Testing times for NHS
JUST over a fortnight ago, Andy Burnham and Matt Hancock met face-to-face in a TV studio.
On March 18’s edition of BBC Question Time – filmed without a studio audience – Greater Manchester’s mayor grilled the health secretary on his claim that frontline worker testing would be ramped up to 25,000 a day within a month.
Mr Burnham, himself a former health secretary, reported ‘a lot of scepticism’ within the upper echelons of the NHS here about whether that was really possible.
“People are saying they can’t see how that’s going to be delivered any time soon, because it requires standing down screening capacity and freeing up lab capacity in other parts of the NHS,” he said.
“And I think people are struggling to see when that will come through.”
In response, the minister said he had been ‘buying tests today,’ before wandering off the point.
Pushed on when the 25,000 figure would be hit, he eventually replied: “That’s going to happen in the next couple of weeks. We’re going as fast as we can.”
That was a couple of weeks ago. The last few days has seen the national front pages full of criticism for the apparent drift since then, while the health secretary said the test figure was just 1,500. Unlike Germany, this country does not have an existing diagnostics sector, he said in the government’s defence, but it would now start to build one. Six weeks into the outbreak and a fortnight into lockdown, he also finally announced government would be working with universities and the private sector.
There have been furrowed brows in Greater Manchester over why that has not happened sooner.
In a region that includes a considerable degree of biomedical expertise, many would contest his claim from a fortnight ago that government has been going ‘as fast as we can.’
The M.E.N. understands both Manchester University and Salford University have spare lab capacity and dozens of scientists – some of them furloughed – in a position to step up to a national testing response. Greater Manchester’s has since politely – but pointedly – noted that there is a significant level of expertise here waiting to be used. Plus, it wants to help.
“What I would want to get over to government is that Greater
Manchester stands ready to help in a national effort to get testing capacity up to the level that is required,” he said.
“I’ve spoken with Dame Nancy Rothwell, Vice Chancellor of Manchester University.
“She’s speaking to the other universities and together with the NHS in Greater Manchester – of course very aligned with our universities – we’re doing all we can to try and mobilise staff, laboratory space and indeed chemical reagents to support the national testing effort.
“That offer goes out from Greater Manchester to the government: we stand ready to help in any way we can to mobilise that extra support to increase the number of tests.”
A number of theories about the slow progress are put forward by senior figures here. The most common is that the NHS is so topdown, it has been unable to move and adapt with the necessary agility.
“Overall it does appear to be that it is to do with the combination of command and control and bureaucracy, which means they just don’t have the flexibility and bandwidth to change tack,” says one source, noting that the approach to testing has so far been strictly centralised. At the beginning of the outbreak, for example, Manchester, Oldham and a number of other local authority areas all had significant community testing programmes ready to go, including the potential for drive-through centres. But weeks later, they still have not had the green light nationally to use them.
A similar assessment is applied by some to the hold-up in deliveries of protection equipment, which has seen national figures insist that it does exist in significant quantities, while local authorities, police forces and hospital trusts find themselves having to wrangle over actually getting hold of it.
The counter to that argument is that the NHS has to be top-down in order to get through a crisis.
Nevertheless although Greater Manchester has identified a number of sites suitable for drive-through NHS frontline testing, including space at Alderley Park, Manchester Airport, Trafford Park and Heaton Park, nothing had apparently been signed off nationally. Again, in Greater Manchester nobody spoken to by the Manchester Evening News seems to know why specifically this is, when the government announced several days ago that there would be five such sites nationally and two have already opened in the south of England.
One possible reason given for the slow pace – including by the government itself – is the lack of chemicals known as ‘reagents,’ the substance used by labs to actually process the tests carried out by hospitals.
Certainly a shortage within the system has caused issues. It is understood the region’s biggest lab, at Manchester Royal Infirmary – which processes tests from a string of hospitals – has not been running at full capacity due to a lack of reagent.
Yet one senior insider says that while this is an issue, ‘it may not be the showstopper everyone is making it out to be,’ arguing that the biotech sector has not actually been asked to step up to make any extra.
And there is another factor some suggest is at play, albeit one denied by Public Health England.
Some believe there is a culture clash within the national health system: between a more academic, ‘purist’ approach towards processes within PHE, and a more pragmatic view taken by those within the NHS itself. Manchester’s experts are on standby. The health secretary may need them if that figure is to withstand more scrutiny than the one he announced a
fortnight ago.
Manchester’s health experts are on standby. The health secretary may need them