Recommendations & Conclusions
25 items
2
Conclusion
Twenty-Third Report - Test and Trace up…
Uptake of NHST&T’s services by the public is variable, and some vulnerable groups are currently much less likely to engage with it. Only a minority of people experiencing COVID-19 symptoms get a test. Between 18% and 33% of people who experience COVID-19 symptoms report getting a test. Some groups, such …
Government response. agree with the Committee’s conclusion. The department assesses the value for money of all its investments. Value for money is evidenced and scrutinised at key approvals and assurance milestones and all programmes in the Government Major Programmes Portfolio must comply …
HM Treasury
3
Conclusion
Twenty-Third Report - Test and Trace up…
NHST&T has focussed on getting programmes up and running and paid less attention to ensuring these programmes delivered the benefits they promised. NHST&T has distributed 691 million lateral flow device (LFD) tests but only 96 million of these have been registered. This represents only 14% of the total so it …
Government response. agree with the Committee’s conclusion. The department recognises the importance of managing supplier performance including the apportionment of financial and programme risk. CAAS (Cost Assurance & Analysis Service) Approvals Team help define specific estimating and scheduling evidence requirements to underpin …
HM Treasury
4
Recommendation
Twenty-Third Report - Test and Trace up…
NHST&T’s approach to laboratory and contact centre usage is still not flexible enough to meet changing demand and risks wasting public money. In 2020–21, NHST&T paid £3.1bn to secure the laboratory capacity to process PCR tests and £911 million for contact tracing, primarily on contact centres. However, NHST&T used only …
Government response. agree with the Committee’s conclusion. The department has a track record of delivering savings; the underlying cost of the Defence Equipment & Support (DE&S) managed element of the Equipment Plan has reduced by £5.4 billion since 2015, excluding Foreign Exchange …
HM Treasury
5
Conclusion
Twenty-Third Report - Test and Trace up…
NHST&T’s continued over-reliance on consultants is likely to cost taxpayers hundreds of millions of pounds. Our previous report found that NHST&T was overly reliant on expensive contractors and temporary staff and recommended that it needed to reduce this. Despite NHST&T committing to reduce the number of consultants it employed, the …
Government response. 5.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2022 5.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it has reduced its dependency on consultants. 5.3 The UKHSA continues to recruit …
HM Treasury
6
Conclusion
Twenty-Third Report - Test and Trace up…
UKHSA has still not set out how it would like to work with local authorities, leaving them little time to plan for the new approach. The UKHSA was announced in March 2021 and is expected to be in place by the end of October 2021. However, NHST&T has still not …
Government response. agree with the Committee’s conclusion. The £16.5 billion extra funding from Spending Review 2020 will support the aims and priorities outlined in the Integrated Review to better counter developing and future threats. Further detail and a breakdown of the £16.5 …
HM Treasury
1
Conclusion
Twenty-Third Report - Test and Trace up…
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), the former Head of the NHS Test and Trace Service (NHST&T), and the Chief Executive of the newly formed UK Health Security Agency (UKHSA) about …
Government response. Based on a report by the National Audit Office, the Committee took evidence on Thursday 08 July from the Department of Health and Social Care, UK Health Security Agency and the former Head of NHST&T. The Committee published its report …
HM Treasury
7
Conclusion
Twenty-Third Report - Test and Trace up…
We asked our witnesses whether these figures meant that NHST&T had been given an unrealistic objective at the outset. The former head of NHST&T told us that it alone could not prevent a lockdown and that it was one of four main tools the Government used to tackle COVID-19. They …
Government response. 1.2 The government does not accept the Committee’s conclusion that NHS Test and Trace had not helped to break chains of transmission nor enabled people to return to a more normal way of life. In September 2021, the government published …
HM Treasury
8
Conclusion
Twenty-Third Report - Test and Trace up…
In April 2021, the Department identified the Delta form of COVID-19 as a variant of concern and within four weeks it had become dominant in the UK, accounting for 99% of positive cases.13 The Chief Executive of the UKHSA told us that even with the benefit of hindsight they could …
Government response. 2021. This is the government’s response to the Committee’s report. Relevant reports • NAO report: Investigation into the British Business Bank’s accreditation of Greensill capital – Session 2021-22 (HC 301) • PAC report: Lessons from Greensill Capital: accreditation to business …
HM Treasury
9
Conclusion
Twenty-Third Report - Test and Trace up…
