Watchdog questions Dido Harding’s accountability on test and trace

NAO says reliance on outsourced staff to handle tracing calls is unique, after using civil servants deemed “unfeasible”
Peter Byrne/PA Wire/PA Images

By Jim Dunton

11 Dec 2020

Public-spending watchdog the National Audit Office has questioned the governance structure ministers created for NHS Test and Trace – which now has a budget of £22bn – as the nation raced to respond to the coronavirus pandemic.

In an interim report on the government’s approach to testing for Covid-19 in England and following up on positive cases and their contacts, the NAO acknowledged that work had rapidly scaled up from a “low base”. But it also noted thousands of outsourced staff had been left with nothing to do for months.

Baroness Dido Harding was controversially appointed to head up NHS Test and Trace as its executive chair in May.

The NAO said that despite the organisation sitting within the Department for Health and Social Care’s finance, information and staffing controls, Harding reports to prime minister Boris Johnson and cabinet secretary Simon Case, rather than DHSC’s ministers or permanent secretary Sir Chris Wormald.

Today’s report says that while the direct reporting to Johnson and Case was a “clear indication of NHST&T’s importance to government as a whole”, the dual reporting lines brought “risks of unclear accountability”. 

The NAO accepted that it had seen no evidence that those accountability risks had materialised, but said it had not undertaken a systematic review to investigate the issue in depth.

Race-equality thinkntank the Runnymede Trust and the Good Law Project are currently crowdfunding a proposed High Court challenge to the appointments of Harding and two other senior figures in the government’s pandemic response because they were not openly recruited.

Elsewhere, the NAO said DHSC considered using civil servants for call-handling work connected to test and trace’s work, only for the move to be “ruled out as unfeasible”. NHST&T subsequently agreed call-handler contracts with the outsourcers Serco and Sitel for “up to £720m” to deliver 18,000 handlers.

The NAO said that by mid-June, the so-called “utilisation rate” for those staff – reflecting the proportion of time they worked during their paid hours – was just 1%, effectively meaning they had little work to do.

The watchdog said DHSC had “no flexibility to reduce the number of call handlers under the original contracts” and had to wait until they had run their three-month initial course before it could negotiate new terms and reduce staff numbers to 12,000. The NAO said utilisation rates remained “well below a target of 50% throughout September and for much of October”.

“This means substantial public resources have been spent on staff who provided minimal services in return,” it said.

The NAO said an internal government review that looked at the test and trace approaches of 15 other countries found some had used private-sector outsourcing to increase testing capacity, but none had done so to increase tracing capacity. It said that was “generally built up from existing tracing and public health expertise” in the other nations.

NAO head Gareth Davies said it was clear that NHST&T had lessons to learn as it rolled out further changes in Covid-19 testing. He said those lessons included planning against a range of outcomes to ensure the organisation is prepared for spikes in demand, increasing its focus on compliance with self-isolation, and setting out a clear strategy for how national and local tracing teams will work together.

“The government has rapidly increased testing and tracing activity, building significant new infrastructure and capacity from scratch,” Davies said.

“However, it has struggled to test and trace as many people as it has capacity to, or to reach the contacts of people testing positive quickly enough.

“Test and trace is core to the UK’s pandemic response. It must improve its performance with a focus on effective engagement with the public and integration with local efforts to improve tracing.”

Davies said the NAO would explore those issues further when it assessed the value for money of test and trace in the spring.

DHSC said millions of people had discovered whether they have Covid-19 and whether they needed to self-isolate in the months since NHST&T was mobilsed.

“Twenty percent of people in the UK have been tested at least once, more than 41 million tests have been carried out and more than two million people in England have been contacted and notified to self-isolate,” a spokesperson said.

“Turnaround times have been steadily improving over recent weeks, and the latest performance figures show that tracing has dramatically improved, now reaching 85.7% of contacts.”

But the spokesperson acknowledged there was “more to do”.

“We are determined to ensure that NHS Test and Trace plays an even more effective role in stopping the spread of the virus,” they said.

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