Source · Select Committees · Public Accounts Committee
Recommendation 2
2
NHST&T still struggles to consistently match supply and demand for its test and trace services,...
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. 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 testing capacity used in November and December has remained under 65%, at the lower end of what NHST&T states is best practice (between 60% and 85%). Even with spare capacity, NHST&T has never met the target to turn around all tests (in face-to-face settings) in 24 hours. In September 2020, NHST&T significantly underestimated the increase in demand for testing when schools and universities returned, resulting in poor performance. When the demand for tests surged again over Christmas, NHST&T feels it managed access to tests better, but there were still dips in turnaround times despite apparent spare laboratory capacity. For tracing, the Department accepts that, with hindsight, it did not need to scale 6 COVID-19: Test, track and trace (part 1) up central tracing services for May as much as it did. While it has sought to reduce capacity and increase flexibility since then, low utilisation rates—well below the target of 50%—persisted into October. Recommendation: For all aspects of its testing and tracing operations, NHST&T should identify opportunities to make better use of the capacity it has paid to create. Where it retains surplus capacity, this should be for a clear and explicit purpose. It needs to strike a better balance between meeting surges in demand, maintaining timely services, having eligibility criteria that allow it to identify as many people with the virus as possible, and not paying unnecessarily for surplus capacity.
Government Response
Acknowledged
HM Government
Acknowledged
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 identify opportunities to make better use of the capacity it has paid to create. Where it retains surplus capacity, this should be for a clear and explicit purpose. It needs to strike a better balance between meeting surges in demand, maintaining timely services, having eligibility criteria that allow it to identify as many people with the virus as possible, and not paying unnecessarily for surplus capacity. 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 600,000 PCR tests per day, compared to 2,000 in April 2020 (statistics are updated daily on the government’s data dashboard). 2.3 The COVID-19 pandemic presents a uniquely unpredictable challenge. NHST&T needs to have sufficient surge capacity to be able to respond swiftly and accurately to increases in demand. But striking a better balance between retaining this essential resilience and demands on public funding is a priority for the service. 2.4 Testing sites are now being used to support both symptomatic and asymptomatic testing, improving utilisation while allowing focus to change quickly (in day) when needed. The service’s laboratory structure has been revised to consolidate processing capacity, automation has increased, and NHST&T has built more flexibility into commercial contracts with laboratories, improving value for money while still allowing capacity for surge. Through these measures the aim is to run at 80% capacity – the highest possible without threatening turnaround times - while being able to respond to surges. For contact tracing, NHST&T has improved forecasting capability and operational response times to judge better what contact tracing resource is needed, and negotiated flexible contracts with commercial providers to allow numbers to be scaled up and down while retaining a pool of surge capacity to support local public health colleagues with sudden outbreaks. 1 5 2.5 NHST&T continues to explore ways to use assets more efficiently and is working with the National Audit Office (NAO) on a future report which will provide more detail on plans for the service.