COVID-19 tixagevimab/cilgavimab (Evusheld) pre-exposure prophlyaxis National Expert Group minutes request

Louise Bicknell made this Freedom of Information request to NHS England Automatic anti-spam measures are in place for this older request. Please let us know if a further response is expected or if you are having trouble responding.

The request was partially successful.

Dear NHS England,

COVID-19 tixagevimab/cilgavimab (Evusheld) pre-exposure prophlyaxis National Expert Group

Please can you provide me with:

1. the minutes of the meetings; and
2. any associated papers (i.e. submitted to support the agenda items, action logs, follow on paperwork that resulted from the decisions/conclusions of the meetings etc)

of the above National Expert Group dated:

26 April 2022
19 May 2022

Yours faithfully,

Louise Bicknell

CONTACTUS, England (NHS ENGLAND – X24), NHS England

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FOICRM (NHS ENGLAND - X24), NHS England

Dear Louise Bicknell, 

NHS England has assessed your communication as a request under the Freedom
of Information (FOI) Act 2000. As such, please be assured that your
request is being dealt with under the terms of the FOI Act and will be
answered within twenty working days.

For further information regarding the FOI Act, please refer to the
Information Commissioner’s Office (ICO) website. For further information
regarding NHS England and the information it publishes please visit our
website here.

If you have any queries about this request or wish to contact us again,
please email [1][NHS England request email] and the message will be
forwarded appropriately. Please remember to quote the above reference
number in any future communications.

Please do not reply to this email. This message has been sent from a
central mailbox. To communicate with NHS England regarding Freedom of
Information (FOI) requests, enquiries or complaints we ask these are sent
directly to NHS England’s customer contact centre. This is to ensure all
communications are progressed correctly. Their postal address, telephone
number and email details are as follows:- PO Box 16738, Redditch, B97 9PT;
0300 3 11 22 33, [2][NHS England request email].

Yours sincerely,

Freedom of Information
Communications Team
Strategy Directorate

NHS England
PO Box 16738
REDDITCH
B97 9PT

Tel: 0300 311 22 33
Email: [3][NHS England request email] 

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Louise Bicknell left an annotation ()

Referred to the ICO on 9/11/22
Response due 27/11/22

Louise Bicknell left an annotation ()

Referred to ICO for failure to respond 26/12/22

Louise Bicknell left an annotation ()

ICO issued decision notice on 6 February for failure to respond within the statutory time limit. Gave 35 working days to reply. Information still outstanding so following up with the ICO

FOICRM (NHS ENGLAND - X24), NHS England

4 Attachments

Dear Louise Bicknell,   

 
Thank you for your Freedom of Information (FOI) request dated 4 November
2022. Please accept our apologies for the delay in responding to your
request. 
 
Your exact request was: 
 
“COVID-19 tixagevimab/cilgavimab (Evusheld) pre-exposure prophlyaxis
National Expert Group 

 

Please can you provide me with: 

 

1. the minutes of the meetings; and 

2. any associated papers (i.e. submitted to support the agenda items,
action logs, follow on paperwork that resulted from the
decisions/conclusions of the meetings etc) 

 

of the above National Expert Group dated: 

 

26 April 2022 

19 May 2022” 

 

 
 NHS England holds information in relation to your request. 
 
Please find attached the meeting papers, including Agendas and together
with outcome documents in the form of the CMO briefings resulting from
each meeting, for the meetings of the Expert Working Group (EWG) convened
to consider Evusheld on 26 April 2022 and 19 May 2022.  

  

Please note that as the files are too large to be sent in one email they
will be sent in three separate emails. 
 
 
Section 40 (Personal information) 
 
Please note that NHS England considers certain information to be exempt
under section 40 of the FOI Act. 
 
Section 40(2) states that requested information is exempt from disclosure
if the first or the second condition at section 40(3A)(a) of the FOI Act
is satisfied. This is on the grounds that it amounts to personal data and
the first condition under section 40(3A)(a) is satisfied, namely that
disclosure would amount to a breach of the first data protection principle
(personal data should be processed lawfully, fairly and in a transparent
manner) as the individuals concerned would have a reasonable expectation
that these items of personal information would not be disclosed into the
public domain. 
 
