Source · Select Committees · Public Accounts Committee
Recommendation 16
16
The Chief Executive of the UKHSA told us that it was “extremely difficult” to predict...
Conclusion
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 both laboratories and contact centres.33 Between September and November 2020, NHST&T set up a cross-government team with commercial and contracting expertise to strengthen contract and operational management. The NAO found that since November, NHST&T had built more flexibility into its contact centre contract to allow it to adjust capacity.34 The former Head of NHST&T told us that NHST&T was working to renegotiate contracts so that it could increase and decrease the number of contract tracers within its national teams far quicker. They told us that, for example, for its call centre staff NHST&T could now flex up to 50% up or down over a four-week period, and up to 100% up or down over an eight-week period.35 Benefits realisation
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.