Is the UK ready for Monday's launch of the NHS coronavirus track and trace app?

Victoria Ward
A person on the NHS coronavirus contact tracing app -  - PA

The track and trace app will be launched nationally next week despite claims that only one in 10 contact tracers have been recruited, it has emerged. 

The Government has insisted that plans to launch the strategy by mid-May are on target. The track and trace system requires the NHS app, 18 thousand contact tracers and adequate testing capacity to be in place. 

The Department of Health and Social Care has promised that 18,000 staff will be “available from the week commencing May 18” and ready to work when the new NHS Covid-19 tracing app is rolled out nationwide.

But Brandon Lewis, the Northern Ireland Secretary, triggered concern when he claimed that, with just days to go, fewer than a tenth of the target had been hired.

“I don't think we've got to 18,000 just yet,” he said. “I think there's about 15,000 applications, we're looking to get up to 18,000."

Downing Street swiftly waded in, insisting that plans to have 18,000 contact tracers by next week were still "on course", and “significantly more” than 1,500 had been recruited, although could not say how many.

Labour said the entire process was "rapidly descending into a shambles", and questioned the hiring of private firm Serco to recruit the majority of the contact tracing team.

The success of the strategy is dependent on adequate numbers downloading the app, a robust testing system and efficient contact tracing. 

Oxford University’s epidemiological modelling suggests that it needs to be used by 56 per cent of the population to be most effective, equating to between 30 to 40 million people.

On the Isle of Wight, where the system is being trialled, “well over half” of the population is taking part. 

A sign telling people in the Isle of Wight to download the NHS coronavirus contact tracing app, which Isle of Wight residents have been getting their hands on, as the island plays the role of guinea pig to the technology which is hoped to enable at least a partial return to normal life - PA

Experts have suggested that if enough people download the app and adhere to the guidance, a much-feared second wave could be prevented.

Of the new army of contact tracers, 15,000 will be call centre workers aided by 3,000 medical professionals.

The team, working from home, will contact those who receive alerts via the app asking them to self-isolate.

Following scripts devised by Public Health England, they will check that individuals understand what is required and tell them where they can access further information. 

If specific concerns are raised, that person will be transferred to a member of the skilled clinical team.

The Government is still debating whether to roll out the app regionally or nationwide.

Epidemiologists have suggested that areas with low reproduction “R” rates could get the app first so restrictions can adjusted accordingly.

Meanwhile, ministers were warned on Friday that millions who do not own smartphones risk being locked out of the app, worsening the “digital divide”.

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The App

Matt Hancock, the Health Secretary, insisted as recently as Monday that the NHS contact-tracing app would be rolled out nationwide by “mid-May”. 

However, no date has yet been set nor any indication given as to whether the strategy will be phased in geographically or launched in one go.

When a user starts to get flu-like symptoms they enter them into the app and an NHS artificial intelligence programme diagnoses if they are likely to have Covid-19. 

If so, the app sends out a notification to those who have had “high-risk” contact with the symptomatic user, advising them to self-isolate. 

It then points the initial user to where they can get a test. If the test comes back negative, a second alert tells the self-isolating group it was a false alarm.

The app initially suffered some technical glitches when it was released last week, with islanders complaining it was bombarding them notifications and not working on some Android phones.

However, on Thursday, the Government said 72,000 people were using the app and an average of 25 people a day were requesting a test. 

Ministers are also under increasing pressure over privacy concerns.

Unlike many other countries, which are opting for the Apple and Google model where all users' data is kept on the phone, the NHS app collects anonymous data via users' postcodes.

The NHS argues that this data could help suppress a second peak by allowing it to identify localised outbreaks.

Harriet Harman, chairman of the parliamentary Joint Committee on Human Rights, has called for new legislation creating a dedicated data tsar to ensure the app’s data is only ever used by the NHS in its pandemic response.

On Friday, MPs on the culture select committee were also warned by charities that the app could worsen the UK’s digital divide as it only works on newer smartphones using the Android 8 or Apple iOS 10 operating systems.

Contact tracing

Of the 18,000 contact tracers to be employed, 15,000 will be call centre workers and 3,000 medical professionals.

Serco will provide the majority of the staff and training for the first group but is working with a network of subcontractors, including Capita, which will bring in around 2,000 people.

Recruitment agencies have placed adverts in recent days seeking staff up and down the country, from Milton Keynes to Liverpool. 

Successful applicants, most of whom will have experience of working in a call centre, will be paid £9.42 an hour - just above the minimum wage - and will work from home in shifts covering 8am to 8pm seven days a week. 

NHS contact tracing app – Are there privacy concerns?

The team will manage the bulk of the calls, working to a predefined script provided by Public Health England. If specific advice is required, that person will be transferred to a member of the medical team.

The ads state it will be a "minimum 12 weeks assignment" but is expected to be longer term. The majority of staff will have contact centre or customer service experience. Many have recently been laid off from the hospitality and travel sectors.

Recruits, who undergo one day’s remote training, are required to be “caring” and to “show empathy and compassion at all times”.

The call handlers will ensure that those told to self-isolate have the information they need and will ask if they have been in close proximity with anyone who does not have the app. 

The vast majority of calls will follow a specific script and are “very formulaic” the Telegraph understands. 

Anyone with specific concerns, for example if they have underlying health conditions, will be transferred to one of the 3,000 clinical professionals.

The skilled team is being recruited by NHS Professionals and will be required to complete the initial telephone assessment of Covid-19 cases who have tested positive, are in self-isolation, and are either vulnerable or unable to use the app. They will also provide support for more complex cases.

All calls will be recorded and both Serco and the Department for Health will undertake random sampling for quality control. “There will be lots of checks and balances,” a source confirmed. “The amount of data that can be gathered and monitored is vast.”

Despite the May 18 deadline, sources confirmed that while a proportion of the staff had been hired and trained, recruitment is ongoing.

One said: “This is only one part of the system but we are focused on having it up and running on time. We are well advanced in terms of hiring and training.”

Testing

The Government has faced significant pressure to ramp up testing and has committed to increasing capacity to 200,000 a day by the end of May.

Without an efficient testing regime in place, the strategy will not work.

But the UK has chosen to take a different approach to many other countries, prompting fears that the app could misdiagnose symptoms and lead to heavier demand for testing.

David Bonsall, an Oxford University epidemiologist advising the NHS on the app, said it triggered its alert at the point of symptoms as it needed to warn people to self-isolate as early as possible.

He said modelling predicted that the number the app would send for tests should stay within the promised 200,000-test-a-day capacity.

Dr Bonsall added: “But it is not so much about the numbers, it is the speed and the logistics around testing we now need to look at. How many testing stations are there going to be? You need to cover the whole of the British Isles. 

“There are parts of the world, if you look at Hong Kong and South Korea and the testing facilities that they have established, where they aim to turn around testing in a matter of hours.”

On the Isle of Wight, residents taking part in the trial who have symptoms are given a reference number and a designated number to call to have a swab test delivered.

However, it remains unclear how the system will work when rolled out nationwide and whether mobile testing units will be used in lieu of a delivery service.

Adverts posted online by Boots, looking for 1,000 unpaid volunteers to carry out tests, have been withdrawn after accusations that the Government was trying to take advantage of public goodwill.