Coronavirus (COVID-19) targeted community testing: national evaluation evidence and insights - final report
This report summarises evidence and insights at a national level from evaluation of targeted community testing (TCT). The report covers the period 18 January 2021 to 26 September 2021.
Annex B: Qualitative Partnership Proformas
March 2021
Community Testing Evaluation Reporting Proforma March 2021
This reporting Proforma has been agreed with local partnership evaluation leads group and Scottish Government policy to trial in March and will be used to inform a national evaluation and Scottish Government Community Testing policy. This is the first version of the Proforma. Feedback on completing this is invited to help improve reporting in future months.
Please complete as much as possible from the data and evidence you have and return by 30th March
Health Board/Local Authority: -
Contact: -
Email: -
Date: -
Model of CT Implemented
MTU and ATS placements data to end of March expected to be provided by PHS additional analysis or presented as cumulative data on dashboard
Self-isolation additional support and promotion of compliance with NPIs
Description of additional support and activity to promote compliance with NPIs and/or self-isolation.
Evaluation of CT
Five key themes for evidence reporting:
1. Data use to identify locations to site CT
2. Implementation of CT
3. Testing uptake and identification of cases
4. Attitudes and Behaviours to testing, isolation and compliance with NPIs
5. Impact on transmission
*** Where a narrative description is suggested please use bullets, be concise and limit content to key points to share (issue/solution). Further detail can be referred to in your own local area evaluation reports. ***
Theme |
Sub-theme |
Findings |
Data source |
|---|---|---|---|
Data |
Key learning from how used data to locate and monitor sites eg most valued indicators (narrative description) Of particular interest: 1. Which community testing sites (MTU/ATS) to date have been sited using WW analysis (either alone or in conjunction with other indicators)? 2. If not used, why not? 3. What do you consider the challenges and/or benefits are of using WW analysis? |
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Implementation |
Key learning – Operational from set up and running of site, eg around staffing; guidance; training; equipment; site issues; major changes to plans etc (narrative description) |
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Key learning – Operational Has staffing CT impacted on other services? |
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Learning about how deploying MTU and ATS (where applicable) Why one and/or other type; conditions best suited to either; length of deployment etc (narrative description) |
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Key learning - Attendance experience Narrative description |
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Key learning – Attendance experience booking; access; experience at test site Quantitative data – core indicator |
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Key learning around additional activity to support self-isolation Narrative description Quantitative data where this exists |
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Key learning around activity to support compliance with NPIs Narrative description |
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Testing Uptake & Case Identification |
Stats to date for Local Partnership (no. tested by MTU/ATS, symptomatic, asymptomatic, cases etc) |
No requirement to complete unless you wish to - An analysis to mid or end of March is expected to be provided by PHS, either as an additional analysis or from cumulative figures presented on the dashboard |
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Who is getting tested? Please provide a summary overview and key quantitative data if available |
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Who is not getting tested? Please provide a summary overview and key quantitative data if available |
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Are those getting tested as expected according to local public health aims, objectives and outcomes of targeted CT? |
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Reasons for not taking up tests |
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Action that has been taken to improve uptake in targeted groups and general learning about how to improve uptake |
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Attitudes & Behaviours |
Compliance with self-isolation (from any local level of engagement or research carried out) |
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Compliance with NPIs (from any local level engagement or research carried out) Eg activities and social contacts of those testing negative |
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Transmission |
What is happening to indicators of disease transmission where CT has been introduced? (It may be that only general trends for larger geographies are likely to be possible here due to declining numbers) |
Description of trends (with any charts or supporting data in an Annex optional):
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Open comment |
Opportunity to provide other feedback on how the programme is operating or impacting in your local area or any other observations. |
May 2021
Local to National Reporting Proforma – Community Testing Evaluation
Please submit by 1st June 2021
To support further understanding of the Targeted Community Testing programme at this stage, we welcome your response to a number of questions. These are presented below a broad summary of understanding of Community Testing to date.
Health Board/Local Authority:
Contact: -
Email: -
Date: -
Programme level understanding to date
Context in Scotland
Restrictions are easing, compliance has improved recently after previously declining since January and contacts have increased – cases may be expected to rise, already being observed in some areas with concern about variant B.1.617.2 ("Indian variant"). Hospitalisations and deaths are low.
A sizeable gap still remains between modelled cases and those detected by testing.
A large proportion of the adult population has been vaccinated but many still remain at risk and vaccination impact on transmission is still to be fully understood.
