Lighthouse Labs: the cost of outsourcing

There has been much criticism of the UK Test and Trace approach during the pandemic.  In this article Graham Checkley looks at how government policy steered community Covid testing on to the rocks.

“… the UK’s preparedness and response, in terms of its plans, policies, and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors”.  Operation Cygnus, 2016. [1]

Private Sector

In March 2020, the UK government announced that community Covid testing would be done by the private sector rather than the NHS.  The outsourced contract value was £5bn for the UK over two years. [2]

While Serco went on to discover the limitations of a spreadsheet for running Track and Trace [3], Medicines Discovery Catapult, an organisation specialising in getting new treatments from research to market, were given the job of establishing the new network of community Covid testing facilities.  This network came to be known as the Lighthouse Labs. [4]

The company was founded as part of the Northern Powerhouse initiative with £5m funding from the government in 2015 [5] and received a further government investment of £55m in 2018. [6]  In 2019 they reported an income of over £8.5m, then charged £7.1m to administrative expenses and reported a loss for the year of £16,000. [5]

So, government money was going in, but with no return on that investment, and apparently there are no shareholders.  Having coordinated the creation of the Lighthouse Labs Network, they currently run a Lighthouse Lab at Alderley Park in Cheshire. [4]

Performance

The Labs themselves have repeatedly faced criticism over their performance.

Firstly, data protection & IT problems meant it was months before detailed information and statistics were getting to GPs, hospital doctors and local councils.  This was blamed for being a major factor behind the major spreads undetected in towns and cities such as Leicester. [7]

Secondly, there have also been questions over the ability of Lighthouse Labs to handle the volume of tests, with at least one case of NHS labs being called in to help them out [8], and there have been failures to meet the test turnaround time target. [9]

So, what is going wrong?

Staffing

If we look at the example of the Lighthouse Lab in Glasgow, we can find a clue.  They started to process samples for Covid-19 testing in late April 2020, and are run by a company called BioAscent, who describe themselves as a “a leading provider of integrated drug discovery services”. [10]

In their launch statement for the new facility, BioAscent stated that “More than 800 volunteers came forward to help with the facility, including highly experiences molecular scientists, technicians and bioinformaticians – all with the relevant skills and experience to carry out COVID-19 testing. The facility has been made possible through the work and commitment of partners, volunteers and University of Glasgow staff, including lab technicians, IT services and colleagues from the Professional Services across the College of Medical, Veterinary and Life Sciences in Glasgow.” [11]

The critical word here is volunteers.  I volunteer with several organisations and the ethos is always the same.  Volunteers can augment an operation but cannot be a substitute for staff. 

This was also the conclusion published in the British Medical Journal in September 2020. It seems to be a staffing problem rather than a shortage of equipment or reagents that is the issue.  “We do know the Lighthouse labs have lost a lot of staff with many postgrads and senior scientists returning to academia,” says Wilson. “But all that was highly predictable.” He adds, “I think they will struggle to recruit staff, as there is a limited pool of experienced scientists, and every hospital trust and health board is fishing from the same pool.” The Mail on Sunday reported that Boris Johnson recently wrote to the heads of 50 top universities and medical schools asking for urgent support to staff the Lighthouse laboratories.” [12]

We don’t have the testing capacity.” Boris Johnson, September 2020. [13]

Conclusion

A private company, founded with a lot of public money, which was not making a profit, was asked by the UK government to establish a network of Covid testing labs.  The labs appear to have been founded with the assistance of large numbers of dedicated volunteers and to be highly reliant on such volunteers for day-to-day operations.  Those volunteers are no longer available, and this is leading to capacity problems.

Rather than invest £5bn in an existing, joined up, NHS testing system, the UK government is paying out the same amount for one that has a poor track record and even now is of questionable use. In February 2021, with over 100,000 dead, we are beginning to realise the true cost of outsourcing.

Acknowledgements

Many thanks to Mike Downham for encouraging me to write this article.

References

[1] Report of UK’s pandemic preparedness leaves questions unanswered, says doctor, BMJ 2020;371:m4499.

[2] UK set to award Covid-19 testing contracts worth £5bn to private bidders, The Guardian, 2020. 

[3] Covid: how Excel may have caused loss of 16,000 test results in England, The Guardian, 2020.

[4] Lighthouse Lab.  The biggest diagnostic lab network in British History, Medicines Discovery Catapult, 2021.

[5] Medicines Discovery Catapult, Wikipedia, 2021.

[6] UK government invests £55 million in Medicines Discovery Catapult, thepharmaletter, 2018.

[7] Outsourced and undermined: the COVID-19 windfall for private providers, BMA, 2020.

[8] Private labs unable to process all Covid tests, NHS email reveals, The Guardian, 2020.

[9] Covid: Speed of Lighthouse lab test results falls again, BBC, 2020.

[10] About us, BioAscent, 2020.

[11] Lighthouse Lab facility begins processing samples for COVID-19, BioAscent, 2020.

[12] Covid-19: What’s going wrong with testing in the UK?, BMJ 2020;370:m3678.

[13] Five highlights from the Prime Minister’s grilling at the liaison committee, LabourList, 2020.


This work is licensed under a Creative Commons 4.0 License.

Skip to content