Recommendation 10

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