An uncertain start to the government’s coronavirus test and trace programme

The government’s test and trace programme, which builds on target-driven efforts to expand testing capacity, is supposed to contain coronavirus infection levels while the lockdown is eased. The stakes are high. Getting the programme wrong could exacerbate the very problem it is trying to solve.

As with the initial testing target, however, the finer details and clear plans for delivery are failing to keep pace with announcements. In the government’s defence, it needs to act fast and take complex decisions. But, as the testing programme showed, making big announcements before answering basic questions about how that programme will work can cause confusion in government and undermine public confidence.

Responsibilities must be clear to everyone

In the early stages of the testing programme, it was not clear – at least to outsiders – which department or body was responsible for the overall strategy. When the Science & Technology Committee chair criticised Public Health England’s (PHE) early decisions, PHE’s response was to deny responsibility for the testing strategy and point the finger at the Department of Health and Social Care (DHSC).       

The government’s approach to test and trace shows that it has learnt some of these lessons. Dido Harding has been appointed as the government tsar in charge, while Leeds chief executive Tom Riordan and NHS trust chief Sarah-Jane Marsh have been asked to lead on tracing and testing respectively. This has clarified core responsibilities and helped to improve accountability. However, as we have previously argued, questions remain over the accountability of government tsars who, unlike ministers, do not give statements to Parliament and don’t face the same level of media scrutiny.

And uncertainty continues: one councillor has pointed to confusing statements from DHSC about who is in charge at a local level. The government needs to make sure the division of responsibilities between DHSC and PHE is crystal clear, to avoid a repeat of the blame shifting on testing.

Announcements and implementation must sit alongside each other

The testing strategy saw the government devote huge amounts of energy to hitting its 100,000 tests per day target on 30 April. However, making sure those tests were accessible to NHS workers, or that the results could be reported in a useful way to local public health officials, initially seemed to be of secondary concern. The UK Statistics Authority has now accused health secretary Matt Hancock of providing data which is 'far from complete and comprehensible... the aim seems to be to show the largest possible number of tests, even at the expense of understanding.' 

But public expectations have again been raised, with Boris Johnson promising a ‘world beating’ system by the start of June. Not surprisingly, Harding has distanced herself from that pledge. Hancock says the system is already proving 'successful', but the government has been unable to provide data on how many people have been contacted.

Problems are already emerging. Local authorities have warned that the system is not yet ready. Newly hired contact tracers have complained of inadequate training and malfunctioning IT systems. Delays in delivering test results have not been solved. And even though ‘test and trace’ is meant to support localised lockdowns, the data problems of the testing programme don’t appear to have been fixed. This means that local officials can’t get a good grasp of the virus’ incidence in their areas. Furthermore, local authorities have said they don’t have the necessary powers to shut schools or businesses where clusters of cases develop.

It will, says Hancock, be everyone’s ‘civic duty’ to engage with the system and self-isolate when contacted and asked to do so. But the row over the actions of Dominic Cummings has eroded trust in the government and its strategy. Teething problems in the roll-out of test and trace, and over-promising when making announcements, will not help in this regard.

Most crucially, however, mistakes on the test and trace programme could have far greater consequences than those made as the government scrambled to hit its April testing target. But at least the government has the opportunity to learn from its own mistakes. In announcing a key programme, it needs to be clear about who is responsible for what area of that programme, and how, and when, each part of it will be implemented.