The results of hundreds of thousands of coronavirus tests carried out at privately run drive-through centres in England have not yet been shared with GPs or local authorities, who complain they have “no idea” where local disease clusters are.
GPs told the Guardian they had been “totally left out of the conversation” after the government said it was still “working on a technical solution” to get Covid-19 test results into individual GP records in England, having promised to do so weeks ago.
Meanwhile, the chief medical officer for England, Prof Chris Whitty, apologised to local health leaders who have not yet received any detailed data from “pillar two” tests conducted by the private firm Deloitte over the past month. These now form the majority of tests being carried out each day, either at drive-through testing centres or via the post.
Initially only patients in hospital could get tests in the UK. Then testing was expanded to NHS staff and care home staff. Now up to 10 million essential workers and their families who are showing symptoms of coronavirus can apply for a test via a government website.
The list of essential workers is the same as the one used to allow the children of key workers to carry on going to school during the lockdown. In addition to health and social care staff, the list includes teachers, judges, some lawyers, religious staff, and journalists providing public service broadcasting.
Also included are local civil servants, police, armed service personnel, fire and rescue service staff, immigration officers and prison and probation staff. Some private-sector staff also qualify including vets, those in food production, essential financial services and information technology, as well as those working in the oil, gas, electricity and water sectors.
During a conference call on Wednesday with directors of public health at local authorities across England, the government’s national coordinator of the UK coronavirus testing programme, Prof John Newton, also apologised for not yet sharing the detailed data. He said there had been “data quality issues”.
Newton admitted that the Deloitte tests did not yet ask people for their ethnicity or whether they worked in health or social care – an oversight described by one director of public health on the call as “really disappointing”. People of colour and healthcare workers and those working in care homes are known to have much higher incidences of the disease.
When the government began its pillar two testing scheme in late March it promised GPs that results would be linked to the medical records of patients in England.
But Nick Mann, a GP at the Well Street surgery in Hackney, London, is one of many doctors to complain this has not happened. “As a GP I’m absolutely fuming, not only with the way it’s been mishandled but with the unreliable information we are getting,” he said. “This government has developed a completely parallel system in order to bypass the NHS, and it’s failing.”
Helen Salisbury, a GP at the Observatory Practice in Oxford, has 100 suspected cases on her list and only five with a confirmed positive test. “We have had absolutely zero information. The only way I know if a patient of mine has tested positive for Covid is if they have been ill enough to be admitted to hospital. It feels like we’ve been completely left out of the conversation, whereas most of the Covid out there is being handled by GPs,” she said.
Those responsible for coordinating the coronavirus response at local authority level in England also say they have not yet received any detailed data from the Deloitte tests.
Dominic Harrison, director of public health at Blackburn with Darwen council in Lancashire, said: “The Deloitte screening programme has now been running for a number of weeks and we have seen no data from that. So I have no idea whether 10, 100 or 1,000 Blackburn with Darwen residents have tested positive.
“I certainly hope they sort that out very very quickly because it is critical information for us in developing the strategy for case finding and contract tracing once the lockdown is lifted..”
Colin Cox, director of public health in Cumbria, said he had received only headline figures from the Deloitte testing centre in Penrith, and no postcode-level data to identify any local clusters.
“We’ll certainly need that level of detail once we get back to a process of contact tracing (though lots of that will be a national process not a local one). Before then, there wouldn’t be a clear policy response to knowing that. But certainly the fragmentation of the testing system has been a challenge,” he said.
Greg Fell, director of public health in Sheffield, said: “If we really want to get to grips with who has tested positive and chasing down their contacts, we need this detailed data fairly rapidly, particularly when the lockdown restrictions are relaxed.”
Prof Martin Marshall, chair of the Royal College of GPs, said: “We would expect GPs to receive a timely copy of a patient’s results, particularly if they are positive, so that we can provide appropriate clinical advice for patients – not just about Covid-19, but having a full picture of a patient’s health, including their medical history, will help us to deliver holistic care to them for other conditions and illnesses.”
This week health ministers in Scotland complained that they had been barred from seeing thousands of coronavirus results from rapid testing sites for weeks because of data restrictions imposed by the UK government.
The Department for Health and Social Care said data from the pillar two testing programme was shared daily with Public Health England, National Services Scotland and the Public Health Agency in Northern Ireland, and would soonbe shared hourly.
“We are working on a solution for local authorities to access data to support local and regional decision-making,” a spokesman said. “We are actively planning to get Covid-19 test results into individual GP records in England. NHS Digital are leading on this, and it involves working closely with the Royal College of GPs and the British Medical Association.
“This needs to be carefully done to minimise any clinical safety risks and ensure it is done accurately. We are making good progress on the technical solution for this work but it will take some time. Scotland, Wales and Northern Ireland will have their own processes relating to healthcare records.”
Deloitte has been approached for comment.
