19 May 2025

(10.30 am)

Lady Hallett: Ms Cartwright.

Ms Cartwright: Good morning, my Lady. The gentleman by the

witness box is Professor Spector. Could I ask, please,

for him to be sworn.

Professor Timothy Spector

PROFESSOR TIMOTHY SPECTOR (affirmed).

Questions From Lead Counsel to the Inquiry for Module 7

Ms Cartwright: Good morning. Could you please give the Inquiry your full name.

Professor Timothy Spector: Timothy Spector.

Lead 7: Professor Spector, you provided a witness statement to Module 7 dated 24 March 2005. Could I ask, please, for the page 12 to be displayed, where we see your signature, and can I ask you, please, to confirm that the contents of that statement are true to the best of your knowledge and belief.

Professor Timothy Spector: They are.

Lead 7: Thank you.

Professor Spector, the principal area of your evidence you’re going to assist us with today is the work of the ZOE App, the symptom app, during the pandemic. But before dealing with that, can we first of all identify you, your background qualifications, and experience, please.

It’s right, isn’t it, that you are professor of genetic epidemiology from King’s College London?

Professor Timothy Spector: That’s correct.

Lead 7: You are director of TwinsUK, and perhaps do you want to just explain to her Ladyship the significance of TwinsUK and how that caused the adaption for the symptom app, please.

Professor Timothy Spector: TwinsUK is a group of – a cohort of 16,000 twins that I set up in 1993 that we’ve been following throughout the whole of the UK, and these are identical and non-identical twins that we use to investigate the causes of all kinds of common, chronic conditions, by comparing, you know, discordant and concordant twins, nature v nurture, and so we’d had lots of experience asking hundreds of questions on hundreds of diseases over the years, and so became quite expert in a very broad way of looking at health and the causes of disease.

Lead 7: Thank you. It’s right, isn’t it, that you’re a consultant rheumatologist as well as your expertise as an epidemiologist?

Professor Timothy Spector: That’s right. So yes, at least my first part of my career 20 years was in rheumatology, which, again, is a branch of medicine that looks at clusters of symptoms, often without definite tests, and conditions. And is –

to be a good diagnostician you have to pick clusters.

So that ended up being useful in this line of work.

Lead 7: Thank you. And again, by way of relevance to the COVID

Symptom Study app, it’s right, isn’t it, that you are

co-founder of the science and nutrition company ZOE?

Professor Timothy Spector: That’s correct, yes, which we founded 2017.

Lead 7: Thank you. And as now we’ll be moving to, you were the

lead researcher behind the COVID Symptom Study app?

Professor Timothy Spector: Yes.

Lead 7: Thank you. Can I ask you then to explain to her Ladyship how it was that you moved to develop the COVID Symptom Study app, please.

Professor Timothy Spector: It all happened as my department was being told by the university that we had to all go home and stop our clinical studies, and, cycling home that day, I said: I can’t just sit and do nothing at home. Let’s think of a way that we could use our twins to act like canaries in a coalmine, if you like, so that we would get something to them. They’re all over the country, it would be a perfect way to see what’s going on using the common symptoms, and I thought that the app was the best way to do it.

I got on the phone, discussed this with the CEO of ZOE, Jonathan Wolf. He thought it was a brilliant idea. Spoke to the company. And then – so they agreed. And at the same time I spoke to my colleague Claire Steves, who was a geriatrician who had been working pretty much on the front line, and she knew about the symptoms, she knew about testing. And so, having those two together, the company was willing to transform their team from doing nutrition into pivoting to doing something for the Covid effort, plus having the clinicians on board from St Thomas’ Hospital, was just the perfect combination of a team that could make this happen.

And we initially wanted to roll it out in just the twins, to see how that got on, but at that time, by the time we’d got it ready, it was clear that there was going to be a full lockdown, and so we released it to everybody. We said there’s no need to do it (unclear).

Lead 7: Thank you.

If I could just pause you there, Professor Spector, because we’ll deal with what you were able to achieve over a very short time period in a moment.

Could I ask, please, for paragraph 4 of your witness statement, which is INQ000575990, at page 2, to be displayed, please.

Professor Spector, it’ll appear on the screen.

Can we expand paragraph 4 please.

You’ve just referenced Claire Steves, and I just want to pick up with you, please, we can see the particular thing that Dr Claire Steves was raising with you on 18 March, that I think was what you’ve described was pivotal as to what was needed, and in particular, that – I summarise it, but the content is there – that, essentially, in a care home someone had tested positive for SARS-CoV-2, and she had wanted to get all of the staff and patients tested but couldn’t because of the restrictive centralised rules on testing, and that nurses in the home had reported non-triggering symptoms like loss of sense of smell and a hoarse voice.

Professor Timothy Spector: Yes, that’s correct.

Lead 7: And can I ask you, because I know with your evidence you’ve provided a huge amount of literature in your literature review about the good work done by the ZOE App, referencing Dr Steves and her identifying early on the desire to test when there were no symptoms, one of the pieces of literature you provided I think deals with what you identified from your work that we’ll come on to: that set out the importance of testing for healthcare workers.

Can I ask you just to give that evidence before we get into what you achieved with the Covid app using what Dr Claire Steves had flagged on 18 March, please.

Professor Timothy Spector: Yes, so she was worried that frontline workers weren’t being given the support they should have been. There was only very limited restrictions on who could get testing and no one was really asking them about their symptoms, and many of them didn’t have full PPE because it was quite restricted.

So that was one of the big drivers behind us, trying to launch this app and give more freedom for healthcare workers to find out whether they were infected or not, and also protect staff.

