Test and Trace 2

Public Accounts Committee Closed Inquiry
Opened: 9 Jun 2021 Closed: 5 Aug 2021 Parliament page
In March this year the Committee reported on the “unimaginable” cost of the UK Government’s test and trace programme, which had nonetheless “failed to deliver on the central promise of averting another lockdown” that was used, in part, to “justify the scale of investment”. The Committee will question senior public … Read more
8 Recommendations
17 Conclusions
1 Report
1 Oral session
1 Letter
1 Event
Oral evidence sessions 1 session
Test and Trace 2
Baroness Dido Harding · NHS Test and Trace Dr Jenny Harries OBE · UK Health Security Agency Jonathan Marron · Department for Health and Social Care Shona Dunn · Department of Health and Social Care Sir Chris Wormald · Department of Health and Social Care
Recommendations & Conclusions
25 results
2 Recommendation Not Addressed
Twenty-Third Report - Test and Tra…
Uptake of NHST&T’s services by the public is variable, and some vulnerable groups are currently...
Uptake of NHST&T’s services by the public is variable, and some vulnerable groups are currently much less likely to engage with it. Only a minority of people experiencing COVID-19 symptoms get a test. Between 18% and 33% of people who … Read more
Government Response
The government's response focused entirely on the department's value for money assessment processes and a commitment to include more detailed evidence in future letters to the Committee. It did not address the specific recommendation to report on underrepresented groups in testing or plans to drive up public engagement with NHST&T.
HM Treasury
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3 Recommendation Not Addressed
Twenty-Third Report - Test and Tra…
NHST&T has focussed on getting programmes up and running and paid less attention to ensuring...
NHST&T has focussed on getting programmes up and running and paid less attention to ensuring these programmes delivered the benefits they promised. NHST&T has distributed 691 million lateral flow device (LFD) tests but only 96 million of these have been … Read more
Government Response
The government's response is entirely unrelated to the committee's recommendation regarding the UKHSA's benefits realisation plan and understanding the actual benefits delivered by its spending.
HM Treasury
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4 Recommendation Not Addressed
Twenty-Third Report - Test and Tra…
NHST&T’s approach to laboratory and contact centre usage is still not flexible enough to meet...
NHST&T’s approach to laboratory and contact centre usage is still not flexible enough to meet changing demand and risks wasting public money. In 2020–21, NHST&T paid £3.1bn to secure the laboratory capacity to process PCR tests and £911 million for … Read more
Government Response
The government's response discusses the Defence Equipment & Support (DE&S) and its cost savings and project delivery, which is entirely irrelevant to the recommendation regarding UKHSA's laboratory and contact centre utilisation targets.
HM Treasury
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5 Recommendation Accepted
Twenty-Third Report - Test and Tra…
NHST&T’s continued over-reliance on consultants is likely to cost taxpayers hundreds of millions of pounds.
NHST&T’s continued over-reliance on consultants is likely to cost taxpayers hundreds of millions of pounds. Our previous report found that NHST&T was overly reliant on expensive contractors and temporary staff and recommended that it needed to reduce this. Despite NHST&T … Read more
Government Response
The government agrees and states the UKHSA wrote to the Committee in December 2021 regarding reducing consultant dependency, continues to recruit civil servants, and will provide further progress updates in March and June 2022 as requested.
HM Treasury
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6 Recommendation Not Addressed
Twenty-Third Report - Test and Tra…
UKHSA has still not set out how it would like to work with local authorities,...
UKHSA has still not set out how it would like to work with local authorities, leaving them little time to plan for the new approach. The UKHSA was announced in March 2021 and is expected to be in place by … Read more
Government Response
The government's response discusses defence funding and equipment plans, and provides general background on NHS Test and Trace, entirely failing to address the recommendation for UKHSA and the Department to provide clarity on the future operating model to local government.
