Putting outsourced contact tracing spend in context

“Test and Trace is costing £22 billion – more than the policing and fire service combined – and yet according to the NAO, up to September only £785 million was allocated to local council public health teams.

Labour has repeatedly criticised the government’s approach to contact tracing for its use of private sector firms, primarily Serco, arguing for greater involvement of local health teams.

While Public Health England (PHE) health teams have consistently reached a greater proportion of contacts than private contact tracers, this isn’t necessarily a fair comparison, as the types of contact tracing differs considerably, as we’ve written before.  

On Monday, partly responding to a Guardian investigation into Serco’s contact tracing, shadow health secretary Jonathan Ashworth claimed that while Test and Trace “is costing £22 billion...only £785 million was allocated to local council public health teams.” 

These figures need a lot of context. As of October, roughly the same amount had been spent on national and local authority tracing efforts.

The Test and Trace figure represents the total budget

Firstly, £22 billion is the annual budget for Test and Trace in England, but nowhere near this has been actually spent so far. 

As reported by the National Audit Office (NAO): “Up to the end of October, [NHS Test and Trace] had spent a total of £4 billion.”

And most of this spending (around £2.8 billion) was for testing and not tracing. Around £478 million was spent on national contact tracing to the end of October.

Contact tracing in England is carried out by a number of organisations. 

National tracing efforts are carried out by healthcare professionals, and contractors from Serco and Sitel.

If a case is linked to a potential outbreak in a communal space (such as a prison, school or care home), it is referred to local health protection teams run by Public Health England for contact tracing.

Finally, some local authorities operate their own tracing operations to support the national efforts.

The budgets of national tracing, PHE regional teams, and local authorities are, to some extent, separate. 

Money for councils represents what has been spent so far

To the end of October, £464 million was spent on the “contain” operation which, the NAO says “refers to activities to identify local COVID-19 outbreaks and support local responses to the pandemic”.

Mr Ashworth’s figure of £785 million also includes money provided to local authorities after the end of October.

In a letter to the health and social care select committee, the head of NHS Test and Trace Baroness Dido Harding said that local tracing spend “is allocated via the Contain Division which is responsible for local authority relationships.”

She added: “Funds from the [contain fund] are allocated with a broad scope, recognising that Local Authorities will be best placed in understanding their region and deciding how money should be used for local test, trace and contain activities e.g. additional contact tracing. 

“Whilst we expect that the amount spent on local contact tracing to be a great proportion of the money allocated, this is left to the judgement of the Local Authority.”

So comparing the spend on “contact tracing” specifically between national and local authority efforts is difficult. However, the level of spending to support councils to contain the virus and to run national contact tracing appear to be similar up to the end of October. 

The NAO says: “The involvement of local authorities in undertaking contact tracing has gradually increased since NHST&T’s launch.”

Finally, given the claim is about local funding, it is unclear how much was spent on PHE local health protection teams in addition to this spending on national contact tracing and local authority support. 

It may be difficult for PHE spending to be split out in this way, as PHE staff have other public health responsibilities.

However, this means it is possible that more is being spent on locally or regionally focused contact tracing efforts already, than is being spent on the national effort.