England’s Covid test and trace spending over £1m a day on consultants

Exclusive: revelations follow MPs’ criticism of flagship service as ‘eye-watering’ waste of taxpayers’ money

England’s flagship test-and-trace service is still spending more than £1m a day on private consultants, official figures reveal weeks after MPs lambasted it as an “eye-watering” waste of taxpayers’ money that is failing to cut Covid infection levels.

Dr Jenny Harries, the chief executive of the UK Health Security Agency (UKHSA), who is responsible for NHS test and trace, told MPs in July there was a “very detailed ramp-down plan” to cut the number of consultants.

But latest figures show that at the end of October it employed 1,230 consultants. Test and trace has average daily contractor rates of £1,100, potentially equating to £1,353,000 a day. The ratio of consultants to civil servants in NHS test and trace in September was 1:1, separate data shows, despite a target set a year ago to reduce the ratio to 60%.

At the same time, new contracts worth millions of pounds are still being awarded to private consultancy firms, the Guardian has found, despite repeated pledges to curb their use.

The test-and-trace system, which has a £37bn two-year budget that is equivalent to almost a fifth of the annual NHS England budget, is designed to identify Covid cases and limit their spread. UK daily reported Covid cases exceeded 50,000 last month and remain at about 40,000 a day.

In November 2020, test and trace promised to cut the number of consultants it employed. At that time, they accounted for 51% of staff, a figure deemed acceptable by some because the system was in its infancy. A year on, the proportion has fallen but official figures show consultants still made up more than a third (34%) of the workforce in September.

The data was published by the UKHSA and the Department of Health and Social Care (DHSC) in response to questions from the Guardian and a series of parliamentary written questions from the shadow health secretary, Jonathan Ashworth.

“There is no justification for continuing with these highly paid expensive consultants,” Ashworth said. “Ministers should ensure every penny piece of taxpayers’ money is spent wisely on patient care – not blown on expensive management consultants.”

Separate research by the Guardian reveals that in the last month the government has quietly published details of at least seven new NHS test-and-trace deals with private contractors, together worth more than £17m. One runs until at least September 2023.

The revelations come after a report by MPs concluded that test and trace had “not achieved its main objective” to enable people to return to a more normal way of life. The public accounts committee said the system’s “continued over-reliance on consultants is likely to cost taxpayers hundreds of millions of pounds”. Meg Hillier, the chair of the committee, said she was concerned the organisation was treating taxpayers like an ATM machine.

Some of the private consultants have been paid rates of more than £6,000 a day.

In June, a report by the National Audit Office (NAO) found that to scale up quickly, test and trace initially “relied heavily on consultancy support at its central office”, adding: “NHST&T told us that this is because many of the skills required were not available from the civil service within the timeframe, and some of the skills and capacities required are on a short-term basis to support the ‘build’ of the organisation.”.

Deloitte won the highest committed contract values (£298m), according to the NAO, followed by IBM (£46m), Accenture (£30m), the Boston Consulting Group (£30m), and PA Consulting Services (£30m).

“Consultants are much more expensive than civil servants or temporary staff from other public services,” the NAO said. “While access to consultancies has provided NHST&T with the skills and capacity needed to build up the test-and-trace capacities quickly, it may not, as NHST&T recognised itself, be the best use of public money to rely on consultancies to deliver the services on an ongoing basis.”

Between November 2020 and February 2021, consultants employed by the programme accounted for 51% of staff, falling slightly to 45% in April 2021. The total number of consultants employed in April (2,239) was higher than in December 2020 (2,164). UKHSA said that at the end of October this year, management consultants made up 11% of the UKHSA workforce. It also said there were a number of different consultants filling expert roles including clinical consultants.

Giving evidence to MPs in July, Harries said it was not her “ambition” to rely on consultants and that “we have a very detailed ramp-down plan”.

In the same evidence session, Shona Dunn, second permanent secretary at the DHSC, was asked by MPs to reassure them she was going to “wean the organisation off expensive consultants and get better value”.

“This is a really sharp area of focus,” she said. “The committee can be absolutely assured that we will not take our eye off this ball.”

A UKHSA spokesperson said: “Prioritising people’s health, saving lives and helping to stop the spread of Covid-19 continues to be our focus. We are working to reduce the number of consultants in a constructive and planned way without having a detrimental effect on our health protection services which we need to change over the course of the pandemic.

“A number of roles require highly sought after specialisms in competitive market places and we have employed consultants to help deliver these vital services. We have significantly reduced consultant workforce in many areas while responding to the unprecedented demands created by Covid-19. We are seeking to build a strong team of expert and generalist civil servants and always recruit to the civil service wherever we can.”


Andrew Gregory Health editor

The GuardianTramp

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