How did we end up in this testing mess?

The UK appear to be having significant problems getting an effective Test and Trace system up and running.  Problems have included

  • Our initial ability to provide mass testing
  • Failure to get an effective tracking/contact system up and running
  • The current problems with test availability leading to queues, delays and potential rationing.

To me, this looks like a classic supply and demand problem. Of course having been in operations management in the past there is a risk that anything will look like that to me. However, in this case, it is not without cause. I think it would be helpful for the NHS at least to starting asking the questions that people responsible for capacity management would ask. So, here are some of the issues I would be looking at if I were running the system.

  1. Did we prepare properly for additional demand at this stage in the process. There was the risk that as cases reduced coming out of lockdown, that this might lead to the system slowing down at exactly the point when an increased number of people were likely to be needing to test.
  2. Was the system set up in a way that would be responsive and flexible. Ideally, you want to avoid command and control and try to stay away from large, centralised test centres. It is better to get the tests out to to the frontline, available in the community, at workplaces and schools. However at the same time you need to ensure that you can move test capability to where it is needed.
  3. This also means that you need to be able to trust the system to deliver. If not, then what tends to happen is that kit and resources are stockpiled/held onto in places where it currently isn’t needed whilst other places go short.
  4. You need to watch out for failure demand.  If we are pumping out lots of tests but they have to be repeated or are not actually needed then that is a failure.  Everytime someone comes back into the system for a further test, every time someone contacts the centre with a problem, every time someone turns up for a test when they did not need one in the first place; on each of those occasions you are engaging failure demand that takes away resources from genuine need.  In that respect, the Government setting targets for numbers of tests and giving themselves a pat on the back when they hit them hinders rather than helps the effort.

If we are to beat the pandemic, we are going to have to work smarter rather than just harder.  We need to make sure that we are properly understanding what is happening.

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