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

Select Committee
Public Accounts Committee HC 932 10 March 2021
Report Status Government responded
Conclusions & Recommendations 23 items (9 recs)
Source View on Parliament website
Government Response (AI assessment · 23 of 23 classified)
Accepted 16
Accepted in Part 1
Acknowledged 2
Deferred 4
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Forty-seventh report from Session 2019-21 · published 31 Aug 2021
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Recommendations & Conclusions

16 results
2 Recommendation Accepted
NHST&T still struggles to consistently match supply and demand for its test and trace services,...
Recommendation
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 Summary
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.
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3 Recommendation Accepted
Although it had to act quickly to scale up the service, NHST&T is still overly...
Recommendation
Although it had to act quickly to scale up the service, NHST&T is still overly reliant on expensive contractors and temporary staff. To scale up the test and trace service rapidly, the Department and NHST&T worked with a wide range … Read more
Government Response Summary
The government accepts the recommendation and states it has implemented a consultancy ramp-down plan to reduce consultant numbers by over 40% by December 2021. This plan includes capability mapping, increased recruitment efforts, replacing consultants with cheaper contractors, and establishing a Commercial Challenge Board for scrutiny of new consultancy requests.
HM Treasury
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4 Recommendation Accepted
The introduction of rapid-results testing was supposed to be a ‘gamechanger’ but confusion persists over...
Recommendation
The introduction of rapid-results testing was supposed to be a ‘gamechanger’ but confusion persists over why and how it should be used in different community settings. Around one-third of people who have coronavirus are asymptomatic. There is now a widespread … Read more
Government Response Summary
The government accepts the recommendation, stating it is reviewing its plan on asymptomatic testing and intends to publish clear information by June 2021 on how and why mass rapid testing will be used, with updates on progress and targets focused on impact and outcomes.
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5 Recommendation Accepted
NHST&T claims to be a learning organisation, but since last May many important stakeholders have...
Recommendation
NHST&T claims to be a learning organisation, but since last May many important stakeholders have at times felt ignored by it. NHST&T emphasises to us that it is “constantly learning what works and what does not” and that it is … Read more
Government Response Summary
The government accepts the recommendation, detailing that NHST&T has significantly extended engagement with partners, updated the Contain Framework, established daily regional team meetings with local authorities, and engages with all sectors through relevant government departments.
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7 Conclusion Accepted
NHST&T’s effectiveness also relies on people complying with its processes, from coming forward to take...
Conclusion
NHST&T’s effectiveness also relies on people complying with its processes, from coming forward to take a test when they have symptoms, to self-isolating in line with requirements. NHST&T noted that the single most important part of the process was people … Read more
Government Response Summary
The government accepts the (implied) recommendation, committing to ongoing and enhanced publication of data on test and trace effectiveness and compliance, including ONS publishing monthly self-isolation data and plans to periodically publish R number estimates by June 2021.
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8 Conclusion Accepted
In September 2020, SAGE concluded that “test and trace was having only a marginal impact...
Conclusion
In September 2020, SAGE concluded that “test and trace was having only a marginal impact on transmission”. NHST&T said that the situation had improved, and highlighted that it was now meeting all its operational performance targets for contact tracing.21 22 … Read more
Government Response Summary
The government accepts the (implied) recommendation, committing to ongoing and enhanced publication of data on test and trace effectiveness and compliance, including ONS publishing monthly self-isolation data and plans to periodically publish R number estimates by June 2021.
HM Treasury
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9 Conclusion Accepted
We found that NHST&T was still struggling to consistently match supply and demand for its...
Conclusion
We found that NHST&T was still struggling to consistently match supply and demand for its test and trace services. In September 2020, NHST&T significantly underestimated the increase in demand for testing, when schools and universities returned.26 Laboratories processing community swab … Read more
Government Response Summary
The government agrees and states the recommendation is implemented, citing a significant increase in PCR testing capacity, improved utilisation of testing sites, revised laboratory structure, increased automation, and more flexible commercial contracts to balance surge capacity with efficiency. For contact tracing, NHST&T has improved forecasting and secured flexible contracts for staff.
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10 Recommendation Accepted
The Department and NHST&T emphasised to us the importance of maintaining excess capacity in the...
Recommendation
The Department and NHST&T emphasised to us the importance of maintaining excess capacity in the test and trace system, due to the difficulty of predicting the pace and direction of COVID-19.29 While we accept the need to build in surplus … Read more
Government Response Summary
The government agrees, stating the recommendation is implemented by significantly increasing PCR testing capacity and improving utilisation through multi-purpose testing sites, revised laboratory structures, and increased automation. NHST&T has also built more flexibility into commercial contracts and improved forecasting for contact tracing to better manage surge capacity and efficiency.
