Surge testing in Hertfordshire

Hertfordshire was part of the first wave of eight council who were asked to carry out surge testing from February. One case of the South African variant that could not be linked back to travel had been identified.

This is part of a series of case-studies published on the 16 March 2021

  • Royal Mail postal routes used to map routes for door-knocking teams
  • Extra mobile testing unit brought in for short period to cope with early demand
  • Fantastic community spirit engendered and take-up was truly exceptional – although some found online registering of PCR tests challenging

What was done?

Hertfordshire was part of the first wave of eight council who were asked to carry out surge testing from 2 February. One case of the South African variant that could not be linked back to travel had been found in the Broxbourne area of the country.

The council was asked to test all residents in one postcode district where around 14,000 people lived. More than 10,000 tests were carried out in just over a week. Some 99 positives were found, but none had the South African variant.

How was it done?

One mobile testing unit was already stationed in the area when the announcement was made and a second was quickly dispatched. Within days a third also arrived because of the huge demand. This was supplemented by a collect-and-drop service at two locations – a library and community centre. These were staffed by county council staff.

All residents in the area were immediately sent a letter informing them of what was happening. This was received within 24hrs of the Government announcement, clearly spelled out what the issue was and the different ways they could get tested. The fire service led the door-knocking with the teams supplemented by district and county council staff and volunteers.

Every home was visited with the on-the-ground teams who delivered PCR tests and could where needed explain the purpose of testing and what people needed to do. A system was also in place to arrange for a nurse to visit and do testing on the door step for those who had difficulty testing themselves.

Those working on the ground said local knowledge was vital. One of the fire service staff used to be a postman so knew about the best routes to move through the area.

Hertfordshire Deputy Chief Fire Officer Chris Bigland said: “That was our biggest take away by far – obtaining the postal routes and using them to do systematic delivery. Their routes are planned for maximum efficiency and even tell you where to park the van for resupply.”

He also said they had police and health care colleagues on hand for instances where door-knocking uncovered safeguarding issues or vulnerable people who were not coping well. “This means your delivery people can keep moving at pace,” he added.

Batches of testing kits were also delivered to sheltered housing, while domiciliary care staff who worked in the area were invited to get a test.

What lessons were learnt?

Public Health Consultant Susan Hamilton, was part of the core team along with the director of public health, the head of communications and the logistics and operations lead at the council, who coordinated the surge testing.

She said the rapid deployment of surge testing meant adjustments had to be made as it was rolled out. “We did encounter challenges as we went along. Quite a few people struggled with the technology. When they collected testing kits to do at home, they had to register the bar codes, but not everyone found this straightforward.

“We soon realised we had to spend a little more time explaining this process at the pick-up locations and at the door and improving our step-by-step guides. We wanted to make it as easy as possible for people.”

Ms Hamilton said what was achieved was made possible by everyone pulling together. “Talks were held over the weekend before it was announced on Monday, but it was still quite a scramble to get things up-and-running. Residents were understandably worried so our communications team played an invaluable role, engaging with the national and regional media, putting information out on social media to allay concerns and link to a single web page. The director of public health did webinars with the community and members to answer questions.

“It was such an incredible response from the local community. But it required a ‘team or teams’ approach. You need to draw on expertise from everywhere. But this is not the sort of thing you can do regularly – or certainly not on this scale. We did not have to stop any service, but it did take a lot of time and staff resource. We had staff working over the weekend. I think we also need more clarity on what the goal is before commencing future operations.”

Contact details

Susan Hamilton
Public Health Consultant
Hertfordshire County Council