UK Test and Trace ‘didn’t achieve objective, too many consultants, poor use of data, expensive’

The British Government's Test and Trace system, which was set up in May 2020 as part of the Department of Health and Social Care's response to help reduce the spread of COVID-19, has been heavily criticised by a group of MPs on the Public Accounts Committee.

And whilst some will grant the government some leniency, given the ‘unprecedented situation' that the UK has faced over the past 18 months or so, reading the report released today it's clear that the Department repeated many of the same mistakes made on previous large-scale public sector projects. In other words, lessons have not been learnt.

There's been an over reliance on highly paid consultants, data hasn't been used properly to monitor success, and to top it all off, it was given a whopping budget of £37 billion for two years. Not to mention that the UK has one of the highest death rates from COVID-19 in the entire world and has been through numerous lockdowns, suggesting that Test and Trace clearly hasn't been that effective in breaking the chain of transmission.

The Public Accounts Committee is calling for urgent improvements to be made. Dame Meg Hillier MP, Chair of the Public Accounts Committee, said:

The national Test & Trace programme was allocated eye watering sums of taxpayers' money in the midst of a global health and economic crisis. It set out bold ambitions but has failed to achieve them despite the vast sums thrown at it.

Only 14% of 691 million lateral flow tests sent out had results reported, and who knows how many took the necessary action based on the results they got, or how many were never used. The continued reliance on the over-priced consultants who ‘delivered' this state of affairs will by itself cost the taxpayer hundreds of millions of pounds.

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. This legacy has to be a focus for government if we are to see any value for the money spent.

Recommendations

The Committee has pulled together a number of conclusions and recommendations for the government to mull over, if it has any interest in achieving this legacy for Test and Trace.

You can read the full report here, but some of the key takeaways include:

• Unbelievably, Test and Trace never actually set out what it specifically needed to do in order to achieve its main objective of breaking chains of COVID-19 transmission. Gaps in data also meant Test and Trace was unable to demonstrate how effective it has been — this problem persists. The Committee is calling on the Department of Health and Social Care to set out in detail its objectives and the impacts it aims to secure, and publish by the end of December 2021 a performance management framework.
• Test and Trace has focused on getting programmes up and running and paid less attention to ensuring these programmes actually deliver the benefits they promised. For example, it has distributed 691 million lateral flow device tests, but only 14% of these have been registered, so it's very hard to judge what benefit they have achieved. The Committee is urging the Department to set out clearly how it plans to deliver the benefits expected from the funding it receives.
• Test and Trace's over reliance on consultants is likely to cost the taxpayer hundreds of millions of pounds. Despite Test and Trace committing to reduce the number of consultants it employed, the number was actually higher in April 2021 (2,239) than in December 2020 (2,164). The Department pays consultants an average of £1,100 per day, but some are paid more. Over a third of the 523 recruitment campaigns run by Test and Trace up to the end of May 2021 failed to appoint anyone. The Committee is urging the Department to detail how it will reduce its dependency on consultants by the end of November 2021.
• The government has still not set out how it would like to work with local authorities, leaving them little time to plan for the new approach (Test and Trace will soon form part of the newly created UK Health Security Agency). The new operating model has not been finalized for the new organization, meaning local authorities will have less than three months to plan for new arrangements. The government must urgently provide clarity to local government and other stakeholders to ensure they have the resources to deliver their parts of the process.

My take

It's hard not to conclude that Test and Trace has mostly been a failure. COVID-19 rates are soaring in the UK and we have one of the worst death rates in the world. Of course other public health policy measures play their part too, but If the primary objective of Test and Trace is to break chains of transmission, it's not succeeding. Equally, it's hard to measure how much success it actually has achieved, given the gaps in data. Reading this report was pretty similar to reading plenty of other big government project reports — National Programme for IT and Universal Credit included. The government has focused on getting something up and running, without actually thinking through how to achieve its outcomes. It's true that this was a huge ask in the first place, but when you're talking £37 billion of public money, this level of scrutiny is important if we want to understand how to deal with any potential future pandemics.