Background to the report

Test and trace programmes are a core public health response in epidemics that can be used with other measures such as social distancing, barriers (such as masks) and handwashing to reduce infections. The basic principles of test and trace are identifying individuals, or groups of individuals, with an infectious disease, and tracing their contacts to limit further transmission. Through early identification, potentially infectious contacts can be encouraged or obliged to reduce interactions with other people, thereby reducing the spread of disease.

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At the start of the COVID-19 outbreak, Public Health England carried out comprehensive test and trace activities for the relatively low numbers of infections. As infection levels grew, government introduced a national lockdown as the main way of reducing transmission of COVID-19, suspending comprehensive contact tracing in mid-March. From April onwards, the Department of Health & Social Care significantly scaled up testing capacity in England. On 28 May 2020, government announced the launch of the new NHS Test and Trace Service (NHST&T), to lead on four areas of pandemic response, known as test, trace, contain and enable, and to bring these together into a single national programme.

Scope of the report

This is the first of two reports. This interim report provides an overview of test and trace services for addressing COVID-19 in England, including how the government’s approach has developed, and how it managed performance and capacity in the period from May to October 2020. This report does not cover post-October planning for mass testing. It covers some aspects of public engagement efforts in relation to improving compliance with tracing.

We intend to publish a further report in spring 2021 which will provide a fuller value‑for‑money assessment of test and trace. This will include an update on spend and performance, and matters not covered here, including examining the end-to‑end process in more depth, the development and implementation of the contact tracing app, and a detailed look at elements of contract management.

Concluding remarks

This is an initial review of the aims, funding and performance of the government’s approach since May. We found that overall NHST&T had achieved a rapid scale-up in activity in respect of both testing and tracing, and had built much new infrastructure and capacity from scratch. However, issues with implementation and potentially the initial choice of delivery model mean that it is not yet achieving all its objectives. As it plans and rolls out further changes in COVID-19 testing, including the introduction of rapid turnaround tests and mass testing, government needs to learn lessons from its experience so far. It is very important that testing and tracing is able to make a bigger contribution to suppressing the infection than it has to date.

Read more about our work on the government’s response to the coronavirus pandemic.

“The government has rapidly increased testing and tracing activity, building significant new infrastructure and capacity from scratch. However, it has struggled to test and trace as many people as it has capacity to, or to reach the contacts of people testing positive quickly enough.

“Test and Trace is core to the UK’s pandemic response. It must improve its performance with a focus on effective engagement with the public and integration with local efforts to improve tracing. We will explore these issues further when we assess the value for money of Test and Trace in spring 2021.”

Gareth Davies, the head of the NAO


Publication details

Press release

View press release (11 Dec 2020)

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