How NHS Test & Trace frittered away £37bn

NHS Test and Trace was given one fundamental task - to “help break chains of Covid-19 transmission and enable people to return towards a more normal way of life”.

On this, the £37billion operation failed, says a highly critical report by the Public Accounts Committee (PAC).

The system - presided over by Baroness Harding, who leaves her NHS post this month - made one broken pledge after another, MPs said on Wednesday.

Perhaps most critically, it “failed to deliver on its central promise of averting another lockdown”. With targets to deliver test results repeatedly missed, the country was plunged into two more.

The report, released on Wednesday and published as the Chancellor set out details of a £5.9billion funding boost for the NHS, could not be a more salutory reminder of the dangers of allocating vast sums of public money without a clear plan.

NHS Test and Trace was never part of the health service, having been created by the Department of Health and Social Care last May, when Boris Johnson promised a “world-beating” tracing system. The report by MPs on the PAC details a system that is anything but.

Testing

In May 2020, the Scientific Advisory Group for Emergencies recommended that for a test and trace system to be effective, no more than 48 hours should elapse between identifying an original case and their contacts self-isolating.

Yet it took until January of this year before NHS Test and Trace met a far easier target - to reach 80 per cent of contacts within 72 hours - the report found.

As cases rose last autumn, waiting times for test results deteriorated.

Meanwhile, labs were underused, with swathes of unused capacity, the report showed. “Between November 2020 and April 2021, the average utilisation of its laboratories was 45 per cent.”

As pressures mounted, performance worsened.

“Over Christmas 2020, when there appeared to be spare laboratory capacity and Covid-19 cases were rising, performance declined and it took longer to provide test results, with only 17 per cent of people receiving test results within 24 hours in December 2020.”

Meanwhile, uptake of testing remains dangerously low, with just 18 to 33 per cent of those with Covid-19 symptoms reporting getting a test, the report noted.

NHS Test and Trace is also responsible for the distribution of lateral flow tests under a programme which is supposed to detect asymptomatic cases of Covid-19, and halt their spread.

Around 700 million lateral flow tests have been sent out by NHS Test and Trace, with the Government encouraging people to take them twice weekly.

The system requires results to be registered online, allowing the spread of the virus to be tracked. But this was achieved in just 14 per cent of cases, the report found.

“It is not clear what benefit the remaining 595 million tests have secured,” MPs said.

Tracing

Quick results are crucial to break the chains of transmission, the very purpose of NHS Test and Trace.

But the failing system saw vast sums frittered on workers who were given little or nothing to do.

Last year, call handlers at NHS Test and Trace told how they were effectively being paid to “watch Netflix” at home, with one saying they received £4,500 without attending to a single call.

Shockingly, the report revealed that deployment of contact tracers fell to an all-time low during the last lockdown.

The report noted: “[NHS Test & Trace] has a 50 per cent target utilisation rate for its contact centre staff, but the highest reached was 49 per cent at the beginning of January 2021 and this had fallen to 11 per cent by the end of February 2021.

“Most of the testing and contact tracing capacity that [NHS Test & Trace] paid for has not been used,” the report bluntly states.

Spending

The sums awarded to NHS Test and Trace were vast, said MPs.

“NHS Test and Trace has been one of the most expensive health programmes delivered in the pandemic with an allocation of an eye-watering £37 billion over two years, although it underspent by £8.7 billion in its first year.

“It has focused on delivering programmes but its outcomes have been muddled and a number of its professed aims have been overstated or not achieved.

“For the vast sums of money set aside for the programme, equal to nearly 20 per cent of the 2020–21 NHS England budget, we need to see a proper long-term strategy and legacy.”

Much of the funding was spent on consultants, brought in from private firms to advise or provide technical skills.

Repeated promises by NHS Test and Trace to cut spending on consultants and employ more of their own staff made little difference.

Despite promises to reduce dependency on management consultants, it employed more in April 2021 than in December 2020, with 2,239 on its books, on average rates of £1,100 a day, and some paid more.

The report stated spending on consultants appeared to have got “out of hand” - with significant discrepancies in accounts of spending levels.

“[NHS Test and Trace] does not have a firm grip on its overall spending on consultants. It estimates that it will spend a total of £195 million on consultancy in 2021–22, but at the same time, indicated it would be spending £300m on its top 10 consultancy suppliers alone ...

“Our first report on [NHS Test and Trace] concluded that it was overly reliant on expensive contractors and temporary staff. We found that by October 2020, it had signed 407 contracts worth £7 billion with 217 public and private organisations. By the end of December 2020, this had risen to over 600 contracts.”

Estimates from NHS Test & Trace this summer suggested that in 2020/21 it would spend £372 million on agency and contractor staff and £195 million on consultancy fees, compared with £52 million on permanent and seconded staff.

The organisation said these figures were expected to rise in final records.

Attempts to secure permanent staff have repeatedly failed, the report suggested. More than a third of the 523 recruitment campaigns up to the end of May 2021 failed to appoint anyone.

Scientists are still more scathing.

Dr Simon Clarke, Associate Professor in Cellular Microbiology, University of Reading, said: “The Public Accounts Committee report has highlighted a great many shortcomings in the NHS Test & Trace service, which it says has failed in its objective of breaking the chains of Covid-19 transmission.

“Baroness Harding previously boasted that the operation was the size of Tesco, without conceding that the supermarket chain actually works.”

What now?

MPs have urged the UK Health Security Agency - which is now responsible for NHS Test and Trace - to set out a clear plan to deliver its objectives.

They said: “[NHS Test & Trace] has focused on delivering programmes but its outcomes have been muddled and a number of its professed aims have been overstated or not achieved. For the vast sums of money set aside for the programme, equal to nearly 20 per cent of the 2020-21 NHS England budget, we need to see a proper long-term strategy and legacy.”

Health officials are now being asked to publish, by the end of this year, a performance management framework setting out how this will be achieved.

Dame Meg Hillier, the chairman of PAC, said such waste of public funds must never be repeated.

“For this huge amount of money, we need to see a legacy system ready to deliver when needed but it’s just not clear what there will be to show in the long term.”

A government spokesperson said: “NHS Test & Trace has delivered on what it set out to do – break chains of transmission and save lives. To date, over 323 million tests have been delivered and almost 20 million people contacted who could otherwise have unknowingly transmitted the virus.

“We have rightly drawn on the extensive expertise of a number of public and private sector partners who have been invaluable in helping us tackle the virus. We’ve built a testing network from scratch that can process millions of tests a day – more than any European country – providing a free LFD or PCR test to anybody who needs one.

“The new UK Health Security Agency will consolidate the knowledge that now exists across our health system to help us tackle future pandemics and threats.”