We consider that the disclosure of this information could breach an
individual’s confidentiality, as there is a risk that individuals may be
identified if this data is put together with other information that is, or
may become, available on that individual. 
 
In this instance, the name and contact details of all staff members at or
below Agenda for Change Band 9 have been withheld, as have job titles in
instances where the release of that information could be used to identify
individuals who have a reasonable expectation of privacy. Similarly, we do
not release personal details of any individuals who do not work for NHS
England. 
 
Section 41 (Information provided in confidence) 
 
As part of the papers for the meeting on 26 April 2022 the Department for
Health and Social care (DHSC) provided the EWG, in confidence, with a
slide pack titled “Summary of indicative cost effectiveness of Evusheld”
(“the slide pack”). 
 
We are withholding the slide pack in full under section 41(1) of the FOI
Act. 
 
Section 41(1) provides that information is exempt if: 
  
it was obtained by the public authority from any other person (including
another public authority), and 
the disclosure of the information to the public (otherwise than under this
Act) by the public authority holding it would constitute a breach of
confidence actionable by that or any other person. 
 
The test in section 41(1)(a) is met. The slide pack was created by DHSC to
include data provided by Astra Zeneca (AZ) under a signed non disclosure
agreement (NDA) and was provided to NHS England for consideration by the
EWG under the terms of that NDA. 
 
The test in section 41(1)(b) is met if it is showed that disclosure would
amount to an actionable breach of confidence. This means: 
  
the information must have the necessary quality of confidence about it; 
the information must have been imparted in circumstances giving rise to an
obligation of confidence. 
disclosure must amount to an unauthorised use of the information to the
detriment of the confider. 
 
We consider that the withheld information has been obtained by NHS England
and it meets the required threshold under section 41(1)(b) as explained in
detail below. 
  
Quality of Confidence 
 
We consider the information has the necessary quality of confidence in
that it is more than trivial and not otherwise accessible. 
 
The information contained within the slide pack has not been previously
published into the public domain and as far as we are aware, this
information has not been shared in any other forum and would not be
accessible outside of the organisations for which sharing was agreed. 
 
The information includes data, throughout, provided by AZ to DHSC relating
to the therapeutic properties of Evusheld including AZ drug trial data,
pharmacodynamic data and pricing information which was provided in
confidence under a Non-Disclosure Agreement (NDA) to assist in the
formation of recommendations around the potential use of Evusheld as a
prophylactic treatment for COVID 19. As such NHS England considers that
there is a genuine interest in the information provided in the slide pack
remaining confidential. 
 
 
Obligation of Confidence 
 
The information contained within the slide pack was compiled by DHSC in
conjunction with AZ and contains data provided by AZ, under a NDA, for the
sole purpose of informing DHSC and named partner organisations (including
NHS England) of their drug trial data, pharmacodynamic data and pricing
information to aid with consideration of Evusheld as a potential
pre-exposure prophylactic option for COVID 19. It has been confirmed that
the analysis provided in the slide pack was done at pace and was intended
for internal purposes to inform decisions around the use of Evusheld,
based on work with AZ. Commercially sensitive information from medicine
manufacturers is routinely shared with named public bodies under formally
signed and legally binding non-disclosure agreements (NDAs) in order to
allow for this type of internal analysis. On this occasion the NDA was
signed by DHSC with specific provision for disclosure in confidence to NHS
England. 
 
Under pandemic specific arrangements, an EWG is formed to advise the UK
Chief Medical Officers in relation to a specific issue or drug, with its
membership considered accordingly, and will therefore provide specialist
advice in relation to the issue for which it was formed. EWGs, and
therefore NHSE, require a safe space in which to obtain information from
other organisations which will inform the advice process for which they
are convened. The slide pack, containing information provided under the
NDA, was supplied to allow the EWG to carry out its deliberations and make
any recommendations to the CMOs in respect of the potential use of
Evusheld as a prophylactic treatment. Consequently, it would not be
expected that the information would be shared more widely. 
 