And this culminated in a paper very early on, that we managed to look in the first month, in the US and the UK, at healthcare workers and their risk of getting Covid, using this symptom app, comparing it to the likelihood of getting a test.

And so this showed us that they were getting something like between 11 and 60 times the risk of developing Covid compared to the general population. And that increased when they had poor PPE, it increased if they were ethnic minorities, and it was three to four times worse in the UK than in the US.

Lead 7: Thank you.

Professor Timothy Spector: So clearly there was something wrong with our systems in place: the risks were much greater for the healthcare staff. And, you know, we wanted to give them every tool possible to protect themselves and their patients, and that that wasn’t the official case. So they were being – they weren’t being helped by the lack of testing.

Lead 7: Thank you.

Professor Spector, you’ve just referenced the US. It’s right, isn’t it, that the app you went on to develop was not only available in the United Kingdom but also was of use in the United States as well?

Professor Timothy Spector: That’s correct. A week after we launched, we did the same in the US.

Lead 7: Thank you. Can we then capture the work that you did to launch the app, please.

Your statement deals how you managed to persuade your investors to take a risk and stop the company working on nutrition to pivot to developing the symptom app?

Professor Timothy Spector: Yes. Everyone wanted to help the general cause. The investors were there. You know, they wanted to obviously make money, they’d put money into the company, but they saw this was a more important goal, and it was universal, their support. They said: yes, go ahead, do what it takes to get this app out there for free to as many million people as you can do in as many countries as possible, and we’ll support you for as long as we can.

And they did that, but we all expected that this would be relatively short-term and that if it was successful, the government or some other agency would take it over.

Lead 7: Thank you.

Perhaps if I cut through the timeline, it’s right, isn’t it, that by 21 March, you had essentially produced a version of the app on the Apple store, so three days after the thought process as you cycled home from hospital?

Professor Timothy Spector: Yes. We had a very crude version in three days, and a more refined one in five days.

Lead 7: Thank you.

Professor Timothy Spector: So sort of usable in five days.

Lead 7: And I think your statement also talks about how you utilised your communication strategy for the ZOE App to publicise the Covid Symptom Study app to get, then, the engagement with people downloading and using the Symptom Study App?

Professor Timothy Spector: That’s correct. So this was a very new way of us communicating, but through Twitter and Facebook we got other people, influencers, to help us, phoned up everyone I knew who was more well known than I was, which was most people and like, you know, celebrities like Stephen Fry, et cetera, Emma Thompson, other people wanted to help, and then they spread the word, and it together off massively, so in 24 hours we had about a million downloads and eventually got to 4 million, as people really wanted to help and do something.

Lead 7: Thank you. And I think you’ve already crystallised the 1 million downloads in 24 hours and I think you were at 2 million downloads by the end of the first week; is that correct?

Professor Timothy Spector: Yes.

Lead 7: Thank you.

Can I then ask to be displayed on the screen, please, paragraph 8 of your witness statement which is at page 3, please. And if paragraph 8 could be expanded. Thank you.

You say this:

“The initial version was specifically designed to be very simple, to take as little time for people, while collecting the essential data. The first few days it contained only nine symptoms, including the three official ones designate by the government: fever, cough and shortness of breath, and others like diarrhoea, chest pain confusion, skipping meals and sore throat. But by the 24th March 2020, we added other symptoms in, as we learned from case reports and colleagues in places like Italy that symptoms were much more widespread than had been reported by the Chinese authorities. We eventually added [I think that should be] over 20 symptoms and we could drop those found not to be relevant. One of the first symptoms we added was loss of smell or taste, anosmia on 24th March 2020.”

And you then tell us that by 27 March Dr Freydin, who was a post-doctorate researcher, biostatistician and epidemiologist from King’s College London:

“… developed a model which identified that this symptom was strongly associated with testing positive for COVID-19, and we made steps to enable this to be written up quickly …”

And if we look as the paragraph continues over the page, I think, significantly, the early utilisation of the app had also identified that, again with the assistance of your NHS and King’s colleagues, including Dr Steves and her team, you found that:

“… in the elderly aged over 75, acute confusion could be the only presenting symptom … [which eventually changed] guidelines for testing in frail older people. And we also had a novel feature that allowed people to report symptoms daily on behalf of, as a proxy for elderly relatives, friends or children.”

I’ve just summarised your statement but perhaps if you want to convey the significance of the identification of loss of smell and taste to – an identification of an indicator of being infectious with Covid, please.

Professor Timothy Spector: Yeah, I think it was a great example of staying flexible and realising that you didn’t have all the answers at the beginning of an outbreak and you had to actually collect information and then change things as they went on, and just because you’d printed a million posters doesn’t mean that that was the truth.

And I think what we did is, very early, started asking questions so that we changed our mind on what we were looking for and what the best symptoms were to actually precisely identify someone who had an infection. And yes, in the end there were 20 symptoms we were asking. It turned out, through subsequent analysis that we did very quickly, that there were 16% of the population – this is based on, you know, millions of readings – 16% of the population only had loss of smell or taste and they didn’t have the other classical symptoms of fever or cough or shortness of breath. So that 16% would have been completely missed.

Also, the – that symptom lasted much longer. So you might have had fever just for a few hours and it would have been not noticed or picked up, whereas the other one was much better.

And when we compared all our data in one of these other papers with US data and from all around the world, it turned out that that, if you had that particular symptom, you had 11 times the risk of having a positive Covid test compared to the classic symptoms of only about three to fourfold.

Lead 7: Thank you.

Professor Timothy Spector: So it was just a real game changer in terms of finding something new that was far better than any sort of novel blood test.

