An army of 18,000 call handlers, recruited at a cost of £720m to trace contacts of coronavirus sufferers, was so under used that tracers were at one point working only one hour out of every 100 they were paid for, a report has found.
The government was accused of “trying to reinvent the wheel” by outsourcing the job of tracing contacts to private firms, rather than giving the job to experienced public health teams.
And the National Audit Office spending watchdog said that “substantial public resources” had been spent on staff who provided “minimal services in return”.
Today’s NAO report found that while the government had rapidly scaled up coronavirus testing in England from a low base, it was “not yet achieving all its objectives” with too few test results delivered within 24 hours, and too few contacts of infected people being reached and told to self-isolate.
The UK was “unusual” internationally in the extent to which it outsourced test and trace to the private sector, and 70 per cent of early contracts by value were directly awarded without competition under emergency measures, the NAO found.
The contact tracers employed by Serco and Sitel were reaching just 60 per cent of close contacts at the end of October, with as few as 64 per cent of contacts made within 48 hours, the report found.
And surveys suggest that the proportion of contacts actually complying with instructions to self-isolate could be as low as 10 per cent, it said.
“Laboratories processing community swab tests were unable to keep pace with the volume of tests and experienced large backlogs, which meant NHS T&T had to limit the number of tests available and commission extra help from other laboratories,” found the NAO.
“Rationing of tests meant some people were told to visit test sites hundreds of miles away.”
A target to provide results within 24 hours of in-person testing in the community has not been met. Turnaround within 24 hours peaked in June at 93 per cent, but collapsed to a low of 14 per cent in mid-October before rising to 38 per cent in early November.
The NAO said that while some other countries had outsourced testing operations, the UK was “unusual” in turning to private firms to trace contacts and instruct them to self-isolate.
Out of a group of 15 countries studied for the report - including France and Germany, as well as some of those most successful in tackling the pandemic, like Singapore, South Korea and Taiwan – most “built their contact tracing capacity using public health and tracing expertise … None extensively use outsourcers.”
The NAO said there was “no shortage of” contact tracers, with the Department of Health and Social Care signing contracts in May for 3,000 health professionals and 18,000 call handlers, but at times they were “barely used”.
By the middle of June the average health professional in the outsourced operation was actively working for just 4 per cent and the average call handler for 1 per cent of the hours for which they were being paid.
Under the terms of contracts, DHSC was unable to reduce numbers of handlers until August, when the workforce was cut to 12,000.
However, utilisation rates remained well below a target of 50 per cent throughout September and for much of October, said the NAO, adding: “This means substantial public resources have been spent on staff who provided minimal services in return.”
The report revealed that by the end of October, NHS T&T had spent £4bn of its £22bn budget for 2020/21, with a further £7bn earmarked for the planned Operation Moonshot mass testing programme.
Spending by that point was £2bn lower than expected, due to underspending on laboratories, machines and mass testing.
Contracts worth £7bn have been signed with 217 public and private organisations to provide supplies, services and infrastructure, including test laboratories and call handlers for tracing. NHS T&T has plans to sign a further 154 contracts, worth £16.2bn, by March 2021.
NHS T&T increased its testing capacity fivefold to 500,000 a day by October, and is now aiming to reach 800,000 by the end of January. But the report found it is not processing as many tests each day as its capacity suggests.
Between May and October the average number of tests carried out each day was only 68 per cent of the published maximum. NAO head Gareth Davies said: “Test and trace is core to the UK's pandemic response. It must improve its performance.”
And the chair of the House of Commons Public Accounts Committee, Meg Hillier said: “The government tried to reinvent the wheel when it centralised testing and tracing, tearing up the usual accountability arrangements and leaving local public health teams out in the cold.
“Testing capacity has risen and it’s easier to get a test locally but test and trace’s performance still isn’t good enough.
“Speed is of the essence but only two-fifths of tests were turned around within 24 hours. And test and trace has only contacted two-thirds of the people it knows were in close contact with someone who tested positive.
“The government needs to urgently work out what’s going wrong at every step of the process. Throwing more money at the problem clearly isn’t the answer. The good news about vaccines doesn’t mean we don’t need a match-fit test and trace system now – and one ready for the planned step-up to mass testing”.
A DHSC spokesperson said: “Since NHS test and trace launched, 20 per cent of people in the UK have been tested at least once, more than 41 million tests have been carried out and more than 2 million people in England have been contacted and notified to self-isolate. Turnaround times have been steadily improving over recent weeks, and the latest performance figures show that tracing has dramatically improved, now reaching 85.7 per cent of contacts.
“We know there is more to do, and yesterday we published the NHS Business Plan, setting out the next phase of improvement for the service, and how we will increase the speed and reach of testing and tracing even further.
“Our aim, as part of the government’s winter plan, is to maximise the impact of testing, contact tracing and self-isolation, hand-in-hand with targeted local restrictions and preventative behaviour like ‘hands, face, space’. As the Covid-19 vaccination programme is rolled out, we are determined to ensure that NHS test and trace plays an even more effective role in stopping the spread of the virus.”
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