Thread by @fascinatorfun

A couple of real stand outs from this rather good @BBC article.

Have a good look at that diagram.

Look at the disjointed, multi-organisational design of it.

https://twitter.com/jolyonmaugham/status/1329675942562832384

Whilst the Government claims “The companies and their leaders involved with testing had "hundreds of years" of experience in the field.” I can tell you that anyone who really had hands on experience of systematic screening would never design a service in this way.

Which if these companies have had “hundreds of years” of experience in running national public health screening programmes including integrated software systems, datasets, comms, sophisticated failsafe, multi-language comms as well as logistics?

None. None of them.

And that is why that response from the Government is so telling @JolyonMaugham

They did not know what they were buying. And still don’t. They THINK they were buying systematic screening

They did not even go to the National Screening Committee to ask for advice & assessment.

Instead they have bought a fragmented set of activities from multiple organisations where contracts were the defining issue as to which company would provide which bits.

“There weren’t even penalty clauses inserted for performance in many”.

Let that sink in.

And it looks as if sub contracting was permitted.

So highly personal data could be passed around multiple - and fragmented organisations.
This won’t work well.

Has anyone seen the terms of ALL these contracts yet?

Lined up the dates on each & every one?

The period of contract

What are the termination provisions if there are no penalty clauses? What does a company have to do to fail in contract delivery such that the contract is terminated? Anyone know @JolyonMaugham ?

What are the handover provisions in the event of termination?

The database? The software systems ? Personnel? The costs? The continuity?

Because, in these conditions, it isn’t just practical to say “Your Fired”.

Continuity of service, data and systems has to be ensured so patients do not get lost.

And there is a costs to that.

And the companies breaching should pay that cost.

That should be in the contracts.

And in systematic public health screening it is decidedly suboptimal to have a little bit provided by a large number of providers as you lose control of the whole.

So..what if you needed to terminate the whole design to make it function well? That is numerous contracts and subcontractors - some of which may have failed to deliver on specified contract terms, others not.

Which is why, in systematic screening where you start really matters

And they started in the wrong place with poor structural design because they did not understand what they were buying and did not ask the organisation that DOES understand what comprises a National Screening Programme. The National Screening Committee

The same is true for the Test element which needs to be an integrated part of the whole
Testing itself achieves little.

It is the follow on actions leading from identifying an infected person that should.

The aim is to isolate all infected & those at onward risk of infection

And also those who may have infected the identified person, but not be aware of it (or deliberately hiding it) - Backward tracing.

So testing needs to be a highly integrated part of the whole.

Instead what did the Government do?

You guessed it. It turned to its chums.

In March, when I heard Randox was flogging its own test I tweeted out a thread saying I hoped the Gov would not use them as they had been investigated for falsifying c 10k lab results, leading to cases being withdrawn and convictions overturned.

That is incredibly serious.

But Owen Patterson MP takes ££££ every year to lobby for them - and he does. Repeatedly.

And Randox sponsors horse racing. All in cohoots with the Jockey Club and the racing industry.

Sorry. I seem to have broken the thread.

Next⬇️

https://twitter.com/fascinatorfun/status/1329745418067062784

As is Matt Hancock, Dido Harding and as was Owen Patterson’s now deceased wife.

So rather than expanding existing NHS labs which HAS integrated software systems and networks to GPs and Public Health they went for their chums who HAVE NEVER run a systematic public health screening programme in their lives.

The thing is, the combination of ignorance, arrogance and ideology meant they did not even realise what they did not know and what they were not buying.

If anyone has a link to the programme this week that went undercover to the test labs inc Randox labs, would they attach the link?

They purchased from a company (Randox) that has had 750k defective kits withdrawn by the MHRA. Whose lab systems seem chaotic from that programme

And which the Sunday Times Investigation team suggests voids large numbers of tests.

We don’t even know the Individual labs comparative performance. We do know their contracts permitted a lower standard of work than permitted in NHS labs

As @dr_ianjackson says ⬇️

In fact I think there are more than 27 workstreams.

Within those boxes in the T&T improvement plan are several more.

Of course Randox is not the only company with a history of serious breach. Serco is too.

https://twitter.com/dr_ianjackson/status/1329745011651584005

A report from @rowlsmanthorpe and @SkyNews on that rest...looking increasingly like a PR exercise than a plan with gritty deliverables to reset.

https://twitter.com/rowlsmanthorpe/status/1329560126043394051