HM Treasury
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1 Conclusion Not Addressed
Twenty-Third Report - Test and Tra…
On the basis of a report by the Comptroller and Auditor General, we took evidence...
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), the former Head of the NHS Test and Trace Service (NHST&T), and the Chief Executive … Read more
Government Response
The government acknowledges the committee took evidence based on the NAO report and published its own report, stating that this is the government's response to it, without addressing any specific recommendation.
HM Treasury
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7 Conclusion Rejected
Twenty-Third Report - Test and Tra…
We asked our witnesses whether these figures meant that NHST&T had been given an unrealistic...
We asked our witnesses whether these figures meant that NHST&T had been given an unrealistic objective at the outset. The former head of NHST&T told us that it alone could not prevent a lockdown and that it was one of … Read more
Government Response
The government explicitly rejects the Committee's implied conclusion that NHS Test and Trace was ineffective, citing the Canna Model and policy documents to demonstrate its estimated transmission reduction and role in reducing positive cases.
HM Treasury
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8 Conclusion Not Addressed
Twenty-Third Report - Test and Tra…
In April 2021, the Department identified the Delta form of COVID-19 as a variant of...
In April 2021, the Department identified the Delta form of COVID-19 as a variant of concern and within four weeks it had become dominant in the UK, accounting for 99% of positive cases.13 The Chief Executive of the UKHSA told … Read more
Government Response
The government's response was a non-sequitur, providing only a list of unrelated reports concerning Greensill Capital, and did not address the committee's conclusion regarding the rapid spread of the Delta variant despite genomic sequencing efforts.
HM Treasury
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9 Recommendation Accepted
Twenty-Third Report - Test and Tra…
In our March 2021 report, we concluded that NHST&T published a lot of performance data...
In our March 2021 report, we concluded that NHST&T published a lot of performance data but that this did not demonstrate how effective test and trace was at reducing transmission of COVID-19. We recommended that NHST&T should improve the data … Read more
Government Response
The government stated that NHS Test and Trace developed a performance framework in summer 2020 and the UKHSA regularly publishes and adapts performance information and supporting methodology. It did not explicitly commit to new actions to improve data to specifically demonstrate effectiveness in reducing transmission or conduct periodic evaluations.
HM Treasury
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10 Conclusion Accepted
Twenty-Third Report - Test and Tra…
The Scientific Advisory Group for Emergencies (SAGE) recommends that, for a test and trace system...
The Scientific Advisory Group for Emergencies (SAGE) recommends that, for a test and trace system to be effective, no more than 48 hours should elapse between identifying an original case and their contacts self-isolating. NHST&T routinely monitors the speed with … Read more
Government Response
The government states that NHS Test and Trace developed and continues to adapt its performance framework, and the UKHSA regularly publishes performance information and methodology.
HM Treasury
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11 Conclusion Rejected
Twenty-Third Report - Test and Tra…
Academics and experts have consistently noted that the effectiveness of test and trace systems rests...
Academics and experts have consistently noted that the effectiveness of test and trace systems rests on adherence to their requirements and high levels of compliance by members of the public, but these are still low for NHST&T. Of those people … Read more
Government Response
The government explicitly rejected the committee's conclusion that NHS Test and Trace had not helped break chains of transmission or enable a return to normal life. It cited the Canna Model, estimating a 10% to 28% transmission reduction, and referred to COVID-19 response plans confirming the system's role in reducing positive cases.
HM Treasury
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12 Conclusion Accepted
Twenty-Third Report - Test and Tra…
We asked our witnesses what progress had been made across government to improve self-isolation rates...
We asked our witnesses what progress had been made across government to improve self-isolation rates since we last examined the programme. The Department asserted that it has done significant work, including appointing a cross-government senior officer with responsibility for compliance … Read more
Government Response
The government states that UKHSA is already delivering targeted communications and campaigns, and making testing accessible through community testing programmes, to drive engagement and reach underrepresented groups, further detailing existing efforts.
HM Treasury
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13 Conclusion Accepted
Twenty-Third Report - Test and Tra…
We asked our witnesses about the role of the NHS COVID-19 app in ensuring that...
We asked our witnesses about the role of the NHS COVID-19 app in ensuring that people self-isolate if they need to, particularly given suggestions that some people might delete the app or stop it being enabled in order to avoid … Read more
Government Response
The government states the UKHSA has already delivered targeted communications and campaigns to drive up engagement and made testing more accessible, including through community testing programmes.
HM Treasury
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14 Conclusion Acknowledged
Twenty-Third Report - Test and Tra…
University College London found that older people, men, and people in lower- income households were...
University College London found that older people, men, and people in lower- income households were consistently less likely to request a test following symptoms.25 We asked our witnesses how the test and trace system could be improved to reach those … Read more
Government Response
The government acknowledges the difficulty in setting precise engagement levels due to self-reporting data, but lists several disproportionately impacted and underserved groups that the UKHSA prioritises for improved engagement.
HM Treasury
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15 Conclusion Rejected
Twenty-Third Report - Test and Tra…
In 2020–21, NHST&T paid £3.1 billion to secure the laboratory capacity to process PCR tests...
In 2020–21, NHST&T paid £3.1 billion to secure the laboratory capacity to process PCR tests and £911 million for contact tracing, primarily for contact centres.30 In our March 2021 report, we found that NHST&T struggled to consistently match supply and … Read more
Government Response
The government rejects the recommendation for capacity utilisation targets, arguing that PCR labs require an 80% maximum to maintain quality, demand fluctuates, and a minimum target would be impractical and costly.
HM Treasury
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16 Conclusion Rejected
Twenty-Third Report - Test and Tra…
The Chief Executive of the UKHSA told us that it was “extremely difficult” to predict...
The Chief Executive of the UKHSA told us that it was “extremely difficult” to predict how much NHST&T would spend on laboratory and contact centre capacity or what demand would be for these services. Witnesses assured us that arrangements had … Read more
Government Response
The government rejects the recommendation to establish utilisation targets, explaining it's impractical due to fluctuating demand and potential compromise of service quality, but confirms UKHSA closely manages contact centre performance and will provide a utilisation update.
HM Treasury
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17 Conclusion Accepted
Twenty-Third Report - Test and Tra…
NHST&T does not yet know how it will secure the promised benefits from the laboratory...
NHST&T does not yet know how it will secure the promised benefits from the laboratory infrastructure it has established. NHST&T’s November 2020 business case for a £10 billion expansion of its testing capability stated that a £150 million investment 30 … Read more
Government Response
The government accepts the recommendation, stating UKHSA continues to strengthen its benefits evaluation and will produce a three-year strategic plan, updated annually, detailing how resources will be used to achieve objectives, with a target implementation date of Spring 2022.
HM Treasury
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18 Conclusion Not Addressed
Twenty-Third Report - Test and Tra…
Since October 2020, NHST&T has introduced lateral flow device (LFD) tests to detect infections in...
Since October 2020, NHST&T has introduced lateral flow device (LFD) tests to detect infections in people without symptoms. NHST&T distributed around 691 million LFD tests between October 2020 and May 2021 as part of its plans to roll out regular … Read more
Government Response
The government response provides a general introduction to NHS Test and Trace and context for the report, but does not address the conclusion regarding the low registration rates of LFD tests or the lack of a system to monitor results.
HM Treasury
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19 Recommendation Accepted
Twenty-Third Report - Test and Tra…
Our first report on NHST&T concluded that it was overly reliant on expensive contractors and...
Our first report on NHST&T concluded that it was overly reliant on expensive contractors and temporary staff. We found that by October 2020, it had signed 407 contracts worth £7 billion with 217 public and private organisations. By the end … Read more
Government Response
The government accepts the recommendation, stating UKHSA has reduced consultant dependency and continues to recruit civil servants, while developing a sustainable resource plan with updates due in March and June 2022, aiming for implementation by June 2022.
HM Treasury
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20 Conclusion Accepted
Twenty-Third Report - Test and Tra…
We therefore asked our witnesses why NHST&T’s use of consultants continued to be so high.
We therefore asked our witnesses why NHST&T’s use of consultants continued to be so high. The previous Head of NHST&T explained that up to the end of May 2021, 196 (37%) of the 523 recruitment campaigns run by NHST&T failed … Read more
Government Response
The government agrees, stating the UKHSA has reduced dependency on consultants and continues to recruit civil servants, with plans to develop a sustainable resource strategy and provide further updates in March and June 2022.
HM Treasury
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21 Conclusion Accepted
Twenty-Third Report - Test and Tra…
We again challenged the Department and NHST&T on the value for money of their spend...
We again challenged the Department and NHST&T on the value for money of their spend on consultants. The Department told us the average day rate for consultants was £1,100 but that some would have “undoubtedly” earned more than that. They … Read more
Government Response
The government accepts the recommendation, stating UKHSA has already reduced consultant dependency and continues to recruit civil servants to replace them, while developing a sustainable resource plan, with updates due in March and June 2022.
HM Treasury
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22 Conclusion Accepted
Twenty-Third Report - Test and Tra…
At the time of the NAO’s report, NHST&T provisionally estimated that it had spent £372...
At the time of the NAO’s report, NHST&T provisionally estimated that it had spent £372 million on agency and contractor staff and £195 million on consultancy fees, compared with £52 million on permanent and seconded staff in 2020–21. It had … Read more
Government Response
The government agrees, stating the UKHSA has reduced dependency on consultants and continues to recruit civil servants, with plans to develop a sustainable resource strategy and provide further updates in March and June 2022.
HM Treasury
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23 Recommendation Accepted
Twenty-Third Report - Test and Tra…
Local authorities and public health experts play a vital role in protecting the health of...
Local authorities and public health experts play a vital role in protecting the health of the population. Our previous report on test, track and trace, concluded that many important stakeholders had at times felt ignored by NHST&T. We found that … Read more
Government Response
The government accepts the recommendation, stating UKHSA continues to engage with local government and partners, citing a £2.1 billion fund, and commits to strengthening these partnerships to co-design a future operating model once funding is agreed, with a target implementation date of Spring 2022.
HM Treasury
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24 Conclusion Accepted
Twenty-Third Report - Test and Tra…
Our report in March 2021 on local government finance highlighted how the pandemic had caused...
Our report in March 2021 on local government finance highlighted how the pandemic had caused sudden and severe drops in local authorities’ income, whilst at the same time creating additional financial pressures from the need to deliver new services and … Read more
Government Response
The government agrees and states the UKHSA is working with local authorities and partners to design its future operating model, aiming to strengthen partnerships and facilitate co-design of policies and responses once funding is agreed.
HM Treasury
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25 Conclusion Accepted
Twenty-Third Report - Test and Tra…
From 1 October, NHST&T will become part of the newly created UKHSA.
From 1 October, NHST&T will become part of the newly created UKHSA. We asked witnesses how they were involving local authorities and other stakeholders in designing the model for this new organisation.59 The Department acknowledged that it had not always … Read more
Government Response
The government agrees and states the UKHSA is continuing to work with local government and partners, committing to strengthen these partnerships to co-design the future operating model for health security once funding from the Spending Review 2021 is agreed.
HM Treasury
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Government Response AI assessment · 25 of 8 classified

Total 8 recs + 17 conclusions
Correspondence 1 letter
25 Oct 2021 Correspondence from Sir Chris Wormald, Department of Health and Social Care and Dr Jenny Harries OBE, UK Health, Security Agency, re follow up session Test, Track and Trace part 2, dated 4 August 2021
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