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Thu 28 October 2021

After months of pressure, more responsibility has been handed to local contact tracers, reports Sam Bright

The UK’s ‘Test and Trace’ system – run by Baroness Dido Harding – has given more power to local authorities in a new ‘Local-0’ trial.

Since the start of the year, certain local authorities have been tasked with contacting individuals who have tested positive for COVID-19 – telling them to self-isolate and providing advice on the support services that are available.

Typically, this process is managed by the national, centralised, Test and Trace system, while local tracing teams are only allowed to contact individuals who have tested positive if the national programme has been unable to reach them for 32 hours.

Statistics released by the Department of Health and Social Care (DHSC) suggest that the centralised system has a 90% success rate in contacting people who have tested positive for the Coronavirus. However, some local teams are boasting an even higher rate of return, during the initial stages of the Local-0 trial. In its first week, Sunderland City Council’s local contact-tracing programme managed to reach 97% of positive cases.

By devolving contact-tracing to local areas, it is hoped that hotspots will be more swiftly identified and support given to those who need it. This seems particularly important given the threat posed by COVID-19 variants, some of which are more transmissible and more resistant to current vaccinations.

“Our local call handlers can talk residents through the range of support available when they make that initial call so it really is better all round,” Gerry Taylor, executive director of Public Health and Integrated Commissioning, told the Sunderland Echo.

However, almost a year after the Test and Trace programme launched, the question remains: why it has taken so long to empower local health teams?

Indeed, Baroness Harding’s operation has been routinely criticised for marginalising established public health authorities and instead opting for a centralised system reliant on private sector consultants and corporate giants.

In September, for example, the Local Government Chronicle revealed that only one Test and Trace executive had public health expertise, whereas several individuals had been hired from retail. Baroness Harding herself used to work for Sainsbury’s and Tesco – and several senior Test and Trace figures were plucked from the higher ranks of the supermarket industry.

The Test and Trace operation has also been heavily populated by management consultants. Recent reports have revealed that more than 2,000 private sector consultants have been employed by the programme, at an average cost of £1,000 a day. Baroness Harding has budgeted for just short of £500 million to be spent on this army of consultants, while the overall budget for the Test and Trace operation has recently soared to £37 billion – comfortably more than the GDP of Latvia.

Baroness Dido Harding and her husband, Government ‘anti-corruption champion’ and Conservative MP John Penrose, both used to work for McKinsey – a management consultancy firm.

Mike Galsworthy explains where public money has been spent during the pandemic on Byline TV

Corporate staff have also been employed to manage the national contact-tracing programme. In December, the National Audit Office (NAO) – the spending watchdog – noted that the Government spent an initial £720 million on contracts for 18,000 contact tracing call handlers – awarded to the outsourcing giants Serco and Sitel. However, the NAO reported that, by June, call handler staff had only been occupied for 1% of their contracted, paid hours.

The Test and Trace programme has been plagued by difficulties since its inception during the early months of the Coronavirus pandemic. During the first wave of infections, the system lagged far behind other countries – forcing Health and Social Care Secretary Matt Hancock to pledge that, by the end of May 2020, the UK would be conducting 100,000 tests a day. This figure was only met after Hancock’s department changed the way that tests were recorded.

The system has also been repeatedly overwhelmed by high case rates. Only 41% of people, for example, received their test results within 24 hours between the end of May and early November – despite Boris Johnson’s pledge in June that all COVID-19 test results would be turned around in 24 hours by the end of that month.

While the system’s performance did improve in June, the proportion of tests turned around in 24 hours deteriorated to a low of 14% in mid-October, before rising to 38% in early November.

Mounting pressure on the system during the second wave of the virus also stalled the efforts of contact-tracers. By the middle of October, the proportion of contacts – people who had been in close proximity to a positive case of COVID-19 – reached by tracers within 48 hours had fallen to 64%.

Meanwhile, the Government’s scientific advisors have suggested that less than 20% of people are fully self-isolating when they are asked to. Part of the reason for this, it has been suggested, is a lack of financial support provided to those forced to self-isolate – currently a £500 payment. The Trades Union Congress has called this level of support “dangerous” since it leaves many individuals in a precarious position – forcing them to decide whether to self-isolate and potentially lose income, if they are unable to claim their normal salary, or simply to carry on working regardless.

“The system as it stands is not fit for purpose,” England’s former Chief Scientific Advisor Sir David King said last June. “We believe that a new approach is required, one that moves away from a centralised system that utilises a local-first approach.”

Of the recent launch of the ‘Local-0’ trial, Baroness Dido Harding said: “Local authorities’ unique knowledge of their communities is invaluable as we work together and, with the support of the national tracing service, their involvement will continue to strengthen our contact-tracing work.”

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