Transparency data

NHS Test and Trace Programme: 2021 to 2022

Published 3 March 2022

On 21 February, in a statement to the House of Commons on Living with COVID-19, the Prime Minister stated that the NHS Test and Trace Programme: “…cost a further £15.7 billion in this financial year, and £2 billion in January alone at the height of the Omicron wave”. This ad hoc publication presents the source of these figures and how they should be interpreted.

Background

The UK Health Security Agency (UKHSA) produces monthly financial management reports for internal decision making. These include a forecast of expenditure for forward planning, based on the most up-to-date information available at the time of preparing the reports.

UKHSA follows the Government Finance Function recommended processes for this management reporting. Experts in the finance team complete assurance checks on these reports. The forecast uses information held in internal systems such as payments, receipts, and adjustments for liabilities. The methodology section provides further details. The forecast applies relevant accounting standards to provide UKHSA’s forward financial view based on the current data.

At the time of forecasting for January 2022, the Omicron threat was high. All services reflected the prevailing science advice to maintain higher levels of service to meet the heightened demand and increase volumes of testing kits.

These figures were provided for the Prime Minister’s statement as a forecast of costs based on current data. The forecast is volatile and may not reflect the true expenditure. Since finalising the January forecast, the government has made several policy announcements that could influence population behaviour but are complex to factor into financial forecasts. These include:

• confirmatory polymerase chain reaction (PCR) tests no longer being required for asymptomatic cases
• reducing self-isolation for those with COVID-19 to 5 full days following 2 negative rapid lateral flow tests
• daily rapid testing for COVID-19 contacts
• the Living with COVID-19 announcement

The actual 2021 to 2022 expenditure for NHS Test and Trace will be published in the Department of Health and Social Care (DHSC) and UKHSA Annual Report and Accounts which are expected by January 2023. The UKHSA annual report and account will include only the expenditure that was incurred from 1 October 2021 (the date at which it become responsible for the operational delivery of NHS Test and Trace).

Methodology

The January forecast response was based on anticipated demand levels driven by the Omicron variant. Internal modelling does not provide one point estimate but a range of outputs designated as high, medium and low forecasts. The medium forecast was used to estimate that 2021 to 2022 spend would increase to £15.7 billion with an estimated £2 billion spend in January 2022.

The main drivers of this estimation were an increased demand for rapid lateral flow and PCR tests, with the associated logistics costs.

This figure was an interim, unaudited forecast made in December 2021, based on internal Omicron assessments. At the time of forecasting, the Omicron variant was expected to peak in January, with an increased number of people expecting to use both rapid lateral flow tests and PCRs for both symptomatic and asymptomatic testing. The modelling considers both science advice and builds on the behavioural changes. Based on experience of Alpha and Delta variants the demand in January 2022 was expected to be the highest since April 2021.

Behavioural changes influenced by policy changes remain the key driver for volatility in forecast figures. In addition, media coverage, for instance on the availability of free rapid lateral flow test kits, can cause spikes in demand and influence behaviour.