Recommendations & Conclusions
23 items
2
Conclusion
Forty-Seventh Report - COVID-19: Test, …
NHST&T still struggles to consistently match supply and demand for its test and trace services, resulting in either sub-standard performance or surplus capacity. We accept the need to build surplus capacity into test and trace services to handle unexpected, sometimes exponential, surges in infections. However, the percentage of total laboratory …
Government response. 2. PAC conclusion: NHST&T still struggles to consistently match supply and demand for its test and trace services, resulting in either sub-standard performance or surplus capacity. 2: PAC recommendation: For all aspects of its testing and tracing operations, NHST&T should …
HM Treasury
3
Conclusion
Forty-Seventh Report - COVID-19: Test, …
Although it had to act quickly to scale up the service, NHST&T is still overly reliant on expensive contractors and temporary staff. To scale up the test and trace service rapidly, the Department and NHST&T worked with a wide range of public and private sector partners, including consultants. By the …
Government response. 3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 Consultants offer quick access to expertise that may otherwise be difficult to recruit – either quickly or indeed at all. They will always have a place but need to …
HM Treasury
4
Recommendation
Forty-Seventh Report - COVID-19: Test, …
The introduction of rapid-results testing was supposed to be a ‘gamechanger’ but confusion persists over why and how it should be used in different community settings. Around one-third of people who have coronavirus are asymptomatic. There is now a widespread roll-out of rapid tests (primarily lateral flow device (LFD) tests, …
Government response. 4.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2021 4.2 Regular rapid tests are a vital tool in helping to identify cases of coronavirus that would otherwise not be found. Around one in three cases show …
HM Treasury
5
Recommendation
Forty-Seventh Report - COVID-19: Test, …
NHST&T claims to be a learning organisation, but since last May many important stakeholders have at times felt ignored by it. NHST&T emphasises to us that it is “constantly learning what works and what does not” and that it is critical to develop “an integrated team of all the different …
Government response. 5.1 The government agrees with the Committee’s recommendation. Recommendation implemented 5.2 The department agree with the committee that NHST&T cannot support citizens and businesses unaided. It is only by working across local and national partners in government, and in critical …
HM Treasury
6
Conclusion
Forty-Seventh Report - COVID-19: Test, …
As we hope for longer-term and sustained reductions in infection levels, the Department needs to think about the future shape of national test and trace services, and how it will secure lasting benefits from its spending. NHST&T will be part of the newly formed National Institute for Health Protection (NIHP). …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: November 2021 6.2 Since its creation in May 2020, NHST&T has set out in periodically updated business plans its strategy for testing and tracing services to respond to the …
HM Treasury
1
Conclusion
Forty-Seventh Report - COVID-19: Test, …
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department), including the NHS Test and Trace Service (NHST&T).1
Government response. Based on a report by the National Audit Office, the Committee took evidence, on Monday 18 January 2021 from the Department of Health & Social Care.The Committee published its report on 10 March 2021. This is the Government’s response to …
HM Treasury
7
Conclusion
Forty-Seventh Report - COVID-19: Test, …
NHST&T’s effectiveness also relies on people complying with its processes, from coming forward to take a test when they have symptoms, to self-isolating in line with requirements. NHST&T noted that the single most important part of the process was people coming forward for testing.18 The National Audit Office also highlighted …
HM Treasury
8
Conclusion
Forty-Seventh Report - COVID-19: Test, …
In September 2020, SAGE concluded that “test and trace was having only a marginal impact on transmission”. NHST&T said that the situation had improved, and highlighted that it was now meeting all its operational performance targets for contact tracing.21 22 It also quoted findings from an “independent verified analysis” which …
HM Treasury
9
Conclusion
Forty-Seventh Report - COVID-19: Test, …
