Approach to test, trace and isolate The Government does not believe that its approach to test, trace and isolate should come down to a simple either/or between a national or local approach, but rather that a combined approach is best suited to delivering results. The NHS Test and Trace service was designed to build on existing arrangements and to provide the additional operational capacity required to support PHE's scientific and specialist contact tracing expertise. of Test and Trace activities. Between April and May 2020, Regional Engagement Teams comprised of senior staff from Government Departments were created to liaise and build relationships with local government colleagues. These teams worked with local stakeholders on the placement of test sites, delivering testing to marginalised and digitally excluded groups, and the instigation of local test sites. From the start, NHS Test and Trace has sought to develop a collaborative and integrated approach, for instance through supporting local authorities in developing Local Outbreak Plans and through a contact tracing system that triages more complex cases to local public health teams in some areas. The Government understands that countries that have adopted a solely local model have struggled to cope with the scale of the pandemic. Equally, it is understood that an entirely national model is not an effective approach to managing the pandemic response. The DHSC has always been clear that NHS Test and Trace will not succeed on its own which is why it works hand-in-hand with trusted partners: academics, local public health experts, local authorities and the NHS, as well as employers and local businesses, and communities across the country. Together, testing and contact tracing is delivered, as well as providing tailored support, advice and guidance to keep the virus under control through a ‘team of teams’ approach. supporting their communities through outbreaks. Across the UK, there is close working to ensure effective and timely local delivery of testing and contact tracing, alongside a robust national network. The Government’s intention has always been to build an integrated national and local service from the outset. This includes, for example, the local coordination and deployment of mobile and local test sites as well as the launch and development of local testing partnerships. NHS Test and Trace contributes to the wider government strategy to keep the reproduction rate (R) below 1, through breaking chains of transmission by using testing to identify people who are infected, tracing their contacts (who are at heightened risk of being infected), and promoting successful self-isolation both for confirmed positive cases and their contacts. It also uses the data and intelligence gained from testing and contact tracing to provide crucial insights into where and how the virus is spreading and to help local authorities prevent and manage local outbreaks. Since NHS Test and Trace was launched in May 2020 NHS Test and Trace has conducted more than 156 million PCR and LFD tests have been processed. It has also traced 6.7 million contacts and asked them to self-isolate to help stop the onward spread of the virus. So far, NHS Test and Trace has successfully reached 86.6% of the people who received a positive test result, and 82.3% of their contacts, making a real impact in breaking the chains of transmission to reduce the R number. NHS Test and Trace impact modelling has estimated that the combination of testing, tracing and self-isolation reduced the R number in October 2020 by around 0.3–0.6, compared to a scenario with only social distancing, restrictions and no self-isolation. Feedback on this model was provided in November by expert academics. A technical annex which provides a detailed mathematical description of the impact modelling approach was published on the 11 February 2021.23 Modelling in place can also assess the impact of changes in the Test and Trace programme on R. In addition, the JBC provides actionable information to local and national decision- makers help understand the spread of Covid-19, including how and why it is spreading, what the consequences might be, and how action might best be prioritised to prevent spread. The JBC also provides advice on border controls, contributes to genomic surveillance of the virus to find new strains and will monitor the effect of the vaccine on transmission. The Government is funding local authorities in England in order to support the ongoing public health and outbreak management costs of tackling Covid-19. The Contain Outbreak Management Fund (COMF) will continue at a rate of £4/head/month until 31 March, taking the total in 2020-21 to £1.7 billion. 23 The Rὺm Model technical annex - GOV.UK (www.gov.uk) While the Government is now in a position to look towards an easing of restrictions, it is important to continue to support local authorities to keep doing their most important public health work in respondi