As such we consider that there was an explicit and an implicit obligation
of confidence for DHSC (and therefore NHSE) to protect the information
provided by AZ under the NDA and therefore there is a reasonable
expectation that it should not be released. 
 
  
Detriment to the confider 
 
We consider disclosing the slide pack would cause detriment to DHSC, NHS
England and to Astra Zeneca. 
 
The only reason DHSC had access to the information to support the creation
of the slide pack was because it was provided to them under an NDA by AZ.
Release of the information would be likely to inhibit DHSC from being able
to collect relevant sensitive information from 3rd parties to inform its
decision making, as well as that of advisory groups such as the EWG, in
the future as organisations would be unlikely to share information with
DHSC, even under an NDA, if that information were to be released into the
public domain. 
 
DHSC must be able to have a free flow of information between the
organisations it works with, especially in times of crisis such as those
seen during the pandemic, to ensure it can carry out decision making
swiftly and robustly. 
 
DHSC would also suffer detriment on the basis that, through no fault of
its own, it would be in breach of the NDA which it signed with AZ to cover
itself and partner organisations including NHSE, were NHS England to
release the slide pack in response to this request. 
 
We also consider disclosure would cause AZ detriment. The slide pack was
produced by DHSC based on information provided by AZ and contains
commercially sensitive data such as drug trial data, clinical research
information that may not yet be in the public domain, or intelligence on
the progress of medicines going through the regulatory approval process. 
Its disclosure would be likely to cause AZ detriment if disclosed. 
 
Such information is routinely shared by pharmaceutical companies to assist
with decision making and policy formation. It is considered as essential
‘soft data’ which allows groups such as EWGs to obtain a clearer picture
in relation to the drug in question when considering making
recommendations. If, however, this level of information was to be released
into the public domain it could cause detriment to AZ as it would allow
their competitors to understand AZ’s commercial practices and pricing
structures as well as their trial results etc putting AZ at a significant
commercial disadvantage and causing them economic loss. 
 
Companies such as AZ spend significant funds developing drugs and
therefore it would be highly damaging to their interests and commercial
activity if information around the development of a specific drug,
including trial data, pharmacodynamic data and pricing structures were to
be released to the world at large. It is for this reason that such
information was provided by AZ under the NDA due to the detriment that
they would be caused if the information were released. Consequently, AZ
would be able to take action against DHSC if the information were to be
released. 
 
Considering the arguments presented above, we therefore consider
disclosure of the information into the public domain would constitute a
breach of confidence actionable by AZ and also possibly by DHSC. 
 
Section 41 is an absolute exemption; however, the common law duty of
confidence has an inherent public interest test that assumes that
information should be withheld unless the public interest in disclosure
outweighs the public interest in maintaining the duty of confidence. While
there is a public interest in openness and the promotion of accountability
of public authorities in decision making, there is a stronger interest in
maintaining the obligation of confidence as a breach of this confidence
may be actionable by third parties. 
 
In addition, other information relevant to your request and the way in
which the decisions were made by the EWG are being released in response to
the request, including other papers provided to the meeting and Meeting
minutes which were  used alongside the slide pack in the formulation of
advice for the CMO. 
 
In the present circumstances, given the sensitive nature of the
information we hold and the circumstances in which it was obtained, NHS
England does not consider that there is a strong public interest in
disregarding the duty of confidence. 
 
Section 43 (Commercial interests) 
 
Section 43(2) is a prejudice-based exemption which states that information
is exempt if its disclosure under the FOI Act would, or would be likely
to, prejudice the commercial interests of any legal person (including the
public authority holding it). 
 
A commercial interest for this purpose relates to a legal person’s ability
to participate competitively in a commercial activity (i.e., the buying or
selling of goods/services). 
 
The slide pack which is being withheld contains pricing details shared
between AZ and DHSC/NHSE in respect of the potential future use of
Evusheld in the management of COVID 19. Covid-19. It also contains
commercially sensitive data around AZ’s development of the drug. We
consider disclosing these details would prejudice AZ’s commercial
interests as well as those of NHS England. 
 
