The government’s new lighthouse laboratories were designed to be able to centralise data on the frontline of the fight against coronavirus – but multiple public health directors say they are still being denied postcode-level and specific patient data for positive tests.
Speaking to The Independent as part of our investigation into the UK’s coronavirus expansion, several said they had been informed about clusters of outbreaks by local media rather than via the NHS test and trace service because key details such as where a person works, or their place of worship, were not routinely recorded.
Summary level information from testing carried out by the Lighthouse Labs, pillar two of the government’s testing strategy, was not made available until earlier this month and provides only aggregate totals.
Public health officials said they had been “encouraged” not to publicly criticise the Lighthouse Labs or NHS Test and Trace, which launched at the end of May.
One director, who asked to remain anonymous, said: “Once it was clear Public Health England did not have the capacity and was going to be overwhelmed they totally abandoned a local approach to testing.
“It would have been much better to have consolidated investment in capacity for testing and contract tracing in the existing public sector infrastructure in PHE regional offices and local directors of public health.
“The Lighthouse Labs were done without any consultation with us about what other options there might have been.”
Data on patients is not supplied to the three lighthouse labs, which were set up in April under a project run by accountancy giant Deloitte, and they are instead given only barcodes. The result for each barcode is then sent to NHS Digital, which marries the data to a patient’s file and sends it to Public Health England.
There is mounting concern over the threat of a second wave of the virus among local health officials who feel they don’t currently have the data and tools they need to fight a resurgence of the infection.
Dominic Harrison, public health director for Blackburn with Darwen Borough Council, said: “We have about five months to get communities ready for the second wave. The epidemiology and spread of the second wave will be different to wave one which spread up from the south and out from metropolitan areas.
“To make a difference to second-wave mortality we need scenario and action planning now. In the 1918 flu pandemic many areas had higher mortality in the second wave than in the first.”
One NHS lab manager told The Independent: “The most useful thing testing gives you is contact tracing and the ability to follow through the chain of transmission. If you’re going to do that you’ve got to doing things within 48 hours. That tells you your timeframe.
“We’re still seeing seven-day turnaround times for tests under the pillar two [lighthouse labs] system which isn’t good enough. We’re not using patient data in a robust way.
“I can just about accept none of us knew what was going to happen so I got the argument that centralised high throughput testing makes some sense but if they don’t engage with the local systems, if you don’t get that right, nothing works.”
They gave examples of patients being tested in A&E and being found to be positive after they had already been tested negative by the lighthouse labs. In other cases doctors tested under pillar two have struggled to be able to confirm that result or share it with their employing NHS trust.
One director in the north of England said: “Local public health directors have no real idea what is happening on their patch and it’s been like that from the beginning and its only just improved in the past few weeks.”
Some NHS trusts, which have ramped up their own coronavirus testing, are telling local care homes to avoid getting tests via pillar two.
One senior manager said: “People lost sight with why they’re doing the test, there is still this obsession with numbers. People taking a week to get a test result, it’s utterly pointless. In that situation the test serves no purpose, you can’t even contact trace at that point as the contacts would all be symptomatic by that stage.”
The NHS test-and-trace system asks people with symptoms to request a test online or via the new NHS 119 number, then, if they are positive, a contact tracer will speak to them to establish who they have been in contact with when they may have been asymptomatically carrying Covid-19.
Baroness Dido Harding, who is leading the NHS test-and-trace service says the vast majority of patient tests are being turnaround within 24 hours but data on this has not been released. Of those tested, the service is still only reaching around two-thirds of people who tested positive.
One local health official said: “We have no idea how many people were being tested in each of our local authorities through that pillar-two testing system. The first time we had sight of any data was the summary data about three weeks ago. We have been regularly asking for the data.
“One of the failures in the system has been to agree a shared data infrastructure between NHS 111 and 119 where patients request a test, or between the testing bodies including Public Health England, and local hospitals, but particularly Deloitte and the lighthouse labs.
“Public Health England have a separate system for outbreaks, the testers are completely separate and NHS 111 and 119 have a different system. We don’t have access to any of them.”
Ian Hudspeth, from the Local Government Association, which represents councils, told The Independent: “Timely and up-to-date data flows from all parts of the NHS test-and-trace service will be a critical tool in managing and containing Covid-19 at a local level.
“This includes the need for granular, postcode level data to make the most of councils’ ability to track down and prevent transmission of the virus. The LGA is working closely with government and national agencies to ensure directors of public Health and their teams working in councils have access to all the data they need to carry out their responsibilities.”
Medicines Discovery Catapult, which operates the lab in Cheshire, confirmed it received no identifiable patient data. Public Health England said it had provided data to local directors of public health but acknowledged more summary detail was not made available until this month.
A Department of Health spokesperson said data would begin to be added to GP records, but this would require new data feeds and system changes.
They added: “The lighthouse labs form part of the biggest network of diagnostic laboratories in British history and has been set up in a matter of months. The UK has one of the largest testing programmes in the world and it draws on the expertise and resources of a number of public and private sector partners which has undoubtedly curbed the spread of the virus and saved lives.”
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