NHS Test and Trace has been one of the most expensive health programmes delivered in the pandemic with an allocated an eye watering £37bn over two years, although it underspent by £8.7 billion in its first year. It has focused on delivering programmes but its outcomes have been muddled and a number of its professed aims have been overstated or not achieved. For the vast sums of money set aside for the programme, equal to nearly 20% of the 2020–21 NHS England budget, we need to see a proper long-term strategy and legacy as it moves into the new UK Health Security Agency (UKHSA.)
In March this year, we reported NHS Test and Trace Service’s (NHST&T) failure to deliver on its central promise of averting another lockdown. Since then, however there have been some improvements. From November 2020 It has significantly increased the number of tests available and reduced the time it takes to provide results. It also increased the proportion of people who have tested positive and their contacts that it reaches, and the speed with which it reaches them, as well as developing the UK’s capacity for genomic sequencing. Despite this, NHST&T has further to go particularly when its architecture and leadership is changing. Urgent improvements are needed regarding public outreach with over 60% of people who experience COVID-19 symptoms reporting that have not been tested, and certain groups such as older people, men, and certain ethnic minorities less likely to engage with the service. When under pressure, as it was over Christmas 2020 and more recently in April, performance deteriorates, with only 17% of people receiving tests within 24 hours in December 2020. In addition, most of the testing and contact tracing capacity that NHST&T paid for has not been used, and despite previous commitments to reduce dependency on consultants, it employed more in April 2021 than in December 2020.If NHST&T is to control spending on consultants it must produce a plan with targets.
NHST&T’s overall goal is to help break the chains of COVID-19 transmission and enable people to return to a more normal way of life, but there have been two national lockdowns since October 2020 and at the time of our evidence session cases were increasing again. It is hard to assess how much of this should be laid at the door of NHST&T, because it has not set out what it specifically needed to do to achieve this objective, and what would be achieved by other policy tools, such as social distancing or temporarily closing parts of the economy.
Finally, NHST&T’s collaboration with local authorities has improved and we were encouraged to hear how local stakeholders are being involved in designing the operating model for the UKHSA, into which NHST&T will be subsumed later this year. The UKHSA will need to get to grips with the issues raised in our report and put in place a sustainable delivery model that makes the best use of national scale and local expertise.