Astra Zeneca's Commercial interests 
 
Releasing the pricing structure would release information into the public
domain about the confidential discussions  between AZ and DHSC in respect
of the pricing of Evusheld, including any discounts or preferential rates
that are only being made available to the UK. If this information becomes
available to the world at large, through release under FOI, competitors
and rival pharmaceutical companies would have access to information about
AZs financial activity and position which would not normally be available
to them and could be used in their own negotiations to undercut AZ in what
is a highly specialised and competitive market. This would prejudice AZ’s
ability to develop, promote and market the drugs which they develop. 
 
The information could also be used by other global purchasers to drive
their negotiations with AZ as they would have access to details of any
discounted or preferential rates being made available to the NHS. This
would prejudice AZ’s ability to obtain fair market prices for their
products. 
 
 
 
NHS England's Commercial interests 
 
We also consider disclosure of the information contained within the slide
pack would be likely to cause prejudice to NHS England’s commercial
interests. 
 
If the information relating to pricing structure were to be released
companies would be less likely to provide us with competitive or reduced
pricing arrangements if they considered that the information would be
released into the public domain. NHS England needs to be able to enter
into negotiations with pharmaceutical companies in respect of the pricing
of drugs and in order to obtain best value for public money in an industry
where the NHS spends a significant proportion of the NHS budget. Releasing
the details of those negotiations and deals would be likely to prejudice
NHS England’s commercial interests as we would no longer be able to obtain
the same level of ‘value for money’ within the agreements we reach if
companies are even slightly less willing to negotiate pricing details with
us in the same way due to the possibility of disclosure.  Revealing
information such as a pricing mechanism can also be detrimental to
negotiations on other contracts and procurements as if an organisation
knows how we cost a service, it could exploit this in any future
negotiations. 
  
The confidential nature of supplier pricing ensures the NHS can secure
best prices from suppliers through its commercial activities. Companies
will not give the NHS such competitive prices if they believe they will be
released into the public domain. If commercially sensitive and
confidential information, including on discounted/negotiated prices were
to be made available to the world at large it would be likely to result in
the destabilisation or distortion of the entire pharmaceutical market
access and procurement processes in England particularly in respect of
future public procurement and tenders. Therefore, confidentiality is a key
component of these agreements which would be likely to be prejudiced if
the information were to be released into the public domain. 
 
 
Public interest test 
 
Section 43 is a ‘qualified exemption’ and therefore NHS England must
conduct a public interest test, which assesses whether releasing the
information would be in the public interest despite the prejudice test
being satisfied. 
 
NHS England has considered the following points are in favour of
disclosure: 

• Promoting accountability and transparency in the spending of public
money, specifically about activities taking place during the pandemic,
and 

• Allowing individuals and organisations to understand decisions
affecting their lives and to debate or challenge them. 

 
NHS England has also considered the following points are in favour of
non-disclosure: 
  

• The need to protect the supplier’s commercial interests so that
contracting with the NHS does not cause them prejudice. 

• The need to protect NHS England’s ability to obtain best value for
public money in a very high value market. There is a public interest
in allowing NHS England to withhold information where disclosure would
negatively affect its ability to negotiate or to compete in a
commercial environment. 

• Releasing the information would undermine the public interest of
gaining access to newer pharmaceutical treatments at cost effective
prices. 

•  

NHS England has concluded that the balance of the public interest lies in
the information being withheld for the reasons outlined above. 
 
 
Copyright: - NHS England operates under the terms of the open government
licence. Please see the NHS England Terms and conditions on the
following link [1]http://www.england.nhs.uk/terms-and-cond...
 
We hope this information is helpful. However, if you are dissatisfied, you
have the right to ask for an internal review. This should be requested in
writing within two months of the date of this letter. Your correspondence
should be labelled “Internal Review” and should outline your concerns
and/or the area(s) you would like the review to consider. Internal Review
requests should be sent to: 
 
NHS England 
PO Box 16738 
REDDITCH 
B97 9PT 
 
Email: [2][NHS England request email] 
 
Please quote the reference number FOI-2211-1870162 in any future
communications. 
 
 
If you are not content with the outcome of the internal review, you have
the right to apply directly to the Information Commissioner for a
decision. The Information Commissioner’s Office (ICO) can be contacted at
the following weblink: 
  
[3]https://ico.org.uk/global/contact-us/ 
 
 
Please note there is no charge for making an appeal. 
 
