Community testing in Hertfordshire

Hertfordshire created a mobile rapid testing service by converting two buses into lateral flow testing units.

This is part of a series of case-studies published on 29 January 2021

  • Two small buses converted into rapid testing units - used in high-risk areas before Christmas and now available for key workers
  • Council believes benefit in having trained staff to supervise or carry out tests
  • Pop-up testing sites and static testing centres to be rolled out

What has been done?

Hertfordshire County Council created a mobile rapid testing service by converting two buses into lateral flow testing units. The buses have space for people to be tested and a small lab area for processing the test. There is no ramp for people with mobility issues so the teams have a small gazebo they set up outside so the nurses can do the swabbing there if need be.

When part of the county was placed into tier four restrictions along with London and other parts of the south east before Christmas, the council deployed the mobile units in their high-risk neighbourhoods. The buses were sent to Broxbourne for two days just before Christmas and then returned for two days between Christmas and the New Year.

Public Health Consultant Claire Laurent said: "It was an opportunity for us to pilot the model and to assess what the uptake might be in the community. In fact, there was huge demand with more than 2,000 tests done across the four days."

Once lockdown was initiated Hertfordshire started to re-think how it could use the mobile units. In mid-January the council started targeting them at key workers and people who had to leave home to work.

Two more buses are now in the process of being converted to allow them to have a presence in the north, south, east and west of the county. <

Ms Laurent said: “It is good to have a flexible resource like this that we can deploy where needed. It means we can try it in different locations and assess the results, and we can target areas with high incidence rates of Covid-19

Lessons learned

The mobile units provide assisted testing – with trained staff on hand to carry out the tests.

Ms Laurent said: “We went for assisted testing because it is quicker and potentially more accurate. We can get through around 1,000 tests a day if we deploy all these mobile units.

We are achieving a high degree of accuracy with virtually no void or invalid tests being taken, something that is less likely with self-testing.

But she said as rapid testing expanded this would have to change. “It is likely that supervised testing and self-testing will increasingly become the norm and we are working flexibly to provide as many options as possible.”

Next steps

Towards the end of January, Hertfordshire will start running pop-up testing facilities in addition to the mobile facility. These are going to be aimed at critical workers and also high-risk workplaces or at places where people may struggle to access testing.

“We have seen outbreaks at prisons so one option would be to set up a testing facility nearby for staff. That would not necessarily be assisted testing – we could let them self-administer the swabs under supervision of trained staff.

“Another option would be to look at how we can support sheltered housing accommodation. They are not part of the national testing that is offered to care homes so it could be of benefit to residents there.

“We have now commissioned two providers to help us with this as redeployment of staff is not so easy. Hertfordshire is also looking to bring two static sites online, plus a short-term provision working with the University of Hertfordshire.

We are being quite careful in how we plan for this. We don’t know how long we will be in lockdown and what rapid testing will be organised nationally.