Lead 7: Thank you. Now can I ask you, then, the paragraph I just read referenced the ability for proxies to be used on the app, and can you assist as to what the significance or the benefit was, was it permitting essentially proxy entering of symptoms to inform usability of the app, please?

Professor Timothy Spector: When we first launched the app there were a lot of criticisms saying that no one above 60 would be able to use it, which I think people would find quite hard to believe nowadays. But that –

Lady Hallett: What a cheek!

Professor Timothy Spector: Exactly. I’m also over 60! But the press were saying, and, you know, the government said there’s no point in launching an app because only young people would be able to use it, this was the thinking back in 2020, interestingly. So we first showed that while we had many people in their eighties using the app, but we did that for some people with poor eyesight or other problems or very sick, they couldn’t do that, people in care homes, for example. So we developed a proxy system which I don’t think anyone has ever – or I’ve not seen it before – that allowed someone on behalf of friends or family to report for them every day and also their children.

So people would be reporting for their children and maybe their elderly relative in a care home that they were looking after, and this was a really innovative, useful way of reporting so we’d been able to capture a much broader section of the community.

And it would have been – if we’d been able to do that more widely and if we’d had more support, we could have got that into more – into lower socioeconomic groups, as well.

Ms Cartwright: Thank you. I’m going to come on to deal with the ‘What-ifs’ in a moment, but I’m also going to come on to deal with the efforts you made, then, having identified the significant finding as to communicating that to the government to inform a change in the policy or identification of symptoms.

Before doing that, can I ask you, we know that it was on 18 May 2020 that the government added anosmia as an officially recognised symptom, but can I ask you, do you believe that the delay, until 18 May, could have weakened public trust as people who experienced anosmia were told they did not meet the criteria for testing or isolation despite the emerging media and international reports?

Professor Timothy Spector: Yes, I think it was a major – obviously during the pandemic there were many episodes that caused loss of trust but I think this was one of the major ones. People could see for themselves – all the GPs I spoke to said, “This is ridiculous, I’m seeing all these patients with loss of smell and taste and yet the government isn’t changing its guidelines and not allowing us to test”, and so generally, we were picking up on this feeling of a lack of trust. That grew and then people followed our podcasts rather than listening to the government ones, who consistently denied there was any effect, when other countries several weeks ahead had actually changed their policies.

So it seemed to be a stubborn response of the government that basically failed to look at UK data, because it came from a predominantly symptom app rather than their own testing.

Lead 7: Can I also, building on that question, please, ask, do you believe the delay in updating the symptom list contributed to preventable admission, particularly among individuals with mild symptoms, who believed they were not infectious?

Professor Timothy Spector: Undoubtedly it did, yes. Many people had mild loss of taste; I mean I myself did. Didn’t realise what it was at the time. And I think there were probably hundreds of thousands of people in that situation. Some of them had other symptoms but some didn’t. So definitely caused unnecessary excess cases, which led to excess Long Covid cases, which led to some hospitalisations, and people infecting their own relatives, which, you know, ended up being tragic, when other countries had acted and the data was there.

Lead 7: Thank you. I’m going to crystallise with the communication from the ZOE App about this view about the symptoms, and then build on what efforts you made.

Could we please have displayed INQ000562712, please.

That’s INQ000562712.

Professor Spector, this is obviously taken from the Covid-19 Symptom Tracker. If we could move on a page, please, it gives some idea around the messaging that went with the app.

If we could move forward two more pages, please. Thank you, just pausing there.

If we could highlight, please, the research update from 1 April 2020.

So essentially, Professor Spector, you were confident to put on the website for the tracker that the analysis did exactly what you’ve told us about:

“… suggests losing your sense of taste and smell may be the best way to tell whether you have COVID-19. Our researchers share their latest update direct from King’s College London.”

And it may seem obvious but why was it clear for you to make your view clear about that on 1 April?

Professor Timothy Spector: Well, as an epidemiologist, we’re used to seeing multiple results of studies, but when you see something that’s so clear-cut as this, that gave 11 or 12-fold increased risk of having a positive Covid-19 test, it leapt out at you that this is something the public should know immediately.

There was no doubt that this was not – this was a spurious result. You know, this was absolutely something that people should know instantly. They shouldn’t be waiting for the slow academic route of journals, etc – even though it was super fast at the time – and that’s why we wanted to warn the people that had been helping us with the app, collecting the data, and this was the – why the app was such a success: because it was a two-way process, that people shared their data with us, they trusted us with it, but they also trusted us to tell them when they could take action based on that information.

So it was really part of our whole ethos in doing this: that we didn’t wait for official approval; we didn’t wait for The Lancet to fully publish the paper. We told people, through every mechanism we could, through the app, through YouTube, whatever, what was going on. Similarly to, you know, whether the area they lived in was dangerous or not.

But this was a classic case, and hopefully the people using the app took action. Those people were possibly spared from infecting others.

Lead 7: Thank you.

Now, you detailed within your witness statement that you were making weekly requests to the government to change the limited definition of infection and to make the loss of sense of taste or smell official policy. But can you, in your own words to her Ladyship, detail the attempts you made to work with the government in respect of the app but also to change the symptoms, please.

Professor Timothy Spector: Well, it started, really, with the symptoms. So, yeah, on a weekly basis we were telling them what was going on. So as soon as we had the data, we’d say: this is what it’s showing, you really need to change the guidance. At the moment you can’t get a test, you can’t stay off work, you can’t, you know, use that as an excuse because it’s not official. Please change these conditions.