Please do not reply to this email. This message has been sent from a
central mailbox. To communicate with NHS England about Freedom of
Information (FOI) requests, enquiries, or complaints we ask these are sent
directly to NHS England’s customer contact centre. This is to ensure all
communications are progressed correctly. Their postal address, telephone
number and email details are as follows: PO Box 16738, Redditch, B97 9PT;
0300 3 11 22 33, [4][NHS England request email]. 
 
Yours sincerely, 
 
Freedom of Information  
NHS England 
  

 

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FOICRM (NHS ENGLAND - X24), NHS England

6 Attachments

Dear Louise Bicknell,

Please find attached additional documents in relation to your request.
 
Yours sincerely,

Freedom of Information Team

NHS England
PO Box 16738
REDDITCH
B97 9PT

Tel: 0300 311 22 33
Email: [1][NHS England request email]
 

 

 

 

show quoted sections

FOICRM (NHS ENGLAND - X24), NHS England

6 Attachments

Dear Louise Bicknell,

Please find attached remaining documents in relation to your request.
 
Yours sincerely,

Freedom of Information Team

NHS England
PO Box 16738
REDDITCH
B97 9PT

Tel: 0300 311 22 33
Email: [1][NHS England request email]
 

 

 

show quoted sections

Dear NHS England,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of NHS England's handling of my FOI request 'COVID-19 tixagevimab/cilgavimab (Evusheld) pre-exposure prophlyaxis National Expert Group minutes request'.

Thank you for providing part of the paperwork requested

Please can you refer this for internal review as a number of papers appear to be missing

Meeting of 26 April 2022

Item 1 refers to the following documents being circulated in advance of the meeting:
-The agenda (I understand that you have lost this)
- Terms of reference (provided)
- Relevant papers including the draft Independent Advisory Group report.

It is unclear from the documents NHS England has provided which ones were provided pre circulated for this meeting or for the subsequent meeting on 19 May 2022, please detail for each document which meeting they were presented at.
.
The Independent Advisory Group Report has not been provided. Please provide this

Item 7 is headed “Cost-effectiveness analysis” and states that an analysis of this was presented. Please provide this presentation

Meeting of 19 May 2022

Item 2 is completely redacted, yet the corresponding item in the meeting of 26 April is not redacted to this extreme extent. Please provide this information with initial of the individuals only redacted

Item 3 refers to the presentation of “a summary of recent evidence“ What papers supported this item?
Also item 3 includes the statement “that high-risk groups may modify their behaviour to less risk-avoidant after taking such a prophylactic agent”. What papers were provided to support this?

Item 4 refers to “[. ] and [. ] (UKHSA) presented evidence from Virus Neutralisation Assays”. What papers supported this item?

Item 5 refers to “an updated pharmacokinetic overview of tixagevimab/cilgavimab “. What papers supported this item?

Please confirm whether Professor James Palmer attended this MAY meeting representing Specialised Commissioning, NHS England and NHS Improvement.

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/c...

Yours faithfully,

Louise Bicknell

Louise Bicknell left an annotation ()

Referred to ICO for failure to respond to request for internal review

Louise Bicknell left an annotation ()

ICO advised to give 40 working days for NHSE to reply to internal review. This has now passed, so sent again to the ICO requesting that they follow up with NHSE on 21 June 2023

FOICRM (NHS ENGLAND - X24), NHS England

1 Attachment

  • Attachment

    20220519 PrEP National Expert Group meeting minutes v0.4 Redacted v2.pdf

    180K Download View as HTML

Freedom of Information Internal Review outcome

Our Ref: FOI-2211-1870162
ICO Ref: IC-240304-T6P5

Dear Louise Bicknell,

We write further to your email of 12 April 2023 in which you requested an
internal review under the Freedom of Information Act 2000 (FOI Act).

The FOI Management team have reviewed your request and this letter
provides an outcome of this review. Please accept our apologies for the
delay in processing your request.