We found that NHST&T was still struggling to consistently match supply and demand for its test and trace services. In September 2020, NHST&T significantly underestimated the increase in demand for testing, when schools and universities returned.26 Laboratories processing community swab tests were unable to keep up with demand, leading to …
HM Treasury
10
Conclusion
Forty-Seventh Report - COVID-19: Test, …
The Department and NHST&T emphasised to us the importance of maintaining excess capacity in the test and trace system, due to the difficulty of predicting the pace and direction of COVID-19.29 While we accept the need to build in surplus capacity to handle surges in infections, we remain concerned that …
Government response. 2.1 The government agrees with the Committee’s recommendation. Recommendation implemented 2.2 Over the past year, the UK government has built the largest network of diagnostic testing facilities in British history. NHST&T now has the capacity to carry out more than …
HM Treasury
11
Conclusion
Forty-Seventh Report - COVID-19: Test, …
For tracing, the Department accepted that, with hindsight, it did not need to scale up central tracing services for May 2020 as quickly as it did. It highlighted the very uncertain environment in April and May and the limited basis it had for estimating the numbers of people it would …
HM Treasury
12
Conclusion
Forty-Seventh Report - COVID-19: Test, …
NHST&T relies on contractors for many of its supplies, services and infrastructure. The Department stated that, to scale up NHST&T so rapidly, it had used a “blended mix” of civil servants, military support, contractors and consultancy support.40 By the end of October 2020, NHST&T had signed 407 contracts worth £7 …
Government response. 3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 Consultants offer quick access to expertise that may otherwise be difficult to recruit – either quickly or indeed at all. They will always have a place but need to …
HM Treasury
13
Conclusion
Forty-Seventh Report - COVID-19: Test, …
The response to a parliamentary question confirmed that, at the beginning of November 2020, there were 2,300 consultants and contractors working for 73 different suppliers in NHST&T, with a total consultancy cost of approximately £375 million up to that point.43 However, when giving evidence to the Science and Technology Committee …
Government response. 3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 Consultants offer quick access to expertise that may otherwise be difficult to recruit – either quickly or indeed at all. They will always have a place but need to …
HM Treasury
14
Conclusion
Forty-Seventh Report - COVID-19: Test, …
We challenged the Department and NHST&T on the value for money and their scrutiny of these consultancy contracts and associated spend. On day rates, the Department felt it had mitigations in place, including specifying within contracts that services are to be obtained from staff at an appropriate grade, rather than …
Government response. 3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 Consultants offer quick access to expertise that may otherwise be difficult to recruit – either quickly or indeed at all. They will always have a place but need to …
HM Treasury
15
Conclusion
Forty-Seventh Report - COVID-19: Test, …
In December 2020, the Department announced that it would roll out mass Lateral Flow Device (LFD) testing for schools and colleges in the New Year, building on its earlier use at universities.51 LFD tests give results within 20–30 minutes, compared with the standard PCR swab tests, which must be sent …
Government response. 4.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2021 4.2 Regular rapid tests are a vital tool in helping to identify cases of coronavirus that would otherwise not be found. Around one in three cases show …
HM Treasury
16
Conclusion
Forty-Seventh Report - COVID-19: Test, …
A number of significant commentators, including the British Medical Association and British Medical Journal, have raised concerns about the effectiveness and risks of mass testing with LFD tests.55 A particular issue raised is the relative accuracy of LFD tests compared to PCR tests and the higher risk of false negatives.56 …
Government response. 4.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2021 4.2 Regular rapid tests are a vital tool in helping to identify cases of coronavirus that would otherwise not be found. Around one in three cases show …
HM Treasury
17
Conclusion
Forty-Seventh Report - COVID-19: Test, …
