Value for Money
The government’s approach to test and trace in England – interim report
Published 11 December 2020
7 recommendations
Department of Health and Social Care
Commercial and financial managementCOVID-19Health and social careLocal governmentLocal services and housingNHSProcurement and contract managementPublic health
nao.org.uk
This interim report provides an overview of test and trace services for addressing COVID-19 in England.
Recommendations (7)
Source: NAO Recommendations Tracker
Department of Health and Social Care
Rec 1
Partially Accepted
No Longer Relevant
We highlight here the most significant risks and issues that NHST&T needs to address in the immediate future. It should:
a) explore how to make fuller use of its theoretical maximum testing capacity each day, so that existing infrastructure and resources are efficiently employed and more of those infected with COVID-19 can be identified and their contacts traced;
Department of Health and Social Care
Rec 2
Partially Accepted
Implemented
b) plan against a range of plausible outcomes to ensure it has flexibility to respond to predictable and unexpected spikes in testing demand. Problems emerged when schools and universities reopened in September, despite a predictable spike in demand. NHST&T also needs to have contingency plans in place so it can respond to unexpected spikes in community testing, in order to provide an effective service, maintain public confidence, and ensure availability of testing for hospital patients;
Department of Health and Social Care
Rec 3
Rejected
c) set out a clear strategy for how national and local tracing teams will work together, informed by a good understanding of local authority capacity and performance. The number of local authority-run schemes is set to increase, and NHST&T needs to be clear about how national and local services align, and who is best placed to carry out activities. It also needs to understand what local authority capacity and funding are required to deliver its objectives;
Department of Health and Social Care
Rec 4
Rejected
d) model and communicate as early as possible how changes in testing policy are likely to affect the workload of national and local tracing services. Such changes could include increased testing of certain categories of key worker and the introduction of mass testing (formerly referred to as Operation Moonshot);
Department of Health and Social Care
Rec 5
Rejected
e) take steps to increase public engagement and compliance with self-isolation. NHST&T is one of a number of bodies, alongside local authorities and the police, who can influence compliance. It must work closely with these bodies, drawing on the best public health and behavioural expertise to identify how its actions can best contribute. For as long as compliance is low, the cost-effectiveness of NHST&T’s activities will inevitably be in doubt;
Department of Health and Social Care
Rec 6
Partially Accepted
Implemented
f) take account to the maximum extent possible of value for money and normal commercial good practice as it procures new infrastructure and services. In particular, it needs to have sufficient flexibility in future contracts to allow government and contractors to respond effectively to changing requirements at reasonable cost; and
Department of Health and Social Care
Rec 7
Accepted
Implemented
g) embed strong and sustainable management structures, controls and lines of accountability. We have noticed arrangements where accountability does not clearly align with organisational and strategic objectives in other aspects of the government’s COVID-19 response. With the creation of the National Institute for Health Protection, there is an opportunity to clarify arrangements.