Case Study: evaluating England’s COVID-19 testing programme
11th February 2025
Oxford University Innovation, in collaboration with Ernst & Young (EY), conducted an independent evaluation of England’s COVID-19 testing programme, commissioned by the UK Health Security Agency.
Overview
In the aftermath of a global pandemic, it is essential to learn from the successes and challenges of COVID-19 response to strengthen future public health strategies. Recognising this, Oxford University Innovation entered into a contract with Ernst & Young (EY) to provide the expertise of the University of Oxford in order to deliver an independent evaluation of England’s COVID-19 testing programme. Commissioned by the UK Health Security Agency (UKHSA) as part of the COVID-19: testing initiative evaluation programme, this project highlighted the power of partnerships in addressing complex public health challenges and OUI’s strength in enabling such partnerships involving University of Oxford academics.
The Challenge
As the national COVID-19 testing programme was rapidly deployed during a time of unprecedented uncertainty, UKHSA required a robust evaluation of its impact. Questions around equity of access, cost-effectiveness, and public health impact demanded an evidence-driven, multidisciplinary approach.
The Collaboration and approach
Under the vision and leadership of Prof Lisa White (Principal Investigator, University of Oxford) and Dr Reshania Naidoo (co-Principal Investigator, EY), who had previously worked together at Oxford, the EY-Oxford Health Analytics Consortium came to fruition, consisting of over 45 members from both institutions. Oxford University Innovation played a key role in bringing together world-leading academic expertise and their global networks from the University of Oxford together with EY.
Through an ‘engine room’ approach established by EY, a foundation for strong Project Management Office governance and operational control was created to support the team and UKHSA leadership as the funder. This approach then allowed academic experts from the University, led by Prof White, to focus on their expertise through a series of agile sprints and ‘integration’ teaming days that fostered a blended, inter-disciplinary teaming approach between the organisations. Oxford University Innovation was a key player, providing the route to partner with EY, support for the Oxford academic team and negotiation of agreements with EY.
Prof. Lisa White, Principal Investigator and Professor of Modelling and Epidemiology at the University of Oxford, said:
“This evaluation captured key lessons to inform future pandemic preparedness, providing evidence-based recommendations and highlighting the need for a robust national health data infrastructure. We hope that some of these learnings can be applied by policymakers now as part of their future outbreak response plans as it could pay dividends in the future.’’
Dr Reshania Naidoo, co-Principal Investigator at EY, added:
“Our consortium was uniquely positioned to deliver enduring value by leveraging our multidisciplinary expertise to evaluate and quantify public health impacts across the general population, NHS, Adult Social Care, and schools. We hope to have done justice to the hard work and sacrifices of the thousands of workers across the frontline and civil service who made this world-first testing programme possible.’’
Dr Tom Fowler, UKHSA Director of Public Health Testing for COVID-19, said:
‘’The consortium has conducted an independent evaluation into the effectiveness of the national testing programme – an extremely complex subject matter as a result of the evolving policy context, timelines and the methodological challenges especially in relation to data and the timescales.
“They approached this with pragmatism, academically rigorous thought leadership with many novel techniques and methods and in a participatory manner with a range of stakeholders across UKHSA, DHSC, DfE, past and present colleagues. Their participatory approach has ensured the absolute right balance – a piece of thought leading evaluation work that has buy in from stakeholders involved, whilst being impartial and objective, and contributing to the knowledge base and evidence around responding to pandemics.”
Findings and Impact
The evaluation culminated in the publication of the first national-scale evaluation of the testing response to COVID-19 in England. This report has been utilised in the COVID inquiry and resulted in four academic publications so far. Key findings and outputs included:
– The national COVID-19 testing programme in England significantly increased case identification, identifying an estimated 40% to 50% of all possible cases (both symptomatic and asymptomatic) at its peak.
– Testing proved to be an effective public health intervention for high-risk groups in adult social care and healthcare settings. Without the testing programme, there would have been higher rates of full-time equivalent (FTE) absenteeism, outbreaks, nosocomial infections, and deaths in these groups.
– By addressing biases in testing behaviours and access through novel debiasing methods across different sociodemographic groups, the team helped uncover gaps in the uptake of public health interventions at fine-scale levels and across sociodemographic groups.
– Creation of a testing strategy explorer app which can be used to simulate the impact of a public health intervention such as testing for future outbreak threats by policymakers.
Looking Ahead
This project underscored OUI’s role in enabling impactful partnerships that address global challenges.
Link to publications:
Full evaluation report (EY website)
An evaluation of the national testing response during the COVID-19 pandemic in England: a multistage mixed-methods study protocol (BMJ Open)
COVID-19 testing and reporting behaviours in England across different sociodemographic groups: a population-based study using testing data and data from community prevalence surveillance surveys (Lancet Digital Health)
Decision to self-isolate during the COVID-19 pandemic in the UK: a rapid scoping review (BMJ Open)
Mass testing for discovery and control of COVID-19 outbreaks in adult social care: an observational study and cost-effectiveness analysis of 14,805 care homes in England (Accepted, BMJ Public Health, 20/01/25)
