What an EXTRAORDINARY admission of our testing system

But foretold

“There's a growing recognition that we may never know for sure what happened with many of those early tests.

"We will probably never know how many people have been tested for the virus." https://news.sky.com/story/coronavirus-the-inside-story-of-how-uks-chaotic-testing-regime-broke-all-the-rules-12022566

2/ Before I proceed to set out the main points from this excellent piece of reporting from @EdConwaySky bear this in mind this.

This pigs ear was forseen given the way the government set about commissioning expanded testing.

3/ They did not grasp they were commissioning information as much as tests

We need to find out, BEFORE the next procurement ( @JolyonMaugham @justinmadders ) how much it would have cost to second University scientists to NHS Labs with more batch processing equipment.

4/. I did forsee it. And so did experienced public health specialist. Have established data systems was a potential strength thrown away in its pursuit of privatising the NHS.

Duplication.

Patients and tests lost.

Now we see constant, daily, historical adjustments

5/ Some days the adjustments run to tens of thousands, as it did yesterday. No explanation, as the should be each day, where and when these results started out and why it took so long to be counted.

The result as we saw last week and month.

6/ Key officials did not have the data needed to track down flare ups really early.

As with Manchester, Liverpool and Leicester.

Yet that is one key purpose of testing. Find it early. Hunt it down early. Support & enforce isolation.

Break the chain of transmission.

7/ NHS Labs & local public health are set up to do this

Why didn’t the Gov reverse its depletion of resource into them over the last decade from January when the incoming storm could be seen?

How much would it have cost to keep tests connected with patients & public health?

8/. The Gov keeps throwing OUR money at the problem allocating another £10 billion to test & trace.

Let’s NOT call it NHS test and trace because it largely is not

Yet the @UKStatsAuth has to write to Hancock to get action on magical numbers produced to daily press conferences

9/ they did not simply have to rely on PHE labs.

They could have expanded NHS labs.

But the cowboys in Government, full of arrogance and bluster, decided to take a gamble and it came up with this.

Using unaccredited labs, borrowed equipment, supported by volunteers.

10/No common IT systems.

No common datasets

No common Standard Operating Systems (SOPS) across labs.

No common Quality Assurance systems and shared learning.

No common test protocols

No common reporting

No common failsafe to close the systems loops and spot errors early

11/.
Yes. I do wonder how @CMO_England and @uksciencechief and Public Health officials could stand at the podium day after day KNOWING that the politicians were releasing grossly misleading data designed to lull the public into a false sense of security.

12/. They must have known it would go wrong. Anyone who has been involved in large scale public systematic screening would have known. Did they warn the Government? Is it in writing in emails, memos, advices?

So it was we embarked upon Pillar 2 numbers theatre in April.

13/. Those of you who follow me will know I was increasingly disconcerted by the growing gap between “tests” & “people tested” even in early May, acceleraring from 20k, to 50k to 100k, 500k then over a million.

It was OBVIOUS there was a big black hole

They doubled down

14/. Even to an outsider looking in. So the Government minister and officials must ALSO have known.

Yet the numbers theatre was pushed ever higher

Disparate Private sector resource was expanded, outside existing NHS lab, public health and systems.

OF COURSE they lost control

15/. Millions of home testing kits have been posted out, but not even a remotely equivalent number of results attached to them.

Components missing, instructions missing, tests difficult to self administer, no return labels, not collected, people told to put the kits in the bin

16/. These tests are time limited.

They have to be turned around quickly a/ to ensure that the person tested was in the infection window b/ so the sample was fresh enough for testing c/ for inward notification, trace and isolation.

17/. Don’t let them get away with “kits were not returned”.

Any competent public health screening programme would be picking this up early in systematic failsafe operations and identifying why, long before it ran to hundreds of thousands let alone millions.

18/. They wouldn’t be pointing at the public.

They would be pointing at themselves saying: “We stuffed up”

They would have a Root Cause Analysis itemising the reasons for non returned test kits of people who had a high risk of being positive. And an action plan to retest.

19/. Then they might have discovered within days that the public WERE returning thousands of kits that were void for a number of reasons. Instead it has been reported THEY ended up in the bins in the labs.

Did they even know?

Did they systematically list the reasons?

20/
Missing tubes
Preserving fluid leakage
unbagged or poor seals resulting in contamination
Bar code errors meaning they could not be connected to the patient
Lab processing errors
System recording errors
Training and QA issues

All systematically analysed. Nope.

21/. It was chaotic
Bags would arrive overnight and they didn’t know where they came from.

Because there was no end-to-end process to close the systems loop they had no way of systematic error identification and early correction.

So primitive it was being done with pen & paper

22/. “barbaric”

Rather than take stock, the numbers theatre continued by the Government, to claimed dizzy heights.

Knowing they were dizzy but now millions shortfall in outcomes.

Deloitte seem to have created systems now that provide better traceability.

But at what cost?

23/ Meanwhile a North Devon Trust was able to explain what they were able to do, turning tests around within 12 hours and reporting on it in systems containing crucial data points connecting the patient, the result, the NHS number and accessible by GPs and public Health.

24/ Not so Pillar 2 tests even on his own staff.

He has had to ask for screenshots, and create a spreadsheet for results. He couldn’t get the results of care home testing to find out who had been tested and the results.

“It was a mess. A total mess”

25/. When question officials said there was no way to get the testing numbers into 6 figures quickly enough.

That response is telling.

WHAT IS THE USE OF 6 FIGURES WHEN THE PEOPLE WHO NEED TO BE TESTED ARE NOT TESTED, AND YOU DO NOT KNOW WHO HAS BEEN TESTED AND THE OUTCOME