We are aware that the Medicines and Healthcare products Regulatory Agency (MHRA), the government’s regulatory body which approves medical devices, approved 51 https://www.gov.uk/government/news/staggered-rollout-of-coronavirus-testing-for-secondary-schools- and-colleges; https://www.gov.uk/government/publications/coronavirus-covid-19-asymptomatic-testing-in- schools-and-colleges/coronavirus-covid-19-asymptomatic-testing-in-schools-and-colleges; https://www.gov.uk/ government/news/all-students-offered-testing-on-return-to-university 52 Qq 13, 16–17, 118 53 C&AG’s Report paras 1.28–1.29 54 Q 117 55 For example:https://www.bma.org.uk/news-and-opinion/the-implications-of-rapid-testing-for-nhs-workers; https://www.bmj.com/content/371/bmj.m4436 56 See, for example, https://www.bmj.com/content/371/bmj.m4916 …
Government response. 4.1 The government agrees with the Committee’s recommendation. Target implementation date: June 2021 4.2 Regular rapid tests are a vital tool in helping to identify cases of coronavirus that would otherwise not be found. Around one in three cases show …
HM Treasury
18
Conclusion
Forty-Seventh Report - COVID-19: Test, …
NHST&T told us the biggest lesson it had learnt from the last year was that “you can only deliver this sort of service as an integrated team of all the different organisations, institutions and individuals in the country”. It said it had learned a lot about “how to build this …
Government response. 5.1 The government agrees with the Committee’s recommendation. Recommendation implemented 5.2 The department agree with the committee that NHST&T cannot support citizens and businesses unaided. It is only by working across local and national partners in government, and in critical …
HM Treasury
19
Conclusion
Forty-Seventh Report - COVID-19: Test, …
The Department acknowledged that it took the decision to build up tracing capacity centrally at the beginning because of the need to do this quickly, but it maintained that there had been “a series of conversations” with local authorities and directors of public health. NHST&T stressed that it had always …
Government response. 5.1 The government agrees with the Committee’s recommendation. Recommendation implemented 5.2 The department agree with the committee that NHST&T cannot support citizens and businesses unaided. It is only by working across local and national partners in government, and in critical …
HM Treasury
20
Conclusion
Forty-Seventh Report - COVID-19: Test, …
While we welcome NHST&T’s increasing collaboration with local authorities, we see a need for it to expand its collaboration with a range of other sectors, reflecting the wider scope of the roll-out of rapid testing. In our local constituencies, we heard of lack of engagement with school heads in the …
Government response. 5.1 The government agrees with the Committee’s recommendation. Recommendation implemented 5.2 The department agree with the committee that NHST&T cannot support citizens and businesses unaided. It is only by working across local and national partners in government, and in critical …
HM Treasury
21
Conclusion
Forty-Seventh Report - COVID-19: Test, …
On 18 August, government announced that a new body, the National Institute for Health Protection (NIHP), would subsume NHST&T, the health protection functions of PHE and the Joint Biosecurity Centre. The executive chair of NHST&T is also acting as interim executive chair for NIHP. The establishment of NIHP is due …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: November 2021 6.2 Since its creation in May 2020, NHST&T has set out in periodically updated business plans its strategy for testing and tracing services to respond to the …
HM Treasury
22
Conclusion
Forty-Seventh Report - COVID-19: Test, …
The 2020 Spending Review allocated £15 billion to NHST&T for 2021–22, to be kept under review as the vaccine programme rolled out.77 The government is now accelerating the roll-out of vaccines across the country, but we are yet to see a future strategy for test and trace in response. NHST&T …
Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: November 2021 6.2 Since its creation in May 2020, NHST&T has set out in periodically updated business plans its strategy for testing and tracing services to respond to the …
HM Treasury
23
Conclusion
Forty-Seventh Report - COVID-19: Test, …
Both the Department and NHST&T signalled the opportunity to generate a long- term legacy from the vast public investment in, and expansion of, diagnostic capacity.80 However, they have not yet articulated how this is going to happen: NHST&T told us it was still working through how laboratory infrastructure should “evolve …
Government response. 6.6 The UK Health Security Agency is being formally established in spring 2021 under its new Chair and Chief Executive, and staff and systems will transfer into the new organisation over the following months. PHE and NHST&T have jointly developed …
HM Treasury