And I was emailing Chris Whitty and Patrick Vallance at the time. They said: it’s not our domain, we’ll pass this on to the deputy CMO, Jonathan Van-Tam.

And I emailed him a few times, didn’t get any reply, and nothing happened.

There was a press briefing several times, because the – because of our continued messaging, some of the press were asking the government to do something about it, and each time they said – well, as far as I could – as I found out, that there was insufficient data to change those criteria, although we’d shown them the data that was subsequently published in The Lancet.

Lead 7: Thank you.

Professor Timothy Spector: And generally, yeah, we wanted the government to get more engaged with the app. It wasn’t our idea to run it as an independent organisation forever. We just thought: this such a great idea, we’ve shown it works, please take it on and use it, and give it to everybody.

But there was just no interest in that at all, and we were actually lucky to survive because, you know, there were attempts to shut us down.

Lead 7: Thank you. And on that –

Lady Hallett: Sorry, what do you mean by “attempts to shut us down”? Lack of support arguably could be an attempt, but how else did they try to shut you down?

Professor Timothy Spector: Through – they contacted the dean of my university –

Lady Hallett: “They”?

Professor Timothy Spector: As I understand it, it was all the NHS –

Lady Hallett: Is this all hearsay or do we have any evidence?

Professor Timothy Spector: Well, a lot of this is done through phone calls so I don’t have any hard evidence or letters. So the principal of my university would phone me up and say, “Listen, you know, people are unhappy about this app because it’s interfering with the government app” – this was mainly from NHSX – “I’ve told them that, you know, I think it’s good but, you know, they’re insistent.”

I also had pressure from the funding bodies, like the Wellcome Trust, to – that I shouldn’t be doing this, I shouldn’t be using their name on my app, because this was against government policy.

So there was quite a lot of pressure that if I hadn’t had the support of a private company, I would have – it would have folded very quickly. So that’s what I mean. There was a lot of behind-the-scenes pressure, that wasn’t public in those first few weeks particularly.

The main reason being stated was that it would – if we distract everyone from the forthcoming NHS app which was going to solve all our problems.

Ms Cartwright: Thank you.

Lady Hallett: They had different functions?

Professor Timothy Spector: Yes, but they said it was a contact and tracing app, not a symptom app, but they thought it was close enough that the public would get confused and they wouldn’t download the NHS app. That was – so the only reason – so the reason I managed to come to a compromise, and there is an email about this, is that I agreed that in the event of the NHS app being launched, I would support it and tell everyone else to download it and use it.

That was the basis of which a sort of d’étente was reached.

Lady Hallett: The government app, you say, is contact and trace. Were you aware of what other steps the government were taking to collect symptoms, up-to-date data on symptoms, as you were doing, to the ZOE App?

Professor Timothy Spector: I was not aware of any that they were doing. Their surveys seemed to be purely based on hospital records or blood collections. And –

Lady Hallett: Well, a blood collection – (overspeaking) – symptom.

Professor Timothy Spector: They were only collecting the classical symptoms, and even on their initial survey, so they had the – their official survey they started just by asking the initial just three symptoms. Only later did they start adding more.

Lady Hallett: I’m sorry to interrupt.

Ms Cartwright: No, no, not at all, my Lady.

Can we please display page 8 of your statement, please, it’s paragraph 16 but it starts the page before, so it’s page 8 I’d like to be displayed, and picking up on the theme that her Ladyship has explored with you.

That’s INQ000575990, please, at page 8. Thank you.

You have detailed in your statement:

“The initial response of the UK Government (NHSX) was not supportive. It was to initially try and see if they could stop us doing the app because they were worried that it would interfere with the COVID-19 app developed by NHSX which was in the trial phase, and we were told it would be released within three weeks to everyone in the [United Kingdom]. The rationale was that the public would be confused and therefore our app would likely damage the major official effort.”

Can I ask you, to your knowledge, was any evidence provided to support the claim that public confusion would arise from multiple apps or was this simply an assertion?

Professor Timothy Spector: Simply an assertion.

Lead 7: To your knowledge did the government undertake any risk-benefit assessment comparing the value of your app’s realtime symptom data with the potential for public confusion?

Professor Timothy Spector: I’m not aware of any.

Lead 7: You have detailed that you were told the NHS app would be ready for release within three weeks. Do you have any views as to whether that was a realistic timeline or was it being used as a way to justify delaying your app’s progression? Are you able to help at all on that?

Professor Timothy Spector: At the time, I took it at face value. But clearly in retrospect, it was a fantasy.

Lead 7: And again –

Professor Timothy Spector: But we had produced one in five days, so I knew it was possible. But, yeah, every time you spoke to them, the timeline changed. So you realised it was not really a realistic …

Lead 7: Thank you. And then again, just on the same page at page 8, you’ve also detailed that pressure was put on your university and funding bodies to make you stop promoting the app, although you confirm that you’ve no written evidence of that.

Can I ask you, what impact did that pressure have on you or the app in practice, please?

Professor Timothy Spector: It made me more determined to carry on. It had the opposite effect.

Lead 7: Now, we’ve heard last week about the development of the app, so we know at this time the NHS did not yet have a functioning alternative app. If you had complied with the request, would you agree that fewer people might have been prompted to report symptoms?

Professor Timothy Spector: So if we’d stopped the app?

Lead 7: Yes.

Professor Timothy Spector: Well, yes, we wouldn’t have had any of this data on symptoms and that’s not just in the UK; that’s in the world. So a lot of the symptomology of what was going on wouldn’t have been available, and it would have been a disaster.

Lead 7: Thank you. That can be removed from the screen, please.

