1. It is the strong and unanimous view of Independent SAGE that implementation of a functional and effective Find, Test, Trace and Isolate and Support system is an essential component of the public health response to the COVID-19 pandemic, and now a matter of extreme urgency. Following a period of intense public health measures incorporating strict social distancing measures to rapidly reduce the current high level of infections, this will ensure that further new infections are minimised, the economy can open up, and give us the best chance of reducing the need for future severe restrictions or full lockdowns.

2. As it stands today, ‘NHS Test and Trace’ is failing. We are witnessing ever increasing delays in the time to receiving test results, the time to contact people with new positive tests, and the time to reach their contacts. Fewer contacts are being reached and there are low levels of isolation amongst those infected and their contacts. After many months of promising a “world class” service, and “record testing capacity”, even Boris Johnson and other government minsters now recognise it requires major improvement. The Chief Scientific Advisor, Sir Patrick Vallance states that Test and Trace has “room for improvement…..that is diminishing its effectiveness “[1]– despite an extraordinarily large budget of £10bn.[2] A senior Conservative MP has suggested that Baroness Dido Harding should resign or be replaced.[3]

3. Independent SAGE has long put forward a comprehensive and scientifically credible case for an integrated Find, Test, Trace, Isolate and Support system.[4] Nothing that has, or has not happened, has changed our view that building such a system is vital.

4. A new overall structure underpinned by robust governance and accountability is required to improve Test and Trace. Independent SAGE has published an emergency plan and blueprint[5] to guide comprehensive reform and rebuild of the Test and Trace system so that it works effectively and prevents the need for repeated lockdowns.

5. Whilst the skills and experience of those currently leading and advising Test and Trace are insufficient for a core public health function,[6] there needs more than just a change of personnel.

6. There is now an urgent need for the misnamed ‘NHS Test and Trace’ to be truly integrated within the NHS, rather than existing as fragmented and outsourced functions with confused lines of accountability. From a new setting within the NHS, it needs to dovetail seamlessly with local Directors of Public Health, Local Authorities and primary care.

7. This will go some way to restoring trust and helping the population to tolerate short term severe restrictions knowing that a fully functional Test and Trace programme will be forthcoming.

8. The current multiple testing pillars should be coordinated and further expanded under the governance of NHS specialist laboratories.

9. Contact tracing should be driven by adequately resourced and supported local Directors of Public Health, in close liaison with local authorities who can ensure appropriate support and resource is available to support those asked to isolate.

10. The current £10bn budget available to ‘NHS Test and Trace’ should be reallocated in keeping with the above requirements.

11. We further advise that it is vital that a new FTTIS structure is in place by the time current statutory restrictions and other social distancing measures are relaxed.

[1] https://www.bbc.co.uk/news/av/uk-54652064

[2] https://www.nhsconfed.org/resources/2020/07/summer-statement

[3] https://news.sky.com/story/coronavirus-senior-conservative-mp-and-johnson-ally-calls-for-dido-harding-to-be-axed-from-test-and-trace-role-12113820

[4] https://www.independentsage.org/category/fttis/

[5] https://www.independentsage.org/emergency-plan-for-stopping-the-spread-of-covid-19-in-england/

[6] https://www.lgcplus.com/services/health-and-care/revealed-top-leadership-team-at-nhs-test-and-trace-includes-just-one-public-health-expert-15-09-2020/