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

4 results

6 Recommendation Deferred

Forty-Seventh Report - COVID-19: T…

As we hope for longer-term and sustained reductions in infection levels, the Department needs to...

As we hope for longer-term and sustained reductions in infection levels, the Department needs to think about the future shape of national test and trace services, and how it will secure lasting benefits from its spending. NHST&T will be part … Read more As we hope for longer-term and sustained reductions in infection levels, the Department needs to think about the future shape of national test and trace services, and how it will secure lasting benefits from its spending. NHST&T will be part of the newly formed National Institute for Health Protection (NIHP). However, the Department has not set out the details or timetable for the establishment of NIHP, scheduled for April 2021. In allocating additional funds to NHST&T, the 2020 Spending Review outlined that this funding will be subject to review as the vaccine programme is rolled out. The Government is now accelerating the roll-out of vaccines across the country, but we have not seen a future strategy for test and trace in response. NHST&T anticipates a continuing need for large-scale testing and tracing alongside the vaccine programme and the Department says it still needs to think through how best to wind down capacity at the appropriate time. The Department and NHST&T talk about leaving a legacy for the NHS through the vast investment in testing capacity, but they have not articulated even at a high level what this will be. We challenged NHST&T whether large testing centres were 8 COVID-19: Test, track and trace (part 1) the best way forward for the NHS, compared to having more testing capacity in local hospitals. NHST&T explained “there is not a single model” and that it is yet to “work through how it should evolve in a post-COVID world”. Recommendation: Within the next six to nine months, the Department should outline publicly its future strategy for testing and tracing services in England, including: • its timetable for transitioning to the new National Institute for Health Protection, • its exit strategy when infection levels reduce, including downscaling, mothballing and reallocating national and local capacity; • how it will cost-effectively maintain a degree of readiness for future surges of COVID-19 and other influenza-like infections; and • how it will Show less

Government Response

The government agrees to outline its future strategy for testing and tracing by November 2021, stating that longer term plans are being considered and will be finalised with the new UK Health Security Agency Chair and Chief Executive before publication.

HM Treasury

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21 Recommendation Deferred

Forty-Seventh Report - COVID-19: T…

On 18 August, government announced that a new body, the National Institute for Health Protection...

On 18 August, government announced that a new body, the National Institute for Health Protection (NIHP), would subsume NHST&T, the health protection functions of PHE and the Joint Biosecurity Centre. The executive chair of NHST&T is also acting as interim … Read more

Government Response

The government agrees with the recommendation to publish details on the transition to the new UK Health Security Agency (UKHSA), setting a target implementation date of November 2021. It confirms the UKHSA is being formally established in spring 2021, with longer-term plans currently under consideration and to be finalised with the new leadership before publication.

HM Treasury

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22 Conclusion Deferred

Forty-Seventh Report - COVID-19: T…

The 2020 Spending Review allocated £15 billion to NHST&T for 2021–22, to be kept under...

The 2020 Spending Review allocated £15 billion to NHST&T for 2021–22, to be kept under review as the vaccine programme rolled out.77 The government is now accelerating the roll-out of vaccines across the country, but we are yet to see … Read more

Government Response

The government agrees with the (implied) recommendation to outline a future strategy by November 2021, stating that longer-term plans are being considered and will be finalised with the new UK Health Security Agency Chair and Chief Executive before publication.

HM Treasury

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23 Recommendation Deferred

Forty-Seventh Report - COVID-19: T…

Both the Department and NHST&T signalled the opportunity to generate a long- term legacy from...

Both the Department and NHST&T signalled the opportunity to generate a long- term legacy from the vast public investment in, and expansion of, diagnostic capacity.80 However, they have not yet articulated how this is going to happen: NHST&T told us … Read more

Government Response

The government states that longer-term plans for the diagnostic capacity legacy are currently under consideration and will be finalised with the new Chair and Chief Executive of the UK Health Security Agency before publication.

HM Treasury

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Government Response AI assessment · 23 of 9 classified

Accepted 16

Accepted in Part 1

Acknowledged 2

Deferred 4

Total 9 recs + 14 conclusions

Correspondence 2 letters

10 Sep 2021 Correspondence from Sir Chris Wormald, Department of Health and Social Care and Dr Jenny Harries OBE, UK Health, Security Agency, re Public Accounts Committee, Forty-Seventh Report of Session 2019-21, COVID-19: Test, Track and Trace (Part 1), dated 22 July 2021

Parliament page

23 Feb 2021 Correspondence from Baroness Harding, Executive Chair, NHS Test and Trace, DHSC & David Williams CB, Second Permanent Secretary, DHSC, re RUM model technical annex final and RUM model technical explainer, dated 11 February 2021

Parliament page