MPs question return on DHSC’s ‘staggering’ £37bn NHS Test and Trace programme

Report flags “persistent reliance” on thousands of consultants, paid up to £6,624 a day and significant unused laboratory capacity for coronavirus tests
Dido Harding PA

By Jim Dunton

10 Mar 2021

The Department of Health and Social Care’s £37bn NHS Test and Trace programme is unable to demonstrate the extent to which its work has slowed the spread of coronavirus, despite its “staggering” cost, according parliament’s Public Accounts Committee.

MPs said that while the operation, led by Conservative peer Baroness Dido Harding, had seen daily Covid testing capacity increase from around 100,000 people in May last year – when it was launched – to 800,000 in January, it was struggling to match demand for its services with supply.

They said the percentage of total laboratory testing capacity used by Test and Trace in November and December 2020 remained under 65%, and that even with the spare capacity, NHS Test and Trace had never met its target to turn around all tests in face-to-face settings in 24 hours.

The report noted that Test and Trace had so far contacted more than 2.5 million people who tested positive for Covid-19 in England and had advised more than 4.5 million of their associated contacts to self-isolate.

But the PAC criticised Test and Trace’s continued reliance on consultants, with around 2,500 people working for day rates ranging from an average of £1,100 to £6,624. Members said it was “concerning” that DHSC was still paying such amounts to so many consultants and that it considered them to be “very competitive rates”.

MPs said Test and Trace should put in place a clear workforce plan and recruitment strategy “to reduce significantly, month by month, its reliance on costly consultants and temporary staff”. They said the programme could learn lessons from ways that other NHS bodies managed the need for additional personnel – such as the creation of staff banks.

The report also called for a step-change in the data published by Test and Trace to give people a better sense of the programme’s effectiveness – something they said the performance figures currently published failed to do. MPs said weekly statistics should include the total time taken to reach contacts after an initial person develops symptoms, data on compliance, and periodic evaluations of Test and Trace’s impact on infection levels.

PAC chair Meg Hillier said Test and Trace had so far cost the nation £23bn from its £37bn allocated funding, which she said was roughly the annual budget of the Department for Transport.

“Despite the unimaginable resources thrown at this project Test and Trace cannot point to a measurable difference to the progress of the pandemic, and the promise on which this huge expense was justified – avoiding another lockdown – has been broken, twice,” she said.

“DHSC and NHST&T must rapidly turn around these fortunes and begin to demonstrate the worth and value of this staggering investment of taxpayers' money. Not only is it essential it delivers an effective system as pupils return to school and more people return to their workplace, but for the billions of pounds spent we need to see a top-class legacy system.

“British taxpayers cannot be treated by government like an ATM machine. We need to see a clear plan and costs better controlled."

The PAC’s recommendations also included a call for DHSC to publicly detail its future strategy for testing and tracing services in England over the next six to nine months.

MPs said the department needed to outline its plans for transitioning to the National Institute for Health Protection, which will succeed Public Health England and which has Harding as its interim executive chair.

They said DHSC also needed to set out its exit strategy for when Covid infection levels reduce, including “downscaling, mothballing and reallocating national and local capacity”, and how it will maintain readiness for future surges of Covid-19 and other influenza-like infections in a cost-effective way.

Additionally, MPs said the department had to explain how it would work with the NHS, public health and local government bodies to “secure continued benefit” from the assets and infrastructure it has created in response to the pandemic.

In a response issued by DHSC, Harding said NHS  Test and Trace was an essential part of the nation’s fight against Covid-19 and that regular testing was a vital tool to stop transmission as the restrictions were eased.

“Protecting communities and saving lives is always our first priority and every pound spent is contributing towards our efforts to keep people safe – with 80% of NHS Test and Trace’s budget spent on buying and carrying out coronavirus tests,” she said.

“After building a testing system from scratch, we have now carried out over 83 million coronavirus tests – more than any other comparable European country – and yesterday alone we conducted over 1.5 million tests.

“We are now rolling out regular rapid asymptomatic testing which is supporting children to go back to school, people to go to work and visitors to see their loved ones in care homes.

“NHS Test and Trace has successfully reached 93.6% of the contacts of positive cases – with 98% being contacted within 24 hours, and the contact-tracing service has already reached more than 9.1 million cases and contacts, making a real impact in breaking chains of transmission.”

DHSC added that it had begun reducing the use of consultants on the Test and Trace programme and that plans were in place to continue scaling back numbers over the coming months.

It said all consultants working for NHS Test & Trace were contracted under standard government terms and conditions, with “appropriate transparency and controls”.

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