In our March 2021 report, we concluded that NHST&T published a lot of performance data but that this did not demonstrate how effective test and trace was at reducing transmission of COVID-19. We recommended that NHST&T should improve the data it published so that people were able to get a …
Government response. 1.3 NHS Test and Trace developed a performance framework in summer 2020 and has continued to adapt it as the government’s plans and objectives for its services have developed during the course of the pandemic. The UKHSA regularly publishes performance …
HM Treasury
10
Conclusion
Twenty-Third Report - Test and Trace up…
The Scientific Advisory Group for Emergencies (SAGE) recommends that, for a test and trace system to be effective, no more than 48 hours should elapse between identifying an original case and their contacts self-isolating. NHST&T routinely monitors the speed with which it provides results for PCR tests carried out in …
Government response. 1.3 NHS Test and Trace developed a performance framework in summer 2020 and has continued to adapt it as the government’s plans and objectives for its services have developed during the course of the pandemic. The UKHSA regularly publishes performance …
HM Treasury
11
Conclusion
Twenty-Third Report - Test and Trace up…
Academics and experts have consistently noted that the effectiveness of test and trace systems rests on adherence to their requirements and high levels of compliance by members of the public, but these are still low for NHST&T. Of those people experiencing symptoms of COVID-19, only 18% to 33% get a …
Government response. 1.2 The government does not accept the Committee’s conclusion that NHS Test and Trace had not helped to break chains of transmission nor enabled people to return to a more normal way of life. In September 2021, the government published …
HM Treasury
12
Conclusion
Twenty-Third Report - Test and Trace up…
We asked our witnesses what progress had been made across government to improve self-isolation rates since we last examined the programme. The Department asserted that it has done significant work, including appointing a cross-government senior officer with responsibility for compliance with self-isolation. It explained that it was focussing on three …
Government response. 2.4 To drive up engagement, the UKHSA has delivered targeted communications and campaigns to these groups and made testing more accessible. Through the targeted community testing programme, local authorities and their partners draw on local knowledge to reach underrepresented groups. …
HM Treasury
13
Conclusion
Twenty-Third Report - Test and Trace up…
We asked our witnesses about the role of the NHS COVID-19 app in ensuring that people self-isolate if they need to, particularly given suggestions that some people might delete the app or stop it being enabled in order to avoid having to self-isolate. The Chief Executive of the UKHSA told …
Government response. 2.4 To drive up engagement, the UKHSA has delivered targeted communications and campaigns to these groups and made testing more accessible. Through the targeted community testing programme, local authorities and their partners draw on local knowledge to reach underrepresented groups. …
HM Treasury
14
Conclusion
Twenty-Third Report - Test and Trace up…
University College London found that older people, men, and people in lower- income households were consistently less likely to request a test following symptoms.25 We asked our witnesses how the test and trace system could be improved to reach those who were not currently being reached. The previous Head of …
Government response. 2.3 As the majority of the data used comes from self-reporting, the UKHSA cannot set out the precise levels of engagement among different groups. However, based on research, data and insight from local government, and voluntary and community sector partners, …
HM Treasury
15
Conclusion
Twenty-Third Report - Test and Trace up…
In 2020–21, NHST&T paid £3.1 billion to secure the laboratory capacity to process PCR tests and £911 million for contact tracing, primarily for contact centres.30 In our March 2021 report, we found that NHST&T struggled to consistently match supply and demand for its test and trace services, resulting in either …
Government response. 4.1 The government disagrees with the Committee’s recommendation. 4.2 The laboratory network for PCR (polymerase chain reaction) testing is designed to have sufficient capacity to operate on a 24/7 basis with maximum utilisation of 80% to allow for routine training, …
HM Treasury
16
Conclusion
Twenty-Third Report - Test and Trace up…
The Chief Executive of the UKHSA told us that it was “extremely difficult” to predict how much NHST&T would spend on laboratory and contact centre capacity or what demand would be for these services. Witnesses assured us that arrangements had been put in place for a more flexible approach for …
Government response. 4.1 The government disagrees with the Committee’s recommendation. 4.2 The laboratory network for PCR (polymerase chain reaction) testing is designed to have sufficient capacity to operate on a 24/7 basis with maximum utilisation of 80% to allow for routine training, …