Now, you had engagement, though, from the Welsh and Scottish Government endorsing the app. Could you tell her Ladyship about that, please.

Professor Timothy Spector: Yes. We were contacted by, I think it was either the Chief Scientific Officers or the Chief Medical Officers of both Scotland and Wales to help them with some geolocalisation of hotspots initially. So they wanted to see where the problems were in their regions, so they could warn the hospitals and reallocate resources. That was the initial enquiry in both of those places where they had very little information on the ground about what was going on.

So they were initially interested in the spatial idea of what was going on, and thought that it had great potential for them to work out what was happening much faster than any official surveys which would normally follow 10 to 14 days later, in terms of what was happening, or relying on hospital admissions, which, again, would be two to three weeks after the initial infections. So we would then be able to predict where hospitals were going to get the biggest burden.

So that was their main reason to contact us.

And so they eventually did start promoting the app, and on social media to some extent in both those places, although not as much as we would have liked.

Lead 7: Thank you. And I think you – in particular from Wales, you identify in your witness statement that you’d been able to identify a hotspot in South Wales using the app?

Professor Timothy Spector: Yes. So there was a couple of hotspots in Wales that we worked with them quite closely to – because they wanted to see how that happened, and worked out the timings of those. And they reported subsequently they found those very useful for their preparation of which hospitals needed to have extra staff in them. So we – in a way, we could predate when the hospitals were going to see a surge in demand by about two weeks.

Lead 7: Thank you. Now you’ve told us in the witness statement about the engagement with the Scottish Government and the Welsh Government in encouraging the app, but it’s right, isn’t it, that ultimately, then, the Welsh Government stopped using the ZOE App.

Can you assist as to what you were informed as to why the Welsh Government stopped using the ZOE App? And I think as part of the preparation materials you’ve also been provided with what has been said by Jo-Anne Daniels about the reasoning. But from your perspective, what did you understand to be the reason why they stop using your app in Wales?

Professor Timothy Spector: At the time I wasn’t following it very closely. So I wasn’t really aware that they had changed their view on it at all. I was too occupied in, really, the rest of it. So I don’t have any great insights into that.

Lead 7: Thank you.

Now can we please display your paragraph 18, which is INQ000575990 at page 9. Thank you.

So at paragraph 18 you detail:

“We were clearly disappointed that the UK Government NHS England were not interested in taking on our app. We’d only anticipated running it for a couple of weeks and then handing it over, showing how successful it was. We believed it could have been rolled out to the majority of the UK population (as an estimate over 40 million people) helped by the fact that we had the facility for people to used to proxy reporting for the young and elderly. This would have given us amazing coverage of the whole of the [United Kingdom] and even in the early days using our subset of population being tested we got a very accurate representation of the pandemic. We were also able to spot trends before the other systems that eventually came into place such as the Department of Health ONS surveys and the episodic Oxford Imperial blood surveys which were generally a week or two behind the ZOE forecasts and at roughly 100 times the cost (ONS costs £390 million). At ZOE we decided to continue with the support of the company and its generous investors for another four months although this used up large resources from the small company. But we felt we were doing an amazing service, and we managed to launch in Sweden and the US although uptake was not as great in those countries for a number of complex local reasons.”

Can I ask you now, under the heading of “what if”, what if there had been funding and encouragement for the 40 million potential take-up of the symptom app? Can you give it your views about what could have been possible in those early days, please?

Professor Timothy Spector: Well, it meant we would have had a complete nationwide screening service. We would have been able to work out in real time what was happening with the pandemic, rather than relying on a combination of modelling and blood tests, which turned out to be not very accurate. And crucially, the 20 billion-odd spent on testing could have been saved or used for other areas of healthcare. Because it turns out that if you combined small amounts of testing with comprehensive symptomatic testing of the whole population, you end up with a pretty comprehensive way of working out what’s going on, and it’s much more cost effective.

So – and it would have reached many other areas of the population that weren’t able to get their testing done, as we’ve been hearing, so weren’t near one of these Lighthouse schemes or – because it would have been able to go into every community. And the idea is we would have been able to go into some of these smaller communities using these proxies, we’d have had the money to translate it into other languages, we’d have been able to get much more out – you know, we just showed what you could do with very limited resources, but if just ten times more resource had been put into it, it could have had a multiplicative effect.

Lady Hallett: Can I just ask, I’m not quite following. How could it have saved the 20 billion-plus on testing? Because you would have used – so if I’m a user of your app, find out that loss of smell could be a symptom, and then I thought the idea was that I would then go and get tested, so know that I was Covid positive. So how would you save the money on the testing programme as a whole?

Professor Timothy Spector: Well, we’d have had – the idea is you set up an algorithm. What we did initially, when only a subset of people were getting tested, we gave a prediction saying it: well, look, with your symptoms, you’re 95% certain to have Covid, ‘Stay at Home’, don’t –

Lady Hallett: So the effect of the test. You’re basically advising me that I’m likely to be positive, so stay at home?

Professor Timothy Spector: Correct. And now we know that the testing wasn’t 100 per cent certain way anyway, only about 70%, it would have served that same purpose.

Lady Hallett: Right.

Professor Timothy Spector: In retrospective, it looks like a good algorithm based on symptoms was about as accurate as these tests were for the overall population. And again, at a fraction of the cost.

And also you are saving two or three days. So that’s quite crucial in this whole idea of an infectious pandemic, because in that time, you’ve got three days of spread to other people using this system of going, waiting for your test, getting the result back 24 hours later. All this time you’re potentially infecting other people. Whereas an instant app that gives you a prediction would allow you to stay at home, isolate much earlier.

Ms Cartwright: Thank you.