FOI request

On 4 November 2022, you requested the following information:

“COVID-19 tixagevimab/cilgavimab (Evusheld) pre-exposure prophlyaxis
National Expert Group

Please can you provide me with:
 

 1. the minutes of the meetings; and
 2. any associated papers (i.e. submitted to support the agenda items,
action logs, follow on paperwork that resulted from the
decisions/conclusions of the meetings etc)

of the above National Expert Group dated:

26 April 2022
19 May 2022”

NHS England responded to your FOI request on 3 April 2023. In our response
we provided some of the information being requested. Some of the
information was withheld under sections 40, 41 and 43 of the FOI Act.

Internal review request

The full terms of your internal review request have been reproduced below:

“Please can you refer this for internal review as a number of papers
appear to be missing

Meeting of 26 April 2022

Item 1 refers to the following documents being circulated in advance of
the meeting:

• The agenda (I understand that you have lost this)
• Terms of reference (provided)
• Relevant papers including the draft Independent Advisory Group report.

It is unclear from the documents NHS England has provided which ones were
provided pre circulated for this meeting or for the subsequent meeting
on19 May 2022, please detail for each document which meeting they were
presented at.

The Independent Advisory Group Report has not been provided. Please
provide this.

Item 7 is headed “Cost-effectiveness analysis” and states that an analysis
of this was presented. Please provide this presentation.

Meeting of 19 May 2022

Item 2 is completely redacted, yet the corresponding item in the meeting
of 26 April is not redacted to this extreme extent. Please provide this
information with initial of the individuals only redacted.

Item 3 refers to the presentation of “a summary of recent evidence“ What
papers supported this item?

Also item 3 includes the statement “that high-risk groups may modify their
behaviour to less risk-avoidant after taking such a prophylactic agent”.
What papers were provided to support this?

Item 4 refers to “[. ] and [. ] (UKHSA) presented evidence from Virus
Neutralisation Assays”. What papers supported this item?

Item 5 refers to “an updated pharmacokinetic overview of
tixagevimab/cilgavimab “. What papers supported this item?

Please confirm whether Professor James Palmer attended this MAY meeting
representing Specialised Commissioning, NHS England and NHS Improvement.”

ICO’s correspondence

NHS England received correspondence from the Information Commissioner’s
Office (ICO) on 28 July 2023. The ICO advised that you are not challenging
NHS England’s reliance on exemptions, however, you consider there is
further information held in scope of your original request.

The ICO asked NHS England to address all of your outstanding queries by 14
August 2023.

Decision

We have reviewed your request for an internal review and the original
decision has been upheld in part.

In summary:

• We have revised the redactions applied to the declaration of interests
under section 40(2) and disclosed further information.
• We have identified an additional document in scope of your request
which is already published online.

Reasons for decision

Please note, we consider that majority of the points you raised in your
request for an internal review are requests for further information.
However, for ease of handling, we have addressed all of your queries in
this correspondence.

Meeting of 26 April 2022
 

 1. It is unclear from the documents NHS England has provided which ones
were provided pre circulated for this meeting or for the subsequent
meeting on 19 May 2022, please detail for each document which meeting
they were presented at.

Please refer to the table below:
 

File Name Which meeting it was
presented at
2022.03.17.484787v1.full_Redacted.pdf April
n/a – these are the
20220426 PrEP National Expert Group meeting minutes minutes of the meeting
final (2)_Redacted.pdf which took place on 26
April 2022
n/a – this is the
20220519 Evusheld agenda_Redacted (1).pdf agenda for the 19 May
2022 meeting
n/a – these are the
20220519 PrEP National Expert Group meeting minutes minutes of the meeting
v0.4 (2)_Redacted.pdf which took place on 19
May 2022
BA.4 revised TS1 with header (1).pptx May
BA2-BA3-BA4&5 Summary Data 9May22_Oxford (1).pptx May
BA4_BA5_v21 with header_Redacted (1).pdf May
CELL-BA.2.pdf with header_Redacted (1).pdf May
n/a - this document
CMO briefing Evusheld 26 April 2022 (4).pdf was produced following
the meeting in April
n/a - this document
CMO Briefing on Evusheld 25May2022 (1).pdf was produced following
the meeting in May
Evusheld data commentary Updated 16th May May
2022_UKHSA_Redacted (2).pdf
Evusheld EWG TOR_Redacted (4).pdf April
NEJMoa2116620 (3).pdf April
nejmoa2116620_appendix (4).pdf April
s41591-022-01792-5 (3).pdf April
section_53 (3).pdf April

