1/19 Given today is April 30th, there will be an understandable focus on testing. We've published a major new briefing which argues that the 100k tests target is a red herring distracting us from the key issue: the need for an updated testing strategy. nhsproviders.org/media/689497/s…
2/19 Usual basis, we are not the Government, we are not @NHSEngland, we are the public voice of the 217 NHS ambulance, community, hospital and mental health trusts. You can find the full basis of our public coronavirus comment here: nhsproviders.org/news-blogs/pre…
3/19 Testing and PPE are the two areas where NHS trust leaders would have liked the English health and care system to have been able to perform better as part of the response to coronavirus. We started from a poor position and have struggled to catch up ever since.
4/19 NHS trust leaders believe they’ve done all they could to support national testing effort. The NHS has tested as many patients as capacity allowed. NHS has grown its testing capacity as quickly as possible. It's tested as many staff as possible, as soon as allowed to do so…
5/19 Trusts have also made as many staff as possible available for testing to support wider testing effort. NHS will today reach end April 25,000 tests/day target it was set. But overall national testing effort has struggled & lots of work still needed to make it fit for purpose.
6/19 Our briefing sets out the difficulties in creating an effective testing regime, essentially from scratch. But there’s been insufficient capacity, questions over strategy, ineffective co-ordination early on. Briefing sets out some questions we’ll need to examine later.
7/19 And many trusts have been frustrated by what they see as an excessive focus on the testing needs of acute hospitals. This has potentially been at the expense of ambulance, community and mental health trusts and primary and social care whose needs are just as important.
8/19 Main focus of our new briefing on testing is what next? Trust leaders need clarity and detail on how the testing regime will develop. At the moment they feel on the end of a series of frequent tactical announcements extending testing to new groups of people….
9/19 …But with no visibility on the forward strategic big picture. They feel they they are being expected, at the drop of a hat, to accommodate these frequent changes with no advance notice or planning, despite the fact that many of changes have significant operational impact.
10/19 We’re also in a new phase: successful negotiation of first peak and working out how to exit lockdown, carefully managing spread, avoiding a second spike and allowing economy to restart. We urgently need an updated testing strategy which answers the following six questions.
11/19 Q1. When will every patient and health and care staff member with suspected COVID-19 symptoms who needs a test actually be able to consistently access that test within an appropriate turnaround time? This was a key commitment made in the 4 April plan.
12/19 Q2. Given the current problems with access to key worker testing promised on 4 April, what are the Government’s immediate plans to rapidly improve access for this core testing group? There have been consistent reports of inadequate capacity and access problems.
13/19 Q3. How quickly does the Government expect swab test capacity to further expand and how will that extra capacity be used/prioritised once created? Q4. What’s the plan for a return to tracking and tracing any new outbreak of virus as part of progressively exiting lockdown?
14/19 Q5. Given the need for effective infection control in health and care settings, what are the detailed plans for systematic regular testing of all staff? Q6. Given current uncertainties on permanent immunity and test reliability, what is the role for antibody testing now?
15/19 The recent public focus on whether 100,000 tests will be performed on April 30 is a red herring - it's just an isolated measure of capacity at a single point in time. It's therefore a distraction from the key issue of how testing strategy needs to develop….
16/19 …All six questions outlined above are just as important tomorrow, irrespective of whether 75,000, 90,000 or 100,000 tests are performed today. Trust leaders are also worried that the “100,000 tests by April 30” target is distorting the testing regime in three key ways….
17/19 1. "100k tests by April 30" focus risks diverting energy from development of proper, next stage, testing strategy. 2. It may be driving testing for testing’s sake – maximising tests on April 30 - as opposed to ensuring each test done for right purpose and delivers value.
18/19 3. The current focus on "100k tests by April 30" may also be placing too great a priority on the number of tests completed, as opposed to whether those who should be tested can actually get a test when required. This is the most important priority.
19/19 Trust leaders and the wider NHS stand ready to play their part in creating the fit for purpose testing regime that is so desperately needed. But they need to know a lot more, in the form of an updated, detailed strategy, as quickly as possible, to do that effectively.