Now you’ve already touched upon with her Ladyship the discussion that was you could continue with developing your app on the condition that once the NHS app was launched, that you would then cease what you were doing and support their endeavours. But to your knowledge, was any consideration given by the UK Government to the potential benefits of the ZOE and NHSX apps operating in parallel, particularly in capturing data from different segments of the population, or from those who may have had lower trust in government platforms?

Professor Timothy Spector: We did suggest it, but it was never taken up. And no one ever came back and asked us for any feasibility.

Lead 7: Thank you.

Lady Hallett: To whom did you suggest it?

Professor Timothy Spector: NHSX, several times in calls we had, and as we were getting progress reports of their pilot studies, we were saying, well, we can do this in parallel. But then it petered out and they didn’t talk to us after those initial pilots.

Ms Cartwright: Can I ask you, did the data collected through your app reveal any early patterns of disparity and symptoms, testing access, or outcomes among ethnic minority populations and if so, how were those insights communicated to public health authorities?

Professor Timothy Spector: Yes. Well, I have referred to this as one of the first days we did, of healthcare workers. So it was clear that we saw in that data, which was based on about 2.5 million population and about 50,000 healthcare workers, that there were big differences between groups, and there were four to fivefold increased risks in ethnic minority healthcare workers compared to non-Hispanic white healthcare workers.

And we published these results in press releases and preprints, and in journals like The Lancet, so they were very public.

Lead 7: Thank you. Can I also ask, please, to what extent was your app successful in reaching diverse communities including those from ethnic minority backgrounds or those typically underrepresented in health data collection?

Professor Timothy Spector: Not as effective as we would have liked. So we were underrepresented in those groups, and that was seen in our data. So we had a greater proportion of white middle-class population than you would expect in a true survey, but we did have all – all groups were represented, it just wasn’t in the right amount. So it was generalisable but not representative.

Lead 7: Thank you.

Could we please go to your paragraph 20 in your statement, INQ000575990, which is at page 10, please. It’s just building on what we’ve touched upon relating to the ‘what if’ scenarios, please.

If we can go down, please, to paragraph 21, please. Thank you. You detail – you state:

“A big reason our app was not trusted enough was the problem of missing asymptomatic cases.”

And you continue that:

“It became clear that asymptomatic individuals had lower viral loads and so were less infectious, whereas missing new symptoms like loss of smell and telling them they were uninfected was likely a worse mistake in public health terms as they had high viral loads and were highly infectious.”

Could you provide any details, please, of the liaison or discussions you had with either representatives of the Welsh Government or Scottish Government or Public Health Wales or Public Health Scotland when they were engaging with your app, please, in respect of the role of asymptomatic transmission or testing, please?

Professor Timothy Spector: To my knowledge, that wasn’t discussed with them. They didn’t raise those questions.

Lead 7: Thank you. And are you able to give any explanation why the Welsh Government so proactively initially embraced your app, and its potential contribution, in a way, to the United Kingdom’s government response?

Professor Timothy Spector: So the question is why did the Welsh and Scottish respond and not England?

Lead 7: Yes, so, proactively. And do you see any correlation between take-up by Scotland and Wales as to having any impact or contribution to the UK Government’s response to your app?

Professor Timothy Spector: No, I assumed that the – NHS England and the UK would do the same as Wales and Scotland, so I was surprised when nothing happened and they didn’t reply.

Lead 7: Thank you.

Lady Hallett: I’m assuming that Northern Ireland didn’t respond or engage with you, from what you’re saying?

Professor Timothy Spector: No, we didn’t have any communication with Northern Ireland, and it turned out that of the separate countries, it was the one that we had the least amount of data on, so we weren’t very good at reporting there. And so not having someone who was engaging with us, it was very difficult to promote it there.

Ms Cartwright: Thank you.

Now, given that you’ve already told us about, and in the statement, as well, that you were able to identify outbreaks in south Wales ahead of official statistics, do you believe similar early warnings could have been generated United Kingdom-wide, had the governments of each of the devolved nations and the United Kingdom government collaborated with you more fully?

Professor Timothy Spector: Yes, I do.

Lead 7: And are you able to assist us with how many days or weeks of early warning might have been provided in respect of what might have been happening in regions, please?

Professor Timothy Spector: Well, I had my earlier answer about how our app was giving data before some of these surveys. So it just – it depends on the timeline we’re talking about. Once the ONS survey got up and running, that was able to deliver these two-weekly reports that, depending on when they came in, would say what was happening overall in the country. But we were always ahead by at least a week, ten days, of any other data sources, so I think for planning and hospitals, and closing down epicentres, it would have been very useful for the vast majority of the country.

Lead 7: Thank you.

Can we please display your paragraph 22, which is INQ000575990 at page 11. Let that be expanded, please.

You say this:

“The impact on health and finances of not using our app nationally is hard to quantify with any precision, but the insistence to continue to rely solely on testing and 2-3 symptoms for several months undoubtedly led to hundreds of thousands of excess infections, thousands of [extra long COVID-19] cases and could have saved at least £10 billion if used properly in conjunction with testing. As an example, we estimated with data from 3.2 million people that nearly 16% of cases presented solely with loss of smell and this symptom was by far the most predictive of COVID-19 infection, it also lasted much longer than fever so more predictive of COVID-19 infection, it also lasted much longer than fever so more likely to be noticed. At the time the government claimed the real figure was less than 2 percent. So, since we first alerted our users with anosmia to self isolate on 1st April to the 18th [May] when the UK government finally agreed to add anosmia as a criteria for testing and isolation, over 6 weeks of government delay had occurred. In this time many extra COVID-19 cases could have been diagnosed early and a large proportion prevented from infecting others by staying home. Instead of wasting £22 billion on a test and trace system which never worked properly, an integrated national app with symptom reporting and selected test sampling would have been done for a fraction of the cost.”

