Cheshire & Merseyside NHS/PHE Testing (Pillar 1)
- Pillar 1: PCR testing capacity in pillar one has increased to ~4,800 tests per day due to the launch of additional rapid testing platforms at a number of our local labs. These platforms will primarily be used in emergency departments for testing urgent and non-elective admissions. Issues related to supply of equipment and suppliers for the new platforms are being worked through which once resolved will further extend capacity. New high throughput equipment is also expected to be delivered to labs shortly which will further extend capacity in pillar one over the coming weeks.
Commercial Testing (Pillar 2)
- Pillar 2 Testing Capacity: Available capacity for pillar 2 continues to be high, with demand running well below available capacity. There is plenty of testing capacity and anyone who needs a test can get a test. We are reviewing our use of pillar 2 testing capacity and resource in line with local priorities and the roll out of SMART and are working with DHSC on this. This will inform a review and revision to the C&M Testing Strategy.
- Regional Testing Centres (RTC): The total number of swabs taken at the RTCs in the period is 4,967.
- Satellite Testing Centres (STC): The total number of swabs taken at our four STCs last week was 308.
- Mobile Testing Sites (MTU): The MTU schedule continues to be reviewed daily against prevalence data; and in conjunction with Directors of Public Health/nominated representatives. We normally have 7 MTU for deployment in the region plus the use of strategic national reserve MTUs and from January we expect three further MTUs to be available to the region which means an allocation of one MTU per Place with a further one available in reserve. See the MTU schedule provided at the bottom of the page.
- Local Testing Sites (LTS): 11,207 tests were carried out by LTSs between 30th November and 6th December 2020. The region has 25 live LTSs. No further sites are to be established this year in Cheshire & Merseyside, however a meeting has been held to progress the second Warrington site and this is now in the pipeline for a site survey early in the New Year. The retrofitting of LTS sites for winter operation has commenced, with most planned for upgrade on 11th December.
Systematic, Meaningful, Asymptomatic, Repeated Testing (SMART) Programme
- The Liverpool MAST pilot has been hugely successful with more than 230,000 tests completed during the pilot period, with more than 1,400 people testing positive without symptoms; people who may well have inadvertently passed the virus on to others. It is this level of testing, and the approach to working at scale at pace that has led to government approving a further business case to provide more support into Liverpool City Region to extend SMART. The Liverpool MAST pilot is now complete and has evolved into being part of the wider Liverpool City Region SMART programme.
- SMART Programme roll out, following the original mass Testing in Liverpool, Directors of Public Health (DsPH) for the Liverpool City Region (LCR) have been successful in securing agreement from Government to be a ‘vanguard’ Tier 2 region. Their agreed business case seeks to extend some of the successful initiatives in the initial Liverpool pilot to the wider LCR footprint, an offer only generally available to Tier 3 regions. DsPH, their teams and the military have been working tirelessly in order to stand up 20 Asymptomatic Test Sites (ATS). The military have undertaken their handover to the LA civilian providers and will leave the region by 14th December.
- Lateral Flow Testing: we continue to work closely with our 9 Local Authorities across C&M to consider how we can best use Lateral Flow Testing as part of SMART programme. There are over 151 testing locations registered for asymptomatic testing in Cheshire and Merseyside. These are a range of targeted (e.g., workplaces) and community asymptomatic testing sites (ATS). Local Authorities are working at pace to stand up the necessary logistical arrangements to support Lateral Flow with support in LCR from Military colleagues as part of extended MACA to 13th More than 300 people across C&M have now attended the military delivered ‘Train the Trainer’ course, which will help establish local workforce to operate Asymptomatic Testing Sites.
- Further testing developments: We continue to explore a number of key areas:
- Ability to ‘dual run’ Local Test Sites to deliver either PCR Testing or LFT – a North West Proposal has been submitted to DHSC requesting this change to make the best use of resources and give DsPH the ability to flex their approach in times of low and high prevalence
- The development of ‘mobile’ ATS models – that can be used within local authorities as required
- Self-Testing, where the person completes the whole testing process on themselves – The evaluation process for this is ongoing primarily with NHS colleagues in Hospital settings – there are no firm dates yet of when we think likely to get approved.
- Confirmatory PCR Test – in the latest version of the SOP it is an express requirement to support all positive LFT results with a confirmatory PCR, to reduce the risk of unnecessary isolation. We continue to work with NHSTT to try and ‘smarten’ up this process and ensure the highest possible compliance.
- NHS Staff Testing through Lateral Flow: The bi-weekly Self-testing Testing model which has been agreed with NHS England is now well underway, rolling out across all NHS Acute, Community and Mental Health Trusts across the North West. In the C&M region, we have received just under 33,000 test kits for NHS Acute and Community staff, approximately 80% of which have now been rolled out to staff to use as part of this voluntary testing scheme. The current data returns show that out of 17,000 test results received the current positivity rating is around 0.4%, which slightly lower than emerging community data feeding through from the community Lateral Flow testing. We understand that the offer of Lateral flow tests is now also being made to Primary Care settings through NHS England and Improvement. We are still awaiting further detail on this but hope to inform further in next week’s briefing.
- Saliva Testing (LAMP): Liverpool are one of the first areas to launch this technology beyond the initial pilots which looked at small volumes to prove the workflows as opposed to a wide application for mass testing, as is our ambition. Good progress has been made this week in relation to the on-boarding of 30 more university students, biomedical scientists and a Laboratory Manager. There remain challenges within the validation process of the assays (low number of positive samples to validate), but with recent national breakthrough with access to control saliva samples, we are hopeful that this may unblock some of the challenges we have been having. We plan to launch with a modest number of tests per week throughout the Christmas period, operating approximately 1,400 tests per week. By the end of January, the lab is hoping to be able to process around 9,000 tests per week, this figure could rise dramatically if gain support to trial automation.
Pillar 1 Test Data: The data this week covers the period 30th November – 6th December, 18,863 tests have been completed (1,591 staff and 17,272 patients).
Pillar 2 Test Data: For period 30th November – 6th December, a total of 28,203 Pillar 2 tests were undertaken.
Appendix 3 – MTU Deployments:
Click here to download the MTU deployments schedule. Please note this is subject to change based on testing response required of outbreaks.