Ahead of the launch in late May of the NHS Test & Trace campaign, the Guardian reported that only 3,000 of the 18,000-strong team of contact tracers then being hired were to have any public health expertise – the rest would just be call handlers.

The experiences of the latter – employed by Serco and Sitel in the ‘tier 1’ group of contact tracers dealing with non-complex cases, 6,000 of whom are set to be stood down by the end of this month – have been widely reported elsewhere, but The Lowdown has managed to talk to one person working in the ‘tier 2’ clinical group, which handles the more complex cases, about her experiences of the test and trace set-up.*

Chris (not her real name) is directly employed as a contract tracer by NHS Professionals (a body owned by the Department of Health & Social Care which normally supplies ‘bank staff’ to hospital trusts) on behalf of Public Health England.

As poor training and unreliable IT were the main criticisms directed at NHS Test & Trace and Public Health England when the campaign began, we kicked off by asking Chris about the support she had received so far on those two fronts.

“Training has been self-directed, and consists of PDFs, webinars, videos and online tests,” she explained. “Most of the support documents are scripts to be used when dealing with contact situations – ie if the person is under 18, if the maximum number of call attempts has already been reached, or if the contact does not wish to participate.

“My only concern [with this] has been the lack of scenario training to help you with difficult contacts or more unusual situations. Only one of the webinars has role-played a contact situation, and this simply followed a compliant case scenario.”

One surprising aspect of the training is the alleged involvement – according to Chris – of ‘social purpose company’ the Behavioural Insights Team, responsible in this instance for introducing new learning techniques to encouraging greater recall from contacts.

Part-owned by the Cabinet Office and commonly known as the Nudge Unit, earlier this year the Behavioural Insights Team was – together with Boris Johnson’s chief adviser Dominic Cummings – reportedly keen on the now-discredited idea of building up herd immunity to defeat covid-19 in the UK.

As for the online tests, those taken by Chris relate mainly to issues such as information governance, and adult and child safeguarding. She had to get a pass rate of 80 per cent in order to take on her role.

More generally, on the IT aspects of the test-and-trace operation, Chris suggested she hasn’t had any particular concerns.

“There were the usual issues with any IT system – passwords needing to be reset, and so on – but the IT support, originally based in Madrid but now in the UK, I think has been efficient and helpful,” she said.

But aside from training and IT issues, had Chris actually been able to achieve much, given the widespread reports of contact tracers being paid to just sit around?

“I can’t say I’ve been busy – I’ve had less than one referral a week since May, although the number is increasing,” Chris said. “I’ve certainly done a lot of reading, hoovering and gardening since taking on this role.

“There’s no set number of cases to work through when you’re on shift. You just log in to see if a case has been passed to you – if it has then you work it until a conclusion has been reached. That can take just a few minutes, if the call goes straight to answer phone, or up to an hour if the contact participates.”

So was Chris able to offer any insight on whether those contacts that did engage with her calls actually go on to self-isolate? And what did she make of the inflated claims of success – in terms of test-and-trace statistics – made recently by prime minister Boris Johnson and health secretary Matt Hancock?

On the first of those two questions, Chris admitted that she’s been given no information on whether any of her contacts have acted as requested.

On the second, Chris merely said, “Absolute cock!”

*We understand that Public Health England, soon to be subsumed within the new National Institute for Health Protection, manages the third tier of the contact tracing operation, dealing with care homes and prisons.

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