Professor Spector, is there anything you wish to expand upon in those clear views expressed in your statement?

Professor Timothy Spector: No, I don’t think so. I didn’t do a full financial assessment, so this is my back-of-an-envelope calculation of what it would be, but it just shows the magnitude of both the cases and the potential cost savings could have been reached.

Lady Hallett: I was thinking about how, if I want to get 10% discount, I have to provide my details. Was your database not an extraordinarily useful source of – not information, but a contactable source for the government in launching their app? So you’ve got one, two, and then 4 million users, and you can put a message out there “Go and use the NHS App”. Was that not a hugely valuable database source for the government?

Professor Timothy Spector: Potentially for the government, yes, it would have been.

Lady Hallett: “We can contact 2-4 million. They may not all be in the UK, obviously, but we can certainly contact” –

Professor Timothy Spector: Most of them were in the UK. So, yes, it would have been an easy way to launch it very fast, rather than doing their own pilot.

Lady Hallett: So you’ve got the two advantages: one, of course, the really important symptom tracker, but then also, if you believe in the contact tracing app, the ability to contact all those people and tell them to use it?

Professor Timothy Spector: Who you knew were good users, who had already been sort of indoctrinated into the way of doing it on a daily basis. Absolutely, yes, it would have been.

Ms Cartwright: Professor Spector, can we now look at the initial – sorry, when the government did announce the change in symptoms, please, on 18 May.

It’s at INQ000237496.

So this was the oral statement to Parliament on 18 May. Thank you.

So just to orientate ourselves, thank you. If we can move forward to page 3 please. Thank you. We can expand, please.

“Throughout this pandemic, we’ve said that if you develop a new continuous cough or a fever then you should immediately self-isolate.

“From today we are including anosmia, which means that if you’ve lost your sense of smell or are experiencing a change in your normal sense of smell or taste, that can be a symptom of coronavirus, even where the other symptoms are not present.”

Pausing there, have you any views on that messaging, particularly in the context of the 16% probability that you had identified from your studies?

Professor Timothy Spector: It seems to be slightly trivialising it, just adding it as an add-on, but this is, you know, a small extra thing they’re doing. It also doesn’t – loss of sense of smell or taste should be more prominent there. So, many people might read that and miss that part of it. And it’s very hard to separate smell and taste in the population. The two really go hand in hand, and that really should have been highlighted much more than it was.

Lead 7: Thank you.

Professor Timothy Spector: As well as its importance and, you know, stating that statistic which was, you know, based on several million people’s data from across the world, so it would have put it in context much more.

Lead 7: Thank you. And I want to ask for clarification of any views also, the next sentence, please:

“So from today, if you develop a continuous cough or fever or anosmia you should immediately self-isolate for at least 7 days in line with the guidelines.”

Just pausing there, obviously the advice about self-isolation, anosmia is only the loss of smell, is that correct? There’s a separate medical term for loss of taste, ageusia.

Professor Timothy Spector: Ageusia, yes.

Lead 7: And so from a clarity of messaging linked to symptoms, do you have any views about this?

Professor Timothy Spector: Yes, it falls short of being clear. And they should I think have probably used the popular terms for it anyway, rather than trying to medicalise it.

Lead 7: Thank you.

Professor Timothy Spector: I think in that – in retrospect, that was a mistake.

Lead 7: Can we then look at the publication of the statement by the United Kingdom Chief Medical Officers, please? It’s INQ000237497.

Over the page, please.

It may be you have answered these questions already but we can see this was then the publication supported by each of the Chief Medical Officers of England, Wales, Scotland, and Northern Ireland. Again we see:

“From today, all individuals should self-isolate if they develop a new continuous cough or fever or anosmia.

“Anosmia is the loss of or a change in your normal sense of smell. It can also affect your sense of taste as the two are closely linked.”

Is there any view you have around this messaging in the context of what your study had identified about clarity of communication?

Professor Timothy Spector: It’s better than the last one, but it’s still not perfect, because the two go together. Some people just – everything just tasted strange. You know, garlic tasted of asparagus, or weird sensations like this. You know, drinking a beer just tasted very strange, and they didn’t notice differences in smell. So I think – yeah, it should have just been “A loss in your normal sense of smell or taste”, and left it at that.

Lead 7: Thank you.

Professor Spector, finally for my purposes, can we turn to your recommendations as detailed within your witness statement, please.

It’s your paragraph 23 at page 11 of your statement, INQ000575990.

You detail that you believe:

“… the ZOE App has shown that a strategy that includes a national symptom-based app is essential as an early response tool allowing the government and the population to know what is going on and assess their personal risks. This should be done at the same time as labs are looking for good rapid diagnostic tests they can subsequently roll out if needed. But future accurate tests cannot be relied on, we used a test with only 70% sensitivity for Covid, and must consider this may not be easy or rapid for the next pandemic pathogen. The government should change its mindset and encourage small companies and universities to develop tools rather than trying to shut them down, or see them as lesser value. Once developed, they can be badged as official UK health tools. Government and Department of Health responses will always be slower than industry, and this hard lesson needs to be learned.”

Professor Spector, is there anything you want to say to expand upon that, particularly what you say about the need for the government to change its mindset?

