Consultants still comprise one in four Test and Trace workers

Efforts to reduce reliance on external providers have had an impact

Credit: Gustave.iii/CC BY-SA 4.0

More than a quarter of people working at NHS Test and Trace are external consultants, nearly a year after a plan to ramp down the involvement of consultancies in the programme.

Meanwhile, the programme – for which a lack of internal digital and data skills has been cited as a key reason for its reliance on commercial providers – is having use temps to fill jobs as it continues struggles to recruit civil servants.

Just over half of the contractors working on Test and Trace left the programme over the course of 10 months last year, as part of a “consultancy ramp down programme” that began in February. As of mid-December, 1,356 consultants had left – 186 more than the plan required.

But, while the figures show efforts to cut the number of consultants are ahead of schedule, they still made up 27% of the Test and Trace workforce last month.

And the UK Health Security Agency, which took over responsibility for NHS Test and Trace when it was formed last spring, is having to use contingent labour to fill gaps when consultants leave.

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While UKHSA is recruiting officials to replace remaining management consultants “as far as possible”, many are put off by the nature of the placements on offer, civil service bosses admitted.

“Covid-19 response roles are generally offered on the basis of short-term loans, secondments and fixed term appointments to avoid a permanent increase in the size of the organisation; however, these are often less attractive, which reduces the supply of candidates,” Department for Health and Social Care permanent secretary Sir Chris Wormald and UKHSA chief Jenny Harries said in a letter to the Public Accounts Committee.

While there has been a “steady increase” in the proportion of roles filled by civil servants since last March, progress has “slowed” as many officials seconded to test and trace during the pandemic have returned to their day jobs, Wormald and Harries said.

They said the workforce strategy allows for the use of contingent labour – contractors or temporary workers from outside the organisation – “in the short term” because it is cheaper than paying consultancy fees.

UKHSA is meanwhile working on a strategy to manage future health threats that will provide “longer term certainty” about how it manages resources “to reflect changing priorities and demands”, the letter added.

The story so far
While the proportion of consultants working on NHS Test and Trace remains high compared to other government services, it is considerably lower than it was a year ago, when they made up 76% of the workforce.

Dido Harding – then head of the scheme – defended the service’s reliance on consultants in November 2020, saying it had been set up “at extraordinary speed” and required bosses to “pull on all the talents across all of society”.

“You can’t offer people permanent jobs when you don’t have a permanent organisation, so you have to employ people either as independent individual consultants or through consultancy organisations,” she said.

Last January, Harding said there was a “plan in place” to cut consultant numbers – which at the time included around 900 Deloitte staff earning around £1,000 a day – “markedly over the course of the next few months”.

However, she warned that the plan depended on being able to recruit civil servants to fill roles.

By the spring, test and trace was still having to “rely heavily” on external support, a National Audit Office report found. As of last April, 2,239 consultants were working on the programme – a slight increase since the previous December – and made up 45% of its central staff.

And in October, a scathing report by the Public Accounts Committee said a lack of digital and data skills were partly to blame for workforce woes on the “eye-wateringly expensive” programme.

Wormald promised to provide another update on the numbers in March, which he said would reflect “future changes in the nature and scale of testing and tracing services as the government’s Covid-19 response continues to evolve to reflect changing circumstances”.


Sam Trendall

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