1/14 Reports today that NHS Test and Trace is experiencing some teething problems. Thread follows, distinguishing between the things to worry about & the things that should be easily fixed. Thread draws on experience from my last job leading 10,000 HMRC contact centre staff.

2/14 Usual basis – we are not the Government, we are not @NHSEngland, we have no operational involvement with NHS Test and Trace. We are the voice of the 217 NHS ambulance, community, hospital and mental health trusts. Full details here: https://nhsproviders.org/news-blogs/press-office.

3/14 In setting up a major new contact service like this, at pace, no surprise to see early operational problems including IT issues (e.g. logins, frozen screens); process glitches; training gaps; incomplete join up between different bits of operation; uneven customer experience.

4/14 This is a key, new, public health service in the middle of the largest public health crisis in a generation. So legitimately frustrated staff will, understandably, share these issues with media outlets on an anonymous basis.

5/14 It becomes a bigger worry if problems are persisting, if staff are reporting that management aren’t listening to them, or if service isn't getting better over time, as call volumes rise. Important to aim high, particularly for this service, but also need to be realistic.

6/14 The nation is in lock down. Call and work volumes will grow as lock down eases. Work volumes likely to be lumpy rather than even, matching fluctuations in the spread of the virus. So shouldn’t be overly worried about early reports of staff initially being under-utilised.

7/14 Our view, from what we have seen, is that the new NHS Test and Trace team are doing the right things, at the fastest pace possible….Given that this work only really started properly once the Government had got past its all-focus-consuming April 30 100k tests target date.

8/14 The six issues we should be worrying about. 1. What risks are the Government running given that important local test and trace plans were commissioned on 22 May and these plans will only be ready by the end of June. These plans seem very important...

9/14 ...Local plans key to help identify local spikes; ensure social distancing in hot spots (transport hubs; parks; beaches) and secure extra testing & tracing if spikes hit. How are these risks being managed in meantime...and taken account of in current lock down easing plans?

10/14 2. Test and trace only works if those affected are willing to self isolate, even though they have no symptoms, for 14 days. This is why last few days have been so difficult. How much does Government think risk has increased and how will it restore lost confidence and trust?

11/14 3. For the NHS trusts we represent, and care homes, there is a major issue with current patchwork quilt of test turnaround times. What is being done to address this and when can we be sure that turnaround times will consistently meet 24 hour international standard?

12/14 4. NHS trusts can’t restart services until they can routinely get tests for patients needing physical treatment on an NHS site, and the staff providing that treatment. Trusts will need external testing support and are still waiting for details of when this will arrive.

13/14 5. UK many weeks behind where it should be on this activity. Many months behind other countries. Why is this? Recognise the UK started from a lower testing base than many others but why wasn’t this work properly started 10-12 weeks ago as opposed to early May?

14/14 6. As @didoharding said yesterday, this service won't be perfect (or world class!) on day one. It was never going to be. But we need as good a service as possible, as quickly as possible. What's the path to achieve this?