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Sun 5 December 2021

Baroness Dido Harding’s testing and contract-tracing operation has increased its reliance on outsourcing – breaking its commitment to MPs, reports Sam Bright

The Government’s COVID-19 ‘Test and Trace’ system, run by Baroness Dido Harding, has broken a commitment to MPs by bolstering its ranks with more private sector consultants, the National Audit Office (NAO) has revealed today.

The spending watchdog has today published its ‘progress report’ into the England’s testing and contract-tracing system, focusing on the period from November 2020 to April 2021.

The report reveals that, between November and February, private sector consultants accounted for more than half (51%) of the Test and Trace staff base, falling to 45% by mid-April. However, even despite this reduction, the number of consultants employed on the Test and Trace scheme in April (2,239) was still higher than in December (2,164).

This violates a commitment previously made by the Department of Health and Social Care (DHSC), and the Test and Trace operation, to reduce its reliance on external consultants. As reported by Byline Times in December, Test and Trace had initiated a hiring spree to scale down the involvement of consultants. This campaign “was explained as relating to the political fall-out around the awarding of [private consultant] contracts, their rates and cost”, an individual who was approached for the roles told Byline Times.

This line was subsequently officially adopted by the DHSC. The department’s second permanent secretary, David Williams, told MPs in January that there was a “plan in place” to see the number of private sector consultants “reduce markedly over the course of the next few months”.

“NHS T&T highlighted many challenges it is facing” to achieve this plan, the NAO report states, “such as a shortage in specialist skills, for example, data scientists and technical architects, in the Civil Service, uncertainties associated with the transition to the new UK Health Security Agency and comparatively low salaries in the Civil Service”.

It has been reported that, on average, the Test and Trace operation has spent £1,000 a day on average for each private sector consultant, whereas it was offering £800 a day for the most senior roles Civil Service roles, gradually scaling down to £350 for some of the most junior roles.

A large number of the private consultants have been seconded from Deloitte, which has been awarded contracts worth some £300 million during the Coronavirus pandemic.


Value for Money?

This comes during a week when the Government has published details of new deals worth some £170 million, awarded to the private sector outsourcing giants Serco and Sitel for contact tracing services.

As the NAO report states, private firms have been heavily relied on to provide the capacity for contact-tracing call centres. However, there is doubt about whether the Government has secured a good return on investment.

As a previous NAO report found, by June 2020, call handler staff had only been occupied for 1% of their contracted paid hours. This figure has since increased, but has still remained below the Government’s target of 50%. This rate peaked at 49% at the beginning of January 2021 as COVID-19 cases increased exponentially, before falling to around 11% by the end of February. The average utilisation rate was 25% between April and May.

The NAO has crunched the numbers and has worked out what this means in terms of cost: the unit cost per contact traced increased from around £5 in October to £47 in February, when the utilisation rate was at its lowest.

The NAO does point out, however, that the Test and Trace system has altered its contracts to allow for the decommissioning of call handlers when case rates are low. “Since November 2020, NHS T&T has built more flexibility into its contact centre contracts to allow it to adjust capacity, and from September 2021 it plans to use staff more flexibly across different services,” the report states.

Serco and Sitel stand to benefit to the tune of £822 million from their call handler contracts, which started in August 2020 and will run until November 2021.

People may be willing to forgive drastic increases in public spending, and even the inefficient deployment of funds, if the results are positive. The top-line figures do not indicate a stellar performance from Test and Trace, however.

As the NAO’s previous report showed, the system has struggled to cope at the very moments that it has been needed most. While 90% of PCR test results in person in the community were returned within 24 hours in April, this figure was just 17% in December, when an upsurge of cases led to the reimplementation of lockdown restrictions.

What’s more, the available evidence suggests that only a minority of people who develop symptoms request a test, while 43% of all people with symptoms say they fully comply with self-isolation requirements. The Government has no target relating to compliance with self-isolation requirements, the NAO points out. This is a considerable oversight, given that the ultimate purpose of the Test and Trace system is for people who test positive to isolate – so that they do not transmit the disease to others.

There is also some confusion about the take-up of rapid lateral flow tests among the population. Between March and May, 691 million lateral flow tests had been distributed, yet only 96 million (14%) had been registered as used. The Government does not know whether the tests that have not been registered have been used or not, the NAO says, and has initiated a programme of research to understand why the registration of test results is so low. £4.2 billion has been spent on the roll-out of rapid testing, according to the watchdog.

“Since we last reported in December, NHS Test and Trace has introduced a lot of changes,” Gareth Davies, the head of the NAO, said. “However, some pressing challenges need to be tackled if it is to achieve its objectives and deliver value for taxpayers.”

“NHS Test and Trace has played an essential role in combating this pandemic and the NAO has recognised many of the rapid improvements we have made in the short lifespan of this organisation,” a DHSC spokesperson said. “The testing and tracing being delivered across the country is saving lives every single day and helping us send this virus into retreat by breaking chains of transmission and spotting outbreaks wherever they exist.”

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