Widely criticised, the NHS Test and Trace system can teach us valuable lessons about the challenges inherent in running grand-scale public sector technology projects
It has been one of the most visible examples of public sector technology and has come in for its fair share of criticism. The NHS Test and Trace programme seeks to identify people who have come into contact with those who tested positive for coronavirus and encourage them to isolate for 14 days. But as well as attempting to trace and contact, it also tries to match requests for tests with available testing capacity.
Test and Trace is meant to be a pillar of the country’s response to the novel coronavirus COVID-19. Yet it hasn’t worked as well as people and politicians had hoped. The project has been criticised for poor efficacy and sluggish responses, though those behind it say it is improving all the time.
Nevertheless, the hiccups and headaches tracing teams have faced in trying to get people contacted by the NHS are an instructive, real-life case study of some of the pitfalls of public sector tech and provide contemporary lessons for future projects.
Think small, not big for public sector tech projects
One of the key problems that has blighted Test and Trace has been its ability to scale. “We make things too complicated all the time,” says Tom Forth of ODI Leeds, a node of the Open Data Institute, which looks at how data can be used to improve public services.
“Specifically on Test and Trace, why have such a big organisation? Why do it for the whole of England? Why not use local authority capacity? I know that doesn’t feel like a tech question, but it really is. Generally tech doesn’t scale very well.”
The UK public sector is fixated on equality in systems, which can result in grand, sweeping projects being developed where piecemeal ones may be better able to serve the population. “This was a problem of scale and complexity,” says Forth. “It is technically a very hard problem to do for the whole of the UK. But we did it because that’s who we are; we are obsessed with equality and a national solution to everything.”
Splitting the system up regionally may have resulted in unequal development at times, but it would have made more logical sense. “This stuff is all pretty widely known by people who write software,” explains Forth. “As simple as possible, as small as possible, as early as possible, then fix, fix, fix.”
Open up SME access
The alternative, if you want a truly national system built from scratch, is unenviable and expensive. Facebook spent $13 billion on research and development last year to run a social networking site, never mind a massive, vitally important system to track a pandemic. Tackling the problem small pieces at a time could have helped speed up rollout and perhaps avoided some of the stumbling blocks.
“Government is very reticent to deal with small and medium-sized enterprisers (SMEs),” says Rod Plummer of Shoothill, a Shewsbury-based software company that has previously bid for government contracts and won just one. “The civil service are risk averse to dealing with SMEs because they’re frightened we’re going to go bust or mad.” But SMEs have the nimbleness to tackle small-scale projects at speed without layers of bureaucracy and have expertise large organisations often don’t.
It’s also important to try and build a firewall between public sector technology projects and those asking for them to be delivered. “Government makes business decisions out of politics, not out of business,” adds Plummer. “Trying to anticipate what they might do, say or think in my world is almost impossible.”
Taking politics out of public sector tech
Political necessity can also muddy the waters, says Forth. Politicians can sometimes stretch the truth or make eye-catching promises to please the electorate that can be difficult to deliver through public sector tech projects. “Sleights of hand or convenient redefinitions that are second nature to humans are incredibly hard to put into databases and to write in code,” he says.
The redefinition of “tests per day” as “tests posted out” to meet landmark targets probably didn’t help those trying to code the NHS Test and Trace system. “We’ve never managed to release the number of tests performed regularly for small areas in England,” says Forth. “I suspect because it would betray some of the lying in the software.”
Allowing blue-sky thinking is also vital. While budgets need to be carefully accounted for, and therefore there’s an inherent conservatism in the procurement and rollout of projects, technology often works through unique ideas. “I was once asked, ‘Did Mrs Miggins ask for this?’” says Plummer. “Did Steve Jobs ask if people wanted the iPhone? No. He just built it and sold millions. If you ask people if they want it before building it, that’s suicide in business.”
No one doubts the herculean task required in building a world-leading Test and Trace system. “It’s very easy to criticise the government over COVID-19, but nobody’s had to face this before,” says Plummer. The scale of some of the missteps along the way, and the reasons those errors were made, are endemic within the world of public sector tech. But there’s hope that the high stakes involved in the Test and Trace programme will cause a rethink, which welcomes in smaller, nimbler, SME-friendly thinking, and that the future may be brighter.