HM Treasury
17
Conclusion
Twenty-Third Report - Test and Trace up…
NHST&T does not yet know how it will secure the promised benefits from the laboratory infrastructure it has established. NHST&T’s November 2020 business case for a £10 billion expansion of its testing capability stated that a £150 million investment 30 C&AG’s report, Figure 6 31 Committee of Public Accounts, COVID-19: …
Government response. 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2022 3.2 Given the nature of the pandemic, UKHSA has focused on rapidly establishing programmes to deliver on the government’s response to the pandemic, including breaking chains of …
HM Treasury
18
Conclusion
Twenty-Third Report - Test and Trace up…
Since October 2020, NHST&T has introduced lateral flow device (LFD) tests to detect infections in people without symptoms. NHST&T distributed around 691 million LFD tests between October 2020 and May 2021 as part of its plans to roll out regular asymptomatic testing. These were initially targeted at specific high-risk groups, …
HM Treasury
19
Conclusion
Twenty-Third Report - Test and Trace up…
Our first report on NHST&T concluded that it was overly reliant on expensive contractors and temporary staff. We found that by October 2020, it had signed 407 contracts worth £7 billion with 217 public and private organisations. By the end of December 2020, this had risen to over 600 contracts. …
Government response. 5.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2022 5.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it has reduced its dependency on consultants. 5.3 The UKHSA continues to recruit …
HM Treasury
20
Conclusion
Twenty-Third Report - Test and Trace up…
We therefore asked our witnesses why NHST&T’s use of consultants continued to be so high. The previous Head of NHST&T explained that up to the end of May 2021, 196 (37%) of the 523 recruitment campaigns run by NHST&T failed to appoint anyone. They told us that this was because …
Government response. 5.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2022 5.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it has reduced its dependency on consultants. 5.3 The UKHSA continues to recruit …
HM Treasury
21
Conclusion
Twenty-Third Report - Test and Trace up…
We again challenged the Department and NHST&T on the value for money of their spend on consultants. The Department told us the average day rate for consultants was £1,100 but that some would have “undoubtedly” earned more than that. They were unable to tell us what NHST&T’s highest paid individual …
Government response. 5.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2022 5.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it has reduced its dependency on consultants. 5.3 The UKHSA continues to recruit …
HM Treasury
22
Conclusion
Twenty-Third Report - Test and Trace up…
At the time of the NAO’s report, NHST&T provisionally estimated that it had spent £372 million on agency and contractor staff and £195 million on consultancy fees, compared with £52 million on permanent and seconded staff in 2020–21. It had not yet completed its year-end checks, and anticipated that the …
Government response. 5.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2022 5.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it has reduced its dependency on consultants. 5.3 The UKHSA continues to recruit …
HM Treasury
23
Conclusion
Twenty-Third Report - Test and Trace up…
Local authorities and public health experts play a vital role in protecting the health of the population. Our previous report on test, track and trace, concluded that many important stakeholders had at times felt ignored by NHST&T. We found that a range of stakeholders had queried why local authorities and …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2022 6.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it continues to work with local government, NHS, the devolved administrations, and other …
HM Treasury
24
Conclusion
Twenty-Third Report - Test and Trace up…
Our report in March 2021 on local government finance highlighted how the pandemic had caused sudden and severe drops in local authorities’ income, whilst at the same time creating additional financial pressures from the need to deliver new services and the increased costs of delivering existing services.54 In 2020–21, NHST&T …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2022 6.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it continues to work with local government, NHS, the devolved administrations, and other …
HM Treasury
25
Conclusion
Twenty-Third Report - Test and Trace up…
From 1 October, NHST&T will become part of the newly created UKHSA. We asked witnesses how they were involving local authorities and other stakeholders in designing the model for this new organisation.59 The Department acknowledged that it had not always got the balance between local and national delivery right. It …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2022 6.2 The UKHSA wrote to the Committee on 16 December 2021 setting out how it continues to work with local government, NHS, the devolved administrations, and other …
HM Treasury