 

 2. The Independent Advisory Group Report has not been provided. Please
provide this.

NHS England confirms that it holds a copy of the Independent Advisory
Group report. However, as the information we hold is already published
online, we will under section 21 of the FOI Act refer you to the published
source:

[1]Higher-risk patients eligible for COVID-19 treatments: independent
advisory group report - GOV.UK (www.gov.uk)

Section 21 of the FOI Act provides an exemption from the right to know if
the information requested is reasonably accessible to the applicant
through other means. This is an absolute exemption which means it is not
subject to the public interest test.
 

 3. Item 7 is headed “Cost-effectiveness analysis” and states that an
analysis of this was presented. Please provide this presentation.

Our original response dated 3 April 2023 confirmed that as part of the
papers for the meeting on 26 April 2022 the Department for Health and
Social care (DHSC) provided the Expert Working Group (EWG), in confidence,
with a slide pack titled “Summary of indicative cost effectiveness of
Evusheld” (“the slide pack”).

We withheld this information in full under section 41 (information
provided in confidence) and section 43 (commercial interests) of the FOI
Act.

We have reviewed the original decision and consider sections 41 and 43(2)
were correctly applied.

With respect to section 41, we consider this information was provided in
confidence to NHS England by a third party and disclosure would constitute
an actionable breach of confidence for the reasons explained in our
original response.

With respect to section 43(2), we consider that we have demonstrated the
exemption is engaged. In respect of the public interest test, NHS England
remain of the view that the public interest is still best served by
withholding this information.

Meeting of 19 May 2022
 

 4. Item 2 is completely redacted, yet the corresponding item in the
meeting of 26 April is not redacted to this extreme extent. Please
provide this information with initial of the individuals only
redacted.

Please refer to the attached document. We have reviewed the redactions
applied under section 40 and upon review, consider some further
information can be disclosed.

The remaining information has been withheld under section 40(2) of the FOI
Act.
 

 5. Item 3 refers to the presentation of “a summary of recent evidence“
What papers supported this item?

We consider this is a request for new information which was not in scope
of your original FOI request dated 4 November 2022.

NHS England does not hold any recorded information in scope of this
question.
 

 6. Also item 3 includes the statement “that high-risk groups may modify
their behaviour to less risk-avoidant after taking such a prophylactic
agent”. What papers were provided to support this?

We consider this is a request for new information which was not in scope
of your original FOI request dated 4 November 2022.

NHS England does not hold any recorded information in scope of this
question.
 

 7. Item 4 refers to “[. ] and [. ] (UKHSA) presented evidence from Virus
Neutralisation Assays”. What papers supported this item?

We consider this is a request for new information which was not in scope
of your original FOI request dated 4 November 2022.

NHS England does not hold any recorded information in scope of this
question.
 

 8. Item 5 refers to “an updated pharmacokinetic overview of
tixagevimab/cilgavimab “. What papers supported this item?

We consider this is a request for new information which was not in scope
of your original FOI request dated 4 November 2022.

NHS England does not hold any recorded information in scope of this
question.
 

 9. Please confirm whether Professor James Palmer attended this MAY
meeting representing Specialised Commissioning, NHS England and NHS
Improvement

We confirm that Professor James Palmer did not attend the meeting which
took place in May.

Review rights

If you are dissatisfied with the responses provided to your new requests
for information, you have the right to ask for an internal review. This
should be requested in writing within two months of the date of this
letter.

If you are not content with our internal review of your original
questions, you have the right to apply directly to the Information
Commissioner for a decision. The Information Commissioner’s Office (ICO)
can be contacted at the following weblink:

[2]https://ico.org.uk/make-a-complaint/foi-...

Please do not reply to this email. This message has been sent from a
central mailbox. All correspondence should be sent to
[3][NHS England request email].

Yours sincerely,

Freedom of Information
NHS England
 

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