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12 Conclusion Accepted
NHST&T relies on contractors for many of its supplies, services and infrastructure.
Conclusion
NHST&T relies on contractors for many of its supplies, services and infrastructure. The Department stated that, to scale up NHST&T so rapidly, it had used a “blended mix” of civil servants, military support, contractors and consultancy support.40 By the end … Read more
Government Response Summary
The government agrees and has established a consultancy ramp-down plan to reduce the number of consultants by over 40% by December 2021, implementing various mechanisms to achieve this.
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13 Conclusion Accepted
The response to a parliamentary question confirmed that, at the beginning of November 2020, there...
Conclusion
The response to a parliamentary question confirmed that, at the beginning of November 2020, there were 2,300 consultants and contractors working for 73 different suppliers in NHST&T, with a total consultancy cost of approximately £375 million up to that point.43 … Read more
Government Response Summary
The government agrees and has established a consultancy ramp-down plan to reduce the number of consultants by over 40% by December 2021, implementing various mechanisms to achieve this.
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14 Conclusion Accepted
We challenged the Department and NHST&T on the value for money and their scrutiny of...
Conclusion
We challenged the Department and NHST&T on the value for money and their scrutiny of these consultancy contracts and associated spend. On day rates, the Department felt it had mitigations in place, including specifying within contracts that services are to … Read more
Government Response Summary
The government accepts the (implied) recommendation, implementing a consultancy ramp-down plan aiming to reduce consultant numbers by over 40% by December 2021 through mechanisms like recruitment, capability mapping, and a Commercial Challenge Board.
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15 Conclusion Accepted
In December 2020, the Department announced that it would roll out mass Lateral Flow Device...
Conclusion
In December 2020, the Department announced that it would roll out mass Lateral Flow Device (LFD) testing for schools and colleges in the New Year, building on its earlier use at universities.51 LFD tests give results within 20–30 minutes, compared … Read more
Government Response Summary
The government agrees and provides a target implementation date of June 2021, detailing that rapid LFD testing has transitioned from targeted eligibility to a universal offer for all from April 2021, with new pharmacy collect and expanded home delivery options. The department is also reviewing and plans to publish its asymptomatic testing plan.
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16 Conclusion Accepted
A number of significant commentators, including the British Medical Association and British Medical Journal, have...
Conclusion
A number of significant commentators, including the British Medical Association and British Medical Journal, have raised concerns about the effectiveness and risks of mass testing with LFD tests.55 A particular issue raised is the relative accuracy of LFD tests compared … Read more
Government Response Summary
The government accepts the (implied) recommendation, stating it is reviewing its plan on asymptomatic testing and intends to publish clear information by June 2021 on how and why mass rapid testing will be used, with updates on progress and targets focused on impact and outcomes, while taking account of test performance.
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17 Conclusion Accepted
We are aware that the Medicines and Healthcare products Regulatory Agency (MHRA), the government’s regulatory...
Conclusion
We are aware that the Medicines and Healthcare products Regulatory Agency (MHRA), the government’s regulatory body which approves medical devices, approved 51 https://www.gov.uk/government/news/staggered-rollout-of-coronavirus-testing-for-secondary-schools- and-colleges; https://www.gov.uk/government/publications/coronavirus-covid-19-asymptomatic-testing-in- schools-and-colleges/coronavirus-covid-19-asymptomatic-testing-in-schools-and-colleges; https://www.gov.uk/ government/news/all-students-offered-testing-on-return-to-university 52 Qq 13, 16–17, 118 53 C&AG’s Report paras 1.28–1.29 54 Q … Read more
Government Response Summary
The government agrees, confirming that regular rapid testing is vital, and commits to reviewing its asymptomatic testing plan and publishing updates on progress and agreed targets by June 2021.
HM Treasury
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18 Conclusion Accepted
NHST&T told us the biggest lesson it had learnt from the last year was that...
Conclusion
NHST&T told us the biggest lesson it had learnt from the last year was that “you can only deliver this sort of service as an integrated team of all the different organisations, institutions and individuals in the country”. It said … Read more
Government Response Summary
The government accepts the (implied) recommendation, detailing that NHST&T has significantly extended engagement with partners, updated the Contain Framework for local and national roles, and established daily regional team meetings with local authorities to support community testing and broader sector engagement.
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19 Conclusion Accepted
The Department acknowledged that it took the decision to build up tracing capacity centrally at...
Conclusion
The Department acknowledged that it took the decision to build up tracing capacity centrally at the beginning because of the need to do this quickly, but it maintained that there had been “a series of conversations” with local authorities and … Read more
Government Response Summary
The government agrees, stating it has significantly extended engagement with local authorities since December 2020 and updated the Contain Framework to clarify roles and responsibilities in breaking chains of transmission.
HM Treasury
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