The government’s test-and-trace programme to combat Covid-19 has repeatedly failed to meet targets for delivering test results and contacting infected people despite costs escalating to £22bn, a damning official report has revealed. The National Audit Office (NAO) has found that the centralised programme is contacting two out of every three people who have been close to someone who has tested positive, with about 40% of test results delivered within 24 hours, well below the government’s targets. The report said a target to provide results within 24 hours of in-person testing deteriorated to a low of 14% in mid-October before rising to 38% in early November. Call handler contracts for those working on test and trace were worth up to £720m but many staff had very little to do, auditors said. By 17 June, the utilisation rate – the proportion of time that someone actively worked during their paid hours – was 4% for health professionals and 1% for call handler staff, the report shows. Utilisation rates remained well below a target of 50% throughout September and for much of October. This means substantial public resources have been spent on staff who provided minimal services in return. Jonathan Ashworth, the shadow health secretary, told the Guardian that the report has uncovered a gaping hole in the UK’s defences against the disease. “The £22bn test and trace now has a budget larger than policing and fire service combined, has seen multimillion pound contracts handed to big private outsourcing firms rather than mobilise experienced public health expertise, and failed to trace sufficient numbers of contacts or ensure those who are contacted have decent financial support to isolate,” he said. The study from Whitehall’s spending watchdog found that up to the end of October, the scheme spent £2bn less than forecast due to underspending on laboratories, machines and mass testing. Of the £15bn of funding confirmed before the November Spending Review, about £12.8bn (85%) was assigned to testing and £1.3bn to tracing. In total, 70% of early contracts by value were directly awarded without competition under emergency measures, the report said. Contracts worth £7bn have been signed with 217 public and private organisations to provide supplies, services and infrastructure, including test laboratories and call handlers for tracing. NHS test and trace (NHST&T) has plans to sign a further 154 contracts, worth £16.2bn, by March 2021. A target to provide results within 24 hours of in-person testing in the community has not been met, auditors found. The report said that turnaround within 24 hours peaked in June at 93% but subsequently deteriorated to reach a low of 14% in mid-October before rebounding to 38% in early November. Auditors found that while the government had “rapidly scaled up” the operation from a low base, at times “parts of the tracing service have barely been used”. The report said: “In May, Department of Health and Social Care (DHSC) signed contracts for the provision of 3,000 health professionals and 18,000 call handlers. The call handler contracts were worth up to £720m . “By 17 June, the utilisation rate (the proportion of time that someone actively worked during their paid hours) was low for both health professional (4%) and call handler staff (1%), indicating that they had little work to do. “DHSC had no flexibility to reduce the number of call handlers under the original contracts, which ran for three months. “It negotiated new terms in August and reduced the number of these staff to 12,000, but utilisation rates remained well below a target of 50% throughout September and for much of October. This means substantial public resources have been spent on staff who provided minimal services in return.” The report found that NHST&T did not plan for the sharp rise in testing demand in September when schools and universities reopened. As a result, laboratories processing community swab tests were unable to keep pace with the volume and experienced large backlogs, which meant NHST&T had to limit the number of tests available. A DHSC spokesperson said turnaround times had been steadily improving over recent weeks, and the latest performance figures showed that tracing had dramatically improved, now reaching 85.7% of contacts. “As the Covid-19 vaccination programme is rolled out, we are determined to ensure that NHS test and trace plays an even more effective role in stopping the spread of the virus.”