Who runs NHS Test and Trace? “Surely the NHS?”, you might say.
Not according to NHS England’s boss, Sir Simon Stevens. When quizzed by the Health and Science Committee last month, Stevens said: “I can’t comment specifically on Test and Trace because that is run by the Department of Health and Social Care rather than the NHS or NHS England per se.”
NHS Test and Trace is not the right name for the contact tracing scheme. But nor is “The Department of Health’s Test and Trace”, or “Serco Test and Trace” — as so many have argued for it to be rebranded as.
Claims that Test and Trace is managed by Serco have spread like wildfire, but they are also red herrings. As the outsourcing firm’s website makes clear, Serco does not manage or have overall responsibility for NHS Test and Trace, nor did it design its app or IT systems. The firm manages facilities at around a quarter of regional testing sites, in addition to some aspects of contact tracing. But it is by no means running the whole show.
Indeed, the answer is far more complicated than any one company or government department being in charge. According to the NHS Test and Trace website, a patchwork of 48 organisations are listed as “data processors” for the contact tracing scheme. Just four of those are NHS bodies.
In comparison, seven government departments have their fingers in the pie. A further 23 private companies offer things like identity verification checks and analysis of anonymised data. In the vast Test and Trace machine, the NHS is in most cases the last link in the chain — handed data that other companies have collected.
Why does that matter? Test and Trace has so far hoovered up more than £22bn of taxpayer money. That’s almost double the amount the UK has spent on Covid vaccines. It’s also more than the combined budgets for the police, fire and counterrorism services in England and Wales this year.
That might be well and good if the ship were plain sailing. But the contact tracing scheme has seen a catalogue of errors since its inception. NHS Test and Trace launched on 28 May last year, after months of delay. The government’s Scientific Advisory Group for Emergencies (Sage) said at the outset that the scheme needed to reach at least 80 per cent of Covid contacts to be deemed effective. After months of underperforming, NHS Test and Trace finally hit that target in December, but only after tweaking its counting methodology several times.
And it’s had no shortage of blunders in the meantime. A spreadsheet error in October meant more than 16,000 positive Covid cases were not recorded in Test and Trace’s official data. In the week before Christmas, it failed to reach more than 30,000 people who tested positive for coronavirus, at the same time the government warned that a new coronavirus mutation was spreading across the country. Crucially, it failed to stave off a second, more deadly wave of coronavirus that has killed almost 80,000 people so far.
Teething problems would be an understatement. And yet there have been no apologies, no sackings, and little in the way of public scrutiny.
The closest thing the contact tracing scheme comes to accountability is Baroness Dido Harding, who was appointed interim chief of the programme in August. Harding is no stranger to digital bungles. The Conservative peer, married to the Prime Minister’s “anti-corruption champion”, was forced out of her previous job as head of TalkTalk in 2017 after a cyber attack revealed the details of 4m customers at the telecoms firm.
Over the past few months, Harding has told various committee meetings that Test and Trace has proved a major success in reducing the R rate across the country. She told a Commons science and technology committee last month that the scheme helped push down R by between 0.3 to 0.6 in October.
After weeks of nagging from MPs and scientists for her to back up those claims, Harding finally revealed her workings last week. Modelling showed that contact tracing cut the R rate by as little as two per cent. It also suggested that testing helped curb the spread of coronavirus by between 18 and 33 per cent — equivalent to a 0.6 to 0.8 reduction in the R rate. But, as the health department admitted, those figures could not be disentangled from the combined effect of people also self-isolating with symptoms.
NHS Test and Trace has come a long way since the start of the pandemic. The number of daily Covid tests has increased a whopping 800 per cent since its launch. But it still has not come far enough. Over the past few weeks, the number of positive cases transferred to Test and Trace and the number of close contacts reached have both declined. At the same time, the average turnaround time for in-person tests and at-home test kits has increased. And antibody tests, which the Prime Minister promised would be “game-changing”, are still not available to the wider public. Test and Trace processes around 4,500 antibody tests on a good day — just under four per cent of its 121,000-a-day capacity.
A larger dose of accountability might just nudge Test and Trace over the line. But the vast spaghetti of Test and Trace has left that hard to come by.
Harding has appeared before the Downing Street press conference just three times. First, on the eve of the scheme’s launch last May, and twice more the next month. In comparison, NHS chiefs Sir Simon Stevens and Professor Stephen Powis have made a combined total of 27 appearances at Number 10’s Covid briefings. Since Harding last spoke at a Number 10 briefing on 18 June, Test and Trace’s total budget has more than doubled.
We need to stop calling it NHS Test and Trace — not just because the NHS plays a small part in it, but because doing so lends it the veneer of accountability afforded to other NHS projects.
The NHS has been rightly recognised for its work throughout the pandemic. After unquestionably the most difficult year in its history, it has now overseen the successful rollout of the nation’s largest ever vaccination programme. How did it do that? Setting ambitious targets, and hauling officials in front of the public to make sure those targets were met. But while Test and Trace might be worthy of the NHS logo, it’s nowhere to be seen on the “I’ve had my Covid vaccination” stickers.
Figures released on Friday suggest we’re on the right track, with the UK R rate of 0.6 to 0.9 meaning coronavirus is, at least for the moment, on the decline. But a properly functioning Test and Trace system will be key to preventing any resurgence in cases as restrictions are lifted. And that will require a much greater level of accountability.
Harding has, to her credit, worn down the seats of government committee meetings over the past few months. But committees don’t make newsreels, and they certainly don’t trickle down to the wider public consciousness. Perhaps renaming the scheme Dido Harding’s Test and Trace might provide that level of accountability that Test and Trace so desperately needs (although it didn’t work out too well for Jo Swinson’s Liberal Democrats).
Either way, lumping the blame on the NHS is unfair on our health service, which has proved the backbone of Britain during the coronavirus crisis. Test and Trace must hold itself up to the same level of scrutiny that the NHS is subjected to to retain that badge of honour — or else ditch the blue and white.