Breaking chains of COVID-19 transmission: Developing the NHS Test and Trace service

On 31 July, Baroness Dido Harding shared the NHS Test and Trace business plan to reduce the spread of the virus as we move into the winter months.

This briefing summarises the plan and its aim for the next three to six months to help break chains of COVID-19 transmission and enable people to return towards a more normal way of life.

The business plan addresses four key areas:

• Contact tracing – finding and isolating people who have COVID-19 and their close contacts
• Local community action to prevent and manage outbreaks
• Enabling individuals, businesses and public services to understand and manage risk
• Building a trusted organisation with and for citizens

Contact tracing

This section summarises the plans and objectives set by the NHS to improve the current test and trace system.

Key points

The test and trace system will be developed further to:

• increase awareness of NHS Test and Trace system and promote greater awareness of the importance of self-isolating
• increase capacity of daily tests to 500,000 by the end of October
• increase number of testing sites across the county to 500 by October and to continue to expand the range of additional local settings where people can access tests
• improve test turnaround times, with the aim of 80 per cent of results being provided within a day
• increase the number of contacts reached and asked to self-isolate
• strengthen collaboration with local government to further enhance contact tracing in relation to more complex cases.

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Managing localised outbreaks in local communities and reducing the risk of local outbreaks

At the beginning of the crisis, the government applied national lockdown measures to reduce the spread. As cases have started to reduce, national lockdowns are being replace by local lockdowns.

This section summaries the objectives set by NHS to achieve an effective local lockdown, with focus being on developing their data and analytics functions to support early identification of outbreaks and drive effective local and national decision making.

Key points

• Extending and enhancing contact tracing from August to help identify clusters and outbreaks and stop them growing into wider community transmission.
• Establishing an effective and resilient integrated operating model to identify and respond to outbreaks, supported by the new CONTAIN framework.
• Supporting county and unitary councils to refine and improve their Local Outbreak Control plans and ensure they have the capacity and capability to deliver.
• Increasing their ability to deploy additional testing capacity to respond to outbreaks and clusters within 24 hours of request, and within 12 wherever possible.
• Establishing robust processes to ensure effective stakeholder engagement.
• Providing tools to support effective community communications and engagement.

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Helping individuals, businesses and public services to better understand and manage risks of COVID-19 transmission

In order to return to a more normal way of living, individuals and businesses alike need to play a part in managing the spread of COVID-19. The NHS Test and Trace service will play a key role in equipping individuals and businesses with tools to manage and understand the risk of COVID-19 transmissions. This section outlines the key steps to be taking to help individuals better understand and manage the transmission of COVID-19.

Key points

• Introducing and promoting widespread adoption of an app that enables users to book a COVID-19 test and, if trials support it, allow for digital contact tracing.
• Using antibody to conduct research studies into antibodies and immunity by September and for the NHS to be at the forefront of research into immunity worldwide.

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Building a trusted test and trace service with and for the citizens who use it

For the test and trace service to be effective, uptake needs to be high among all groups. It has been found that some groups are less likely to access the service for reasons such as lack of awareness or distrust in the service itself. This section outlines they key steps that will be taken too build a trusted test and trace service.

Key points

• Improving awareness and understanding of Test and Trace through a new marketing campaign and targeted communications strategies.
• The strategy will be tailored to different audiences, with the aim to reaching into and engage with key groups, prioritising the most vulnerable and those less likely to engage with the service.
• Developing a diverse and engaged workforce that reflects the communities that they serve, with a focus on the equality diversity and inclusion.

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NHS Confederation viewpoint

To successfully reduce the transmission of COVID-19 and to help people return to a more normal way of living, a robust test and trace system is vital. We recognise that the NHS Test and Trace system has only been running for eight weeks and acknowledge the efforts that have been put into it.

The business plan sets out a number of welcome actions to improve the test and trace system especially around the involvement of local organisations and the overall improvement of the test and trace system.

As we know, it is vital that testing turnaround is quick to reduce the spread. Having previously called for faster turnaround times for test results and having expressed concerns around the number of people the test and trace service was reaching, we will continue to monitor this objective especially as lockdown is lifted.

Following concerns from our members on the lack of data being shared locally and the involvement of local organisations and systems in conducting tracing, we are pleased to see that this business plan details a model that has been designed to be local by default and partnership based. We will continue to work with government officials to ensure local involvement.

Finally, COVID-19 has further exposed health inequalities especially among black and minority ethnic groups. It is pleasing to see that more is being done to ensure that the Test and Trace service is accessible and trusted by all, but it is essential that the service engage with community networks.

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