Source · Select Committees · Public Accounts Committee
Recommendation 15
15
In 2020–21, NHST&T paid £3.1 billion to secure the laboratory capacity to process PCR tests...
Conclusion
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 sub-standard performance or surplus capacity. We recommended that NHST&T needed to make better use of the capacity it had paid to create and strike a better balance between meeting surges in demand and maintaining timely services.31 However, NHST&T only used a minority of the laboratory and contact centre capacity that it paid for in 2020–21. In December 2020, the NAO found that, for its laboratories, NHST&T set a threshold utilisation rate of 85%, beyond which it felt they could not operate safely or reliably. By June 2021, this figure had been revised to 80%. However, the Chief Executive of the UKHSA told us that the figure was actually closer to 70%. The percentage of laboratory capacity that has been used is well below this. Between November 2020 and April 2021, the average utilisation of NHST&T’s laboratories was 45% and it does not have a target for their utilisation. Over Christmas 2020, when there appeared to be spare laboratory capacity as highlighted in the NAO report, some aspects of NHST&T’s performance nevertheless dipped as cases rose. For example, it provided only 17% of in-person PCR test results within 24 hours in December compared to 38% at the end of October. While NHST&T does have a 50% average utilisation target for its contact centre staff, the highest achieved was 49% at the beginning of January 2021 and this had declined to 11% by the end of February.32
Government Response
Not Addressed
HM Government
Not Addressed
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, maintenance and repair. Operating beyond this 80% utilisation level increases turnaround times for test results and is the level at which there is a risk to quality of service. This significantly reduces the benefits of testing both in health protection terms and as a way of enabling people who test negative to resume normal activities. 4.3 Demand for PCR tests fluctuates significantly. Setting a minimum utilisation target that applies uniformly across a given time period would mean either setting that target at such a low level that it would not be meaningful or having a target that it was not possible to meet on days or weeks of lower demand without artificially stimulating demand for testing leading to unnecessary costs. 4.4 A significant proportion of the laboratory network is contracted on a flexible basis, which means that the UKHSA does not incur costs if tests are not processed. There is not, however, sufficient commercial capacity of the required standard to fully meet projected demand for PCR testing, so it is also essential to retain the core Lighthouse Laboratory network. 4.5 The contact centres that form part of the NHS Test and Trace service are resourced to meet forecast demand. As demand fluctuates from day to day, it is not possible to predict exactly what number of agents should be on shift to meet a set utilisation target. The UKHSA closely manages the performance and utilisation of its contact centres. 4.6 The UKHSA will write to the committee in January 2022 to provide an update on laboratory and contact centre utilisation, including the recent surge in demand. This will cover the first 9 months of 2021-22 and the actions the UKHSA is taking to ensure that capacity in both these areas remains as closely matched to demand as possible.