Source · Select Committees · Public Accounts Committee
Recommendation 10
10
The Department and NHST&T emphasised to us the importance of maintaining excess capacity in the...
Conclusion
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 significant mismatches in supply 19 Qq 96–102; C&AG’s report, para 25 20 Qq 25–26, 96–100 21 Q 14 22 See footnote 17 for details of changes in how NHST&T reaches household contacts and the associated performance metrics. 23 Qq 13,25 24 Department of Health & Social Care, The Rúm Model Technical Annex – assessing the impact of test, trace and isolate parameters on COVID-19 transmission in an October-like environment, 11 February 2021. 25 https://www.liverpool.ac.uk/research/news/articles/covid-19-liverpool-community-testing-pilot-interim-findings- published/; https://www.bmj.com/content/371/bmj.m4690 26 Qq 83–85 27 C&AG’s Report, para 17 28 C&AG’s Report, paras 15, 22 29 Qq 46, 89–90, 95 12 COVID-19: Test, track and trace (part 1) and demand do lead to some capacity being persistently under-used. To take the example of laboratory capacity for swab testing, NHST&T intentionally runs this at less than 100%, noting that best practice is to run at between 60% and 85%.30 However, throughout November and December 2020, the weekly percentage of total laboratory testing capacity used (for swab tests administered in community and hospital settings) remained below 65%.31 And even with this apparent spare capacity, NHST&T has never met its target to turn around tests taken face-to-face within 24 hours.32 NHST&T told us its target was to turn these tests around as quickly as possible, with a particular interest in whether people get results the day after they take a test.33 As demand for tests surged over Christmas 2020, NHST&T felt it managed access better than it had in September, but the increase in volumes still led to increased turnaround times, despite apparent spare laborat
Government Response
Acknowledged
HM Government
Acknowledged
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. 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.