Community testing is just one of many pathways of testing. Pathways are being developed continuously and of particular relevance is Universal testing, which was fully launched 26 April enabling anyone to obtain an LFD test kit by ordering online, or collecting from local/regional test sites and increasingly from MTUs. The vast majority to date have been ordered online.
Targeted community testing is intended to be data driven placement of testing capabilities to best support identification of cases, especially hidden (non-symptomatic) cases to stop chains of transmission.
Building capability is intended to help create the infrastructure to be able to detect cases now, but also better manage potential future rise in cases or outbreaks.
Models of testing
Models are varied across and within local partnerships and have evolved over time. Key changes are as follows, but different models exist in each local area:
- MTU only - the expansion of targeted community testing initially involved deployment of MTUs offering PCR tests only and testing both symptomatic and non-symptomatic people.
- MTU +/- ATS - From 11th February ATS started to be established in a few health boards and has since grown offering LFD testing for non-symptomatic people in targeted communities. Not all Boards have offered both.
- MTU +/- Pop-up/mobile ATS - ATS tended to be fixed but increasingly pop-up versions have been created. The next evolution has been to develop mobile ATS to reduce time to set up and avoid issues around availability of appropriate sites.
- MTU with LFD collect +/- mobile ATS - Most recently has been the addition of offering LFD kits to collect from MTUs in addition to their PCR testing. Only a few boards are trialling this at present.
Community testing understanding and impacts
Cases identified – to 9 May 6,989 (2114 of which were non-symptomatic)
Targeting – Community testing has consistently had the highest positive case rate (0.7% as at 10 May) for its LFD testing when compared to other LFD pathways such as University testing (0.3%) and Healthcare workers (0.1%) and for total LFDs (0.1%).
Community testing has shown early encouraging signs of reaching more deprived groups (SIMD1) which other research indicate are typically less likely to come forward for testing. However, further analysis is required.
Community testing trends – testing had decreased from a peak in March in line with decreasing incidence. There is a tendency towards increased proportion of testing taking place through MTUs.
Influences on uptake – Overall, capacity appears much underutilised, but context is important to understanding this better and may change if prevalence increases again.
A range of barriers and motivations have been described and are being addressed through enhanced communications nationally and locally with communications and engagement remaining a key aspect of targeting.
Unintended consequences – a positive consequence is that some partnerships have used community testing as another opportunity to engage with some groups and offer wider well-being support.
Questions
As much as possible, please state the evidence on which your responses are based (where applicable) and feel free to illustrate with data
NB: We acknowledge that partnerships are at different stages with Community Testing with different resources. Please complete as far as possible, but we accept there may be some gaps.
What helps support targeting to achieve case identification and good reach
1. Given the primary aim of Community Testing is to find cases and break chains of transmission, how successful or not do you feel you have been at finding cases and why?
2. How have you assessed success?
3. In your experience what has helped most to achieve good case detection?
4. What has not worked so well?
5. Any suggestions for changes to improve targeting? Eg what you may be planning to try or for others to consider?
6. Have you experienced any limitations on your ability to conduct effective targeted community testing? Yes/no
a. If yes – please describe what these are/have been
b. What solutions, if any, have you planned or applied?
7. How aware are local communities of community testing in their neighbourhoods?
8. What is helping most to ensure awareness and how do you know?
Public attitudes and behaviours
9. In your area, what is the level of public acceptability of community testing and willingness to get tested?
10. What is the level of people's understanding of where and how to get a test depending on whether they are symptomatic, a contact or have been offered asymptomatic community testing?
11. Are there particular population groups who are not engaging either due to low awareness or for other reasons? Yes/No/Don't know
a. If yes – what groups and why?
12. What are:
a. the top 5 motivations for getting tested at the community testing sites?
b. the top 5 barriers to get tested?
c. What evidence are the responses to a and b based on?
13. Are there particular motivations and/or barriers evident for specific population groups? Yes/No/Don't Know
14. If yes, please describe what you understand these to be and based on what evidence
15. How are barriers and motivations being addressed?
16. What has worked well with communications and engagement around barriers and motivations, and how do you know?
17. Do you offer additional support to help self-isolate as part of community testing over and above what was already on offer in your area? (ie something more than additional signposting)? Yes/no/not sure
a. If yes, what is additional?
b. What, if any evidence, is there of whether it is helping or not?
Community testing in the longer term
18. How has the Universal Available Offer impacted how community testing is operating in your area?
19. What, if any, any unintended consequences are you aware of from community testing (both positive or negative)?
General
20. If you wish, please provide comment on the understanding presented at the beginning and how that relates to your local partnership.
21. If you wish, please provide any other feedback on community testing.
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