Private labs unable to process all Covid tests, NHS email reveals

Laboratories that analyse swabs from people in the community, including care homes, were stretched to capacity even in late August, unable to process all the Covid test samples coming in and seeking help from the NHS, the Guardian can reveal.

On 24 August, all NHS labs, which process hospital Covid tests, were sent an email from NHS England “regarding the urgent call for support from the pillar 2 team” – the Lighthouse labs analysing the community swabs.

“This is due to a surge in current capacity and is a short term call for support potentially for the next 2-3 weeks,” said the email from Amanda Parsons, the national strategic improvement programme delivery lead.

“Please may I ask for any labs who have not yet responded (and many thanks to those who have and offered support, you will have heard from me recently) to make contact if they are able to offer an additional 500 or more tests per day.”

The appeal was so urgent that labs were asked to respond within 24 hours.

The first private sector Lighthouse labs were set up in April by a project run by the accountancy firm Deloitte, bypassing the NHS and the public health network. They have operated separately from the NHS labs and use different kit. This was potentially a problem for NHS labs willing to help.

The email said people from one NHS lab that had taken on some of the Lighthouse workload on a pilot basis was available to talk though potential issues, including logistics, supplies and IT.

The email, seen by the Guardian, was sent three weeks ago but the testing situation has not improved. There were accusations on Monday that it had deteriorated into a “shambles”, with people in 10 of the worst-hit coronavirus hotspots unable to get tests.

Prof Alan McNally, of the Institute of Microbiology and Infection at Birmingham University, who helped set up the first Lighthouse lab in Milton Keynes, said it was hard to know why tests were unavailable. “It is the most closely guarded secret in the UK right now,” he told BBC Radio 4’s PM programme on Monday.

“It’s definitely not a staffing issue. My understanding is the labs are still churning out the same number of tests they have been since May and June.

“I wish that there would have been some clarity and honesty and open communication. If this was Public Heath England or the NHS that was running this testing system, there would be full transparency and public disclosure of what the issues were.”

It was fairly clear, he said, that the private labs were intended to be a long-term replacement for the public health network. “Infectious disease diagnostics were going down a privatised route.”

Allan Wilson, the president of the Institute of Biomedical Science, the professional body for lab scientists, said more openness from the private sector labs was essential. They had not disclosed how many tests they were able to carry out, he said, and may now be overwhelmed because their capacity was insufficient.

“We are calling for transparency. We need someone to lift the lid on the Lighthouse labs and say what is the capacity,” he said.

On the government’s coronavirus website, testing capacity is given as a total of pillars 1 (NHS) and 2 (Lighthouse labs). This week it totalled 243,817. But Wilson said the NHS labs were doing a fairly steady 100,000 to 120,000 tests, and taking over some care home testing. That left the Lighthouse on not much more, with high and rising demand from the community.

He said the secrecy was frustrating. “We really want the NHS labs and Lighthouse labs to work together in a single stream so we can pull together and maximise capacity. Some of the Lighthouse labs are quite close to NHS labs, but we don’t communicate meaningfully at all and we are constantly rebuffed.”

Wilson said he didn’t think the Lighthouse labs ever reached the capacity that was hoped. “That’s been exposed because there is a bulge in demand.” He said there was a cold virus circulating, causing symptoms which resemble those of coronavirus, and schools had returned, which always led to viruses being passed around in non-Covid times.

He said the two pillars – NHS and community – should be merged and samples taken and processed locally.

He said it was not just people being sent miles for a test; the samples were then dispatched long distances to labs. He had heard of somebody whose test was done in Derby and sent to Glasgow for processing.

McNally said processing delays risked the samples deteriorating to the point where they were no longer useful and should be repeated. “If you’re struggling with demand on a daily basis, as they start to accumulate and you get days behind, all those tests are essentially spoiled – even tests that contain lots of virus,” he said.

The Department of Health and Social Care said capacity was the highest it had ever been, but there was “significant demand” for tests. It estimated about 25% of people booking tests were not eligible because they did not have symptoms and were not part of an at-risk group.

“New booking slots and home testing kits are made available daily for people with symptoms and we are targeting testing capacity at the areas that need it most,” a spokesman said.

“Our laboratories are processing more than a million tests a week and we recently announced new facilities and technology to process results even faster. If you do not have symptoms and are not eligible to get a test you can continue to protect yourself if you wash your hands, wear a face covering and follow social distancing rules.”

The Guardian

Leave a Reply