July 12, 2020
AliExpress WW

NHS Test and Trace: This Shouldn’t Be

AliExpress WW

The doctor talks about his experience in the testing and tracking service.

AliExpress WW

On the afternoon of May 27, 2020, British Prime Minister Boris Johnson told the Commons Liaison Committee that it was time to “leave” because his special adviser Dominic Cummings had violated the blocking rules. A few hours later, Matt Hancock, Secretary of Health, announced the launch of a testing and tracking service in England.

The launch was news to me, the doctor and contact tracker, and, as it turned out, to many others.

Within a year, I was transferred from my first clinical position at the age of 15 to work as a clinical contacts specialist in the testing and tracking service. As one of the 3000 clinical contacts, I had to talk on the phone with people who had a positive result for Covid-19. I had to conduct a public health risk assessment and identify any potential contacts. At least 18,000 non-clinical call handlers have been tasked with monitoring these contacts. Johnson described it as a “beating the world” system that would handle 10,000 new cases per day.

An email appeared in my inbox at 9:48 p.m. on the night of Hancock’s announcement: “The NHS Test and Tracing will begin tomorrow!” Then a series of further emails and text messages: “You play a decisive role in the fight against coronavirus” and “Go live at 8 in the morning!”

It was a quick change from the NHS Professionals message two days before: “Please be patient during the sessions, as this is a very test environment.” Many of us have not completed the training, and technical problems have been put to the promised false calls.

Not that training mattered anyway. The Contact Tracking and Counseling Service (CTAS) website was unavailable to me on launch day, and tracers were notified of a “critical incident.” The Department of Health denied that the system had failed, but acknowledged that technical difficulties arose, saying the problems were “resolved quickly.”

During my shifts at the end of that week, there were no cases to follow, an experience that was repeated by others who spoke to other major media and newspapers, labeling the system as “chaotic” and “complete routine”. “I don’t know anyone who called a member of the public,” one of them said.

So what went wrong? One thing seems obvious: too many organizations spoil the broth. NHS used us as clinical indicators, but we were hired by Capita and placed in Public Health England (PHE). Sitel provided access to applications and tracing systems, and all of them required different usernames and passwords. Synergy CRM distributes cases and stores scripts, CTAS collects contact trace information, RingCentral is used for voice calls, and MaxConnect is used to store contact knowledge. All of these systems were available through Amazon Workspace. The training was initially conducted in the PHE learning space, and then transferred to e-health education through Health Education England.

When systems are turned off, cracks quickly appear. A simple reset of the broken password before the change required a call to Sitel (waiting time 45 minutes) to register the problem; Amazon email for password reset followed 24 hours later. From time to time, the installed systems shone through. Registration at NHS Professionals went smoothly: its platform made it easy to change orders and access payrolls. But calls for basic training required to be held for 45 minutes – subsequently, this helpline number was completely withdrawn. Email requests have not been answered. The organization seemed to be taken aback by Hancock’s statement.

Last weekend, it seemed to me, at least, a tacit recognition that this system was not yet suitable for use in clinics. I received a notification that all my future shifts have been canceled. Available social worker shifts over the next two months seem to have disappeared. It used to be up to 50 per day. Could this really be connected with a sharp increase in the number of social workers suddenly ordering thousands of shifts overnight? NHS experts told me in a chat that the demand was satisfied, and that I should continue to check for updates on the site. Internal reports suggest that full functionality can only appear in September or October.

The just published official data indicate that Test and Trace were not able to track a third of those who gave a positive result (and, consequently, their contacts) from May 28 to June 3. However, the Independent Sage called Hancock’s statement that 85% of contacts were tracked as “deeply misleading,” because Test and Trace completely missed 75% of all new symptoms during this time.

When I think about the last weeks, three thoughts come to mind:

First, before the next pandemic, there is an urgent need to prioritize a well-funded tracking system with improved testing capabilities and with the support of local governments that have been ignored. According to the Emergencies Research Advisory Group, in early March, the PHE had just 290 contact tracking tools that could “cope with five new cases a week.” 5 To give an idea of ​​the upcoming task, more than 300,000 people gave a positive result. for SARS-CoV-2 in the UK. Community wide tracking stopped on March 12th.

Secondly, any upcoming investigation should investigate the intricate formation of the Test and Trace and interview interested stakeholders. Patients suffer when heterogeneous companies with different interests gather in haste. Ministers used special powers to bypass established tender processes, transfer of contracts to private companies without open competition. email leakSerco CEO Rupert Soames doubted that the scheme would develop smoothly, but wanted to “strengthen the position of the private sector in the public sector supply chain.” As a trace, I, an employee of the NHS, are implicated in privatization secretly? 2

Finally, it is a call for candor and sincerity regarding the failure of the UK government’s public health measures. UK Statistical Office said Hancock, the test data is “far from complete and understandable,” the tests were recounted twice, and the loud figures violated the rules or, at least, played quickly and lost with them. 8

As the tracking system expands, I hope that some logistical problems can be fixed, but issues of lost trust and broken transparency will be much more difficult to fix.

This article is made freely available for use in accordance with the terms and conditions of the BMJ website for the duration of the covid-19 pandemic or until the BMJ determines otherwise. You can use, download and print the article for any legal, non-commercial purposes (including extracting text and data), provided that all copyright and trademark notices are preserved.

https://bmj.com/coronavirus/usage

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