Professor Timothy Spector: Yeah, I mean this is an example of government, Department of Health, mindsets that – they don’t like to change their opinions easily, and they’re not flexible. They came to a conclusion that these are the symptoms, they had a small group of people making these decisions, they said the public could only take a certain amount of information, otherwise, you know, they’ll get confused, therefore we mustn’t confuse the public even if the science changes quite considerably.

And this is a really bad mistake, because it makes the public totally lose trust with a government and we see this time and again. I’m seeing it in the nutrition field all the time. They won’t change some rule, and the same committee, the same group of people is there making those decisions. They never get new people in that, you know, don’t have a vested interest in keeping those things going.

So this is just an example of how many things work, unfortunately, in this country. And how we’ve ended up with, you know, what was the best public health system in the world to perhaps, you know, one of the poorest, in the developing countries.

We’re not protected by our public health department anymore. And it’s interesting, I’d never had one communication from Public Health England in all this time. And even now, have not had any – anyone coming to say, “Oh, what lessons could we learn from your app? That you interacted with these millions of people who gave you all their data, and people are still logging today. How did you do it? How can we do this for the future?”

So I think it’s frightening that that hasn’t happened, and that we don’t have an app ready to go for the next pandemic where we may not know what the virus is. We may not know if – it might be a fungus, it might be a nerve agent. We don’t know. But if we have this technology ready to go, if a company of, you know, 20 engineers put this out in four or five days, what should a huge country like the United Kingdom be able to do? They should be able to get something out in a matter of hours if it’s all set up and teed up to do this. And so that’s really my main plea, here, is let’s not repeat mistakes, let’s not assume that symptoms are trivialised. If we trivialised diseases based on symptoms, we would dismiss the whole of mental health as not being diagnoseable.

We don’t do that. We trust in symptom clusters. Let’s do this because it’s completely doable. So I would like that to be – I would like to be protected against the next pandemic by this being rolled out and we learn our lessons.

Lead 7: Thank you.

Professor Spector, I do have some additional questions just to see if you have any views, again to inform recommendations.

Can I ask, please, what lessons should be drawn from the ZOE App about the importance of participatory community driven data collection in improving equity in pandemic response?

Professor Timothy Spector: I think it’s a perfect example of not forcing people to come for testing, but allowing them – it to go to their homes, and everyone – most people have access to the Internet, so it does allow equity, and if the funding is there to translate it into other languages, then it can go broadly, and if we use this proxy system it would also allow community leaders to go and disseminate it into those poorer parts of society. So I think it fits perfectly into that remit.

Lead 7: Thank you. From your experience or expertise, how can digital health technologies be better designed to build trust with ethnic minority users, reduce digital exclusion and support culturally appropriate communication strategies?

Professor Timothy Spector: I’ve partly answered that, but I think allowing AI to change the language, which could be done very simply now, and I think what we showed in this is that by providing data back to people, that enables this trust, this two-way system. And this is something the government still hasn’t learnt. So most surveys done by government do not give any of the information back. Much too worried about data breaches than they are about health of the nation. And I think this is at the heart of a lot of these problems, were why governments have not embraced systems like we were able to do at ZOE, is because of this fear/aversion of letting someone see data they shouldn’t see at the cost of people’s lives. And I think this runs very deep in our system.

But we showed, if you give people back data, they respond and give you their personal data. And it really does work. And, you know, it’s why it was so popular. And it also provided – we haven’t talked about a psychological help for many people, as well. So people still stop me in the street and say, “Thank you, you know, you got me through the pandemic with the app. I felt there was someone I could talk to.”

And I felt this is something that may not get mentioned much in this Inquiry, but I think the psychological elements of how we can support a population. This is a great way of doing it.

Lead 7: Thank you. And that may feed into this next question, and I’ve only got two questions now, Professor Spector.

In light of the lessons from the ZOE App, how can future public health campaigns ensure that messaging about health risks/testing is culturally appropriate and tailored to diverse ethnic communities, particularly those that were historically hesitant to engage with government-led initiatives?

Professor Timothy Spector: I think I’ve probably answered that, maybe in the previous answer.

Lead 7: Thank you.

Then finally, please, do you have any views as to centralised control over testing and data systems over opportunities to work with community-informed independent tools like the ZOE App and demographic inclusivity or representation?

Professor Timothy Spector: Yes, well, I think centralising in this scenario, we’ve seen the difference between what a small start-up company could do and what a huge centralised system like NHSX was able to do. One was a success, one was a failure.

Ms Cartwright: My Lady, those are my questions. There are Rule 10 requests from FEMHO and Covid Bereaved Families for Justice.

Lady Hallett: I was just checking, I wasn’t sure whether you hadn’t asked Mr Thomas’s questions.

Ms Cartwright: Oh, I think I have.

Lady Hallett: I think you’ve asked them almost word for word, hasn’t she, Mr Thomas?

Professor Thomas: More or less. Can I just piggyback on just one?

Lady Hallett: Yes, of course.

Ms Cartwright: Can I just apologise to my learned friend.

Questions From Professor Thomas KC

Professor Thomas: Not at all.

Good morning, Professor.

Lady Hallett: This is Mr Thomas.

Professor Thomas: My name is Leslie Thomas. I’m representing FEMHO, the Federation of Ethnic Minority Healthcare Organisations.

Ms Cartwright King’s Counsel has touched upon the questions that I did want to ask you. Can I just ask one question that flows on from that.

Just so you’re aware of the context, those who I represent are, you know, very concerned and wish to examine the extent to which government preference for centralised control may have restricted the integration of independent community-driven tools such as the ZOE App, and want to know and explore whether there are alternatives for a more inclusive approach going forward, and being forward-looking.

So that’s the context. Okay?

So I suppose the question is this: