UK Inquiry Tracker

COVID-19: Test, track and trace (part 1)

Public Accounts Committee Closed Inquiry

Opened: 17 Dec 2020 Closed: 17 May 2021 Parliament page

Test and trace programmes are a core public health response in epidemics that can be used with other measures such as social distancing, barriers (such as masks) and handwashing to reduce infections. The basic principles of test and trace are identifying individuals, or groups of individuals, with an infectious disease, … Read more Test and trace programmes are a core public health response in epidemics that can be used with other measures such as social distancing, barriers (such as masks) and handwashing to reduce infections. The basic principles of test and trace are identifying individuals, or groups of individuals, with an infectious disease, and tracing their contacts to limit further transmission. Through early identification, potentially infectious contacts can be encouraged or obliged to reduce interactions with other people, thereby reducing the spread of disease. The National Audit Office’s (NAO) first, interim report on test and trace finds that the government has rapidly scaled up COVID-19 testing and tracing from a low base, but is achieving too few test results delivered within 24 hours and too few contacts of infected people being reached and told to self-isolate. The Department of Health & Social Care (DHSC) rapidly increased testing capacity in England from April and launched the NHS Test and Trace Service (NHST&T) at the end of May to lead the overall test and trace programme. NHST&T’s budget for 2020-21 has grown over time and now stands at £22 billion. Of the £15 billion of funding confirmed before the November Spending Review, around £12.8 billion (85%) is assigned to testing and £1.3 billion to tracing. Much of the additional £7 billion budget allocated in the Spending Review will be needed for mass testing, which was formerly referred to as “Operation Moonshot”. Contracts worth £7 billion have been signed with 217 public and private organisations to provide supplies, services and infrastructure, including test laboratories and call handlers for tracing. NHST&T has plans to sign a further 154 contracts, worth £16.2 billion, by March 2021. In total, 70% of early contracts by value were directly awarded without competition under emergency measures that were in use across government. International comparisons show that outsourcing is a part of many testing systems but is unusual for tracing. A range of stakeholders have queried why the government did not involve local authorities more in its initial approach to tracing, given their previous experience in this area. The government did not document with a business case the basis for the delivery model it initially chose until September. A target to provide results within 24 hours of in-person testing in the community has not been met. Turnaround within 24 hours peaked in June at 93% but subsequently deteriorated to reach a low of 14% in mid-October before rising to 38% in early November. NHST&T did not plan for the sharp rise in testing demand in September when schools and universities reopened. Laboratories processing community swab tests were unable to keep pace with the volume of tests and experienced large backlogs, which meant NHST&T had to limit the number of tests available and commission extra help from other laboratories. Rationing of tests meant some people were told to visit test sites hundreds of miles away. It is important to get hold of people with COVID-19 or who might have been exposed to it quickly so they can self-isolate, but the service saw increases in the time taken to reach people between May and mid-October, before improvements in the last two weeks of October. At times, parts of the national tracing service have barely been used: in May, DHSC signed contracts for the provision of 3,000 health professionals and 18,000 call handlers. The call handler contracts were worth up to £720 million. By 17 June, the utilisation rate (the proportion of time that someone actively worked during their paid hours) was low for both health professional (4%) and call handler staff (1%), indicating that they had little work to do. This means substantial public resources have been spent on staff who provided minimal services in return. National and local government have tried to increase public engagement with tracing, but surveys suggest that the proportion of contacts fully complying with requests to self-isolate might range from 10% to 59%. NHST&T acknowledges that non-compliance poses a key risk to its success and has taken steps to increase levels of self-isolation, for example by making follow-up calls to people while they are self-isolating. For as long as compliance is low, the cost-effectiveness of NHST&T’s activities will inevitably be in doubt. The Committee will question senior officials and executives at DHSC and NHS Test & Trace. If you have evidence on the effectiveness and value for money of the UK’s test and trace programme to date, please submit it here by 6pm on Monday 11 January 2021. Show less

9 Recommendations

14 Conclusions

1 Report

1 Oral session

2 Letters

1 Event

Activity timeline 5 events

10 Sep
2021

Correspondence

Correspondence from Sir Chris Wormald, Department of Health and Social Care and Dr Jenny Harries OBE, UK Health, Security Agency, re Public…

31 Aug
2021

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Forty-seventh report from Session 2019-21

10 Mar
2021

Report published

Forty-Seventh Report - COVID-19: Test, track and trace (part 1)

23 Feb
2021

Correspondence

Correspondence from Baroness Harding, Executive Chair, NHS Test and Trace, DHSC & David Williams CB, Second Permanent Secretary, DHSC, re R…

18 Jan
2021

Oral evidence

COVID-19: Test, track and trace (part 1)

Oral evidence sessions 1 session

18 Jan 2021

View on parliament.uk

COVID-19: Test, track and trace (part 1)

Baroness Dido Harding · NHS Test and Trace David Williams · Daily Mail Jonathon Marron · Public Health England Sir Chris Wormald · Department of Health and Social Care

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
Forty-Seventh Report - COVID-19: Test, track and trace (part 1)	HC 932	10 Mar 2021	23	Responded

Recommendations & Conclusions

16 results

2 Recommendation Accepted

Forty-Seventh Report - COVID-19: T…

NHST&T still struggles to consistently match supply and demand for its test and trace services,...

NHST&T still struggles to consistently match supply and demand for its test and trace services, resulting in either sub-standard performance or surplus capacity. We accept the need to build surplus capacity into test and trace services to handle unexpected, sometimes … Read more

Government Response

The government accepts the recommendation, stating it has implemented measures to improve capacity utilisation, including revising laboratory structures, increasing automation, negotiating flexible commercial contracts aiming for 80% capacity, and improving forecasting and flexible contracts for contact tracing.

HM Treasury

COVID-19: Test, track and trace (part 1)

Activity timeline 5 events

Oral evidence sessions 1 session

Reports 1 report · click to expand

Recommendations & Conclusions

NHST&T still struggles to consistently match supply and demand for its test and trace services,...

Although it had to act quickly to scale up the service, NHST&T is still overly...

The introduction of rapid-results testing was supposed to be a ‘gamechanger’ but confusion persists over...

NHST&T claims to be a learning organisation, but since last May many important stakeholders have...

NHST&T’s effectiveness also relies on people complying with its processes, from coming forward to take...

In September 2020, SAGE concluded that “test and trace was having only a marginal impact...

We found that NHST&T was still struggling to consistently match supply and demand for its...

The Department and NHST&T emphasised to us the importance of maintaining excess capacity in the...

NHST&T relies on contractors for many of its supplies, services and infrastructure.

The response to a parliamentary question confirmed that, at the beginning of November 2020, there...

We challenged the Department and NHST&T on the value for money and their scrutiny of...

In December 2020, the Department announced that it would roll out mass Lateral Flow Device...

A number of significant commentators, including the British Medical Association and British Medical Journal, have...

We are aware that the Medicines and Healthcare products Regulatory Agency (MHRA), the government’s regulatory...

NHST&T told us the biggest lesson it had learnt from the last year was that...

The Department acknowledged that it took the decision to build up tracing capacity centrally at...

Government Response AI assessment · 23 of 9 classified

Correspondence 2 letters