PAC report slams reliance on consulting at NHS Test and Trace

Consultants recruited to fill technical skills gaps on the NHS Test and Trace programme are expected to cost £300m amid concerns spend has gotten “out of hand”

A Public Accounts Committee (PAC) report scrutinising Covid-19 contact tracing programme NHS Test and Trace (NHST&T) said its reliance on consultants prompted by a shortage of technical skills in government contributed to a bill of millions of pounds to the taxpayer.

Published 27 October, the report describes NHST&T as a “muddled” and “overstated” programme, which is also considered one of the most expensive health programmes delivered since the emergence of the Covid-19 pandemic, with a budget of £37bn over two years, the initiative equals to nearly 20% of the entire NHS England spending for 2020-21.

However, the report argues that most of the testing and contact-tracing capacity the programme paid for has not been utilised and that it failed ”to deliver on its central promise of averting another lockdown”.

Among its findings, the PAC report makes a number of points relating to NHST&T’s over-dependency of third-party resources. According to the report, despite previous commitments to reduce dependency on consultants and temporary staff, NHST&T has employed more professionals under that capacity, with 2,239 people employed in April 2021, a 3.3% increase on the number of consultants employed in December 2020.

NHST&T told the Public Accounts Committee that the promised reduction on the use of external consultants relied on the availability of civil service recruits to fill posts and on future demand for test and trace services. However, the PAC report noted that 37% of the 523 recruitment campaigns ran by the programme failed to appoint anyone.

The shortage of professionals skilled in the data, digital, operational and project delivery areas within the civil service was cited as one of the main reasons why NHST&T could not reduce its reliance on consultants, the PAC heard. The former head of the programme noted that it needed to reduce use of consultants in a staged manner to ensure the required skills transfer to permanent staff.

The report also mentions data from the National Audit Office (NAO) on NHST&T spending estimates on agency and contractor staff, which reached £372m, on top of £195m in consultancy fees. This compares with £52m spent on permanent and seconded staff in 2020-21.

The NAO estimated that consultancy spend for the NHS service with the top 10 consultancies with the highest contract values was expected to reach £300m, which prompted PAC concerns that expenditure in this area at NHST&T “may have gotten out of hand”.

“The national Test & Trace programme was allocated eye-watering sums of taxpayers’ money in the midst of a global health and economic crisis. It set out bold ambitions, but has failed to achieve them despite the vast sums thrown at it,” said Public Accounts Committee chair Meg Hillier MP.

“The continued reliance on the over-priced consultants who ‘delivered’ this state of affairs will by itself cost the taxpayer hundreds of millions of pounds,” she added. The PAC report found the daily rate for consultants was £1,100, but in some were paid way over that amount.

In an explanation about the programme’s over-reliance on consultants, NHST&T previous head Dido Harding said that the nature of the pandemic required the service to pool all the human resources that it could, including volunteers, the Army, civil servants and consultants.

Regarding consultants specifically, the previous programme head noted that Track & Trace needed consultants not only because the required skills were non-existent in the civil service, but partly because a number of the roles were temporary given the nature of the project.

Responding to the Public Accounts Committee, the UK Heath Security Agency (UKHSA) told the PAC that the programme had reduced the number of consultants in place from a peak of 2,504 to 1,864 over the previous four months.

The UKHSA also noted that it has a “very detailed ramp-down plan” to reduce use of consulting resource by the end of March 2022, and that it was committed to doing so “balanced with the delivery of national priorities, ensuring the sustainable handover of critical knowledge, and managing recruitment into high-skill roles”.

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