A new report by NHS Providers says the public focus on delivering 100,000 tests on April 30 for COVID-19 is a "red herring" and is distracting from the key issue – the need for a clear, updated, testing strategy as we start planning to exit lockdown.

Testing questions in testing times says that NHS trust leaders believe they have done all they can to support the national testing effort so far but are increasingly frustrated with the lack of clarity on how the testing regime will be developed for this next phase.

NHS trust leaders believe they have done all they can to support the national testing effort so far but are increasingly frustrated with the lack of clarity on how the testing regime will be developed for this next phase.

   

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At the moment they feel they are on the end of a series of frequent tactical announcements extending the testing criteria to new groups with no visibility on any longer term strategy, and are being expected at the drop of a hat to accommodate these changes with no advance notice or planning.

They are worried that the push for 100,000 tests a day may also be driving "testing for testing's sake" in order to maximise the numbers, rather than ensuring that those who need a test can actually get one, which is the most important priority.

The report also highlights concerns that in focusing on the needs of acute hospitals, those of ambulance, community and mental health trusts, alongside GPs and social care, have not been given sufficient weight.

The report also highlights concerns that in focusing on the needs of acute hospitals, those of ambulance, community and mental health trusts, alongside GPs and social care, have not been given sufficient weight.

   

The report acknowledges that the UK started from a comparatively weak position in trying to create an effective testing regime. This was a complex challenge. Initial capacity was insufficient and dispersed, and accountabilities were fragmented.

However the report is clear that trust leaders and the NHS are dependent on government plans as ministers have overall responsibility for testing strategy, co-ordination, determining who should be tested, and plans for expanding testing capacity.

It sets out the key ingredients for an effective testing regime:

• a clear overall strategy  
• the right testing criteria – who should be tested for what purpose, when and how often
• the right capacity, access and reliability – so those who need a test can get easy access to one that’s processed quickly and accurately whenever required
• excellent co-ordination – ensuring a complex system, with a vast number of different organisations and people involved, runs smoothly end-to-end.

As attention moves increasingly from the initial peak of the pandemic towards ending the lockdown, the need for an updated strategy is becoming more urgent. The report sets out six questions this updated strategy must address:

• When will every patient and health and care staff member with suspected COVID-19 symptoms who needs a test be able to consistently get one within an appropriate turnaround time?
• How will the current problems with access to key worker testing be overcome?
• What are the detailed plans for the expansion of current  swab testing, and how will the government prioritise the increased capacity?
• What is the plan to return to tracking and tracing any new outbreak of the virus as part of progressively exiting lockdown?
• Given the need to control the risk of cross infection in healthcare settings, what are the detailed plans to move to systematic regular testing of all NHS and care staff?
• What role does the government now expect antibody testing – to identify people who have had the virus - to play?

The chief executive of NHS Providers, Chris Hopson, said:

"The NHS has achieved so much in confronting the challenges posed by coronavirus.

"However testing is one area where, despite all the work delivered by trusts and the NHS, the health and care system as a whole has struggled to develop an effective, coordinated approach.

Testing is one area where, despite all the work delivered by trusts and the NHS, the health and care system as a whole has struggled to develop an effective, coordinated approach.

Chris Hopson    Chief executive

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"Our report sets out some important questions on what’s happened so far that any subsequent public inquiry may want to explore.

"But as we consider the route out of lockdown, what trust leaders need now is clarity on the testing regime from here on.

"Setting a target for a number of tests for 30 April may have had a galvanising effect. But what matters most is an updated strategy to take us through the exit from lockdown.

Setting a target for a number of tests for 30 April may have had a galvanising effect. But what matters most is an updated strategy to take us through the exit from lockdown.

Chris Hopson    Chief executive

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"Trusts stand ready to play their part in delivering that new testing regime, but they need to know a lot more, as quickly as possible, to play that part effectively".