage exactly which vaccine it was going to be used for was another critical factor in ensuring ultimate success.
Once we had selected our portfolio, our negotiation team, led by Maddy McTernan, a director in UK Government Investments, went to work. But this was not commodity procurement of drugs; we needed to build partnerships and alliances with the companies we wanted to work with and each one of those was very different. For example, the deal with Oxford University and AstraZeneca was for a vaccine that had been developed in the UK with government investment, and Oxford had then brought in AstraZeneca with government support. We put in place government-funded manufacturing capacity and agreed a not-for-profit/ not-for-loss deal which also promoted the international manufacture and distribution of that vaccine. This was a very different negotiation than for the Pfizer-BioNTech vaccine, which had been produced without any initial investment from the UK. Given the unique distribution challenges of the –70°C cold chain of this vaccine, the joint development of a supply and distribution solution between the
Sir Patrick Vallance was quick to identify vaccines as the most likely route out of the pandemic
Kate Bingham chaired the VTF
ORIGINAL STEERING GROUP OF THE VACCINE TASKFORCE
Chair: Kate Bingham Deputy chair: Clive Dix Director general, BEIS: Nick Elliott Director, BEIS: Ruth Todd Director, BEIS: Tim Colley Director, BEIS: Dan Osgood Director, UK Government Investments: Madelaine McTernan National Institute for Health Research: Divya Chadha Manek Manufacturing advisor: Ian McCubbin CEO, BioIndustry Association: Steve Bates Clinical and public health adviser to the VTF: Professor Jonathan Van-Tam
UK and Pfizer became a key part of this deal. The collaborative and close partnership we built ensured that the UK got as much supply as possible, as early as possible.
Getty
Good leadership
My key role as DG was to bring together and lead this unique team and to make sure that the different but complementary skills of those from the public and private sectors came together effectively, while keeping the focus on delivering the outcome. This was achieved through good old-fashioned leadership: setting the vision, building trust, empowering individuals, bringing people together to find solutions and believing in their ability to do so. It was hard work and took time and effort – there was no silver bullet.
In practical terms, it’s important to understand that as a leader you rarely actually deliver anything yourself. It is our people in our programme and project teams who do the work. It is the individual experts within our collective teams who actually know how to get things done in the most effective way. What they need help with is clarity of vision and knowing what success looks like. They need some guidelines to work within and somewhere to go for help and support when required, but most of all they need to be trusted to get on and deliver.
The job of a leader is to make sure that every single person on the team is able to operate at 100 per cent of their individual effectiveness, and that you know what is needed to enable each individual to achieve that. Everybody is different, so everybody will need a different way to enable them to operate like that. It’s about understanding who your people are, what motivates them, what they find easy, what they find difficult, what personal and professional challenges they are coping with and how to overcome them. That all takes time, effort and engagement, which was challenging.
What was also challenging was that we had to do this in an environment where we were working remotely throughout. One of the big challenges that we are all going to face as leaders post-COVID-19 is how we continue to maximise all the benefits of technology to facilitate remote working but still find a way to build meaningful personal relationships at the same time.
Ending on a high
At the end of November 2020, the Pfizer-BioNTech Phase 3 trial results arrived. They proved the vaccine to be both safe and effective. It was an absolutely amazing moment. We’d never known until that point whether or not we would even have a vaccine, and to have the first one proven to be so successful was quite amazing. By 2 December 2020, the UK had approved that vaccine – the first country in the world to do so – and by 8 December, just one week later, Margaret Keenan was the first person to receive it. Within a three-week period, we’d gone from trial results, through regulatory approval, to distribution and deployment. That was a fantastic time for all of us in the VTF, because we knew then that Sir Patrick had been right and vaccines were going to give us a way out of the pandemic.
Listen to Nick’s full account of running the Taskforce in APM’s ‘From the Frontline’ podcast series at apm.org.uk/resources/the-apm-podcast
