Efforts to prevent the nationwide spread of coronavirus have been dealt a blow after it emerged thathealth officials in England and Scotland are struggling to match hundreds of thousands of coronavirus test results to patient records.
Up to 350,000 Covid-19 test samples – those carried out at drive-through centres between 2 April and 6 May – are believed to have been taken without recording individual NHS numbers or full addresses, making it harder for health authorities to track the pandemic and cases in their areas, the Guardian has learned.
It comes as the government launched a test and trace system to spot signs of fresh outbreaks. As lockdown measures are lifted, there are concerns about the risk of a second wave of coronavirus.
The devolved governments of Scotland, Wales and Northern Ireland have said they warned the health secretary, Matt Hancock, about the problem in March, before he set a target on 2 April to test 100,000 people a day by the end of that month.
Wales and Northern Ireland insisted on changes to the system in their areas in order to make it effective and ensure every result was linked quickly to each persons patient records. But England and Scotland were left with a booking system which, nearly two months after the programme launched, has left health agencies still trying to retrospectively match each result with individual patient records. This means that while individuals receive their results, their doctors are not automatically notified.
Clinicians say this meant health managers and family doctors were not able to use results from drive-through centres to contain outbreaks and boost local testing capacity where needed.
The Department of Health and Social Care (DHSC) confirmed in early May it was working to match results to patient records but that this could take “some time”.
Medical experts suggested this was a critical flaw in the projects design. Martin Marshall, the chair of the Royal College of General Practitioners, said: “Chasing targets and large numbers are meaningless … The absence of results going to patient records is making it difficult for general practice to manage the pandemic, and when it comes to track and trace, if we dont have the information we cant do what we need to do.”
Marshall wrote to Hancock earlier this month asking for GPs to get access to the missing results.
The rapid testing centres, set up by the DHSC with help from management consultants at the accounting firm Deloitte, are the backbone of Hancocks plan to control the spread of coronavirus. They account for one-third of all tests carried out each day, and that proportion is set to rise.
Initially reserved for key workers, the scheme is now open to anyone in the UK aged five and over who is showing symptoms.
When Hancock launched the scheme, which is operated by the army and private contractors acting independently of the NHS, he vowed to bring together “the best minds and the best science this country has to offer”.
Allan Wilson, the president of the Institute of Biomedical Science, the membership body for the UKs hospital microbiologists and lab technicians, said the programme design had been rushed.
“If you dont have the unique number we all use within the NHS systems then you cannot easily link the test result to the individual patient records,” Wilson said. “How are you going to test, trace and isolate if you cant locate the positive cases?”
The problem does not affect the tests carried out by NHS laboratories, which process results for hospital staff, patients and some care homes. Currently running at 27,000 a day, these tests are automatically linked to health records and can be seen by GPs and health managers.
The government is creating new databases to be used by the national track and trace call centre, which will gather information from those infected. However, the system will take time to scale. And clinicians fear that unless existing results can be matched to patient records, the data from those will be lost, with incomplete records of who has had the disease.
Hancock created a separate network operated by private contractors instead of relying on the NHS to increase the UKs testing capacity.
Deloitte designed the booking and results systems, and the outsourcing companies Sodexo, Mitie, G4S and Serco manage the swabbing centres, located in out-of-town car parks. Swabs are then sent to pop-up laboratories capable of processing 75,000 tests per day.
The DHSC said few people know their NHS numbers so it made sense to allow people to book using their names, date of birth and postcode. It arguedthat this allowed people to be matched with their patient records locally later.
The DHSC said: “We are proud of the achievement of our public and private sector partners and the amazing work of their staff and volunteers in creating a programme that is easy to use during a stressful and worrying time when they have symptoms of coronavirus.
“We have been working collaboratively across the UK to increase access to testing and as a result, we have seen a huge rise in the number of tests over a matter of weeks.”
Deloitte declined to comment further, other than to say it was one of a number of private and public contractors supporting the work.
Jonathan Ashworth, Labours shadow health secretary, said: “The governments testing and tracing regime is looking increasingly shambolic. Ministers insisted on ploughing on with handing this contract to Deloitte which has meant GPs and local directors of public health kept in the dark over test results while patient records dont get updated.
“This is no way to run an effective public health response to this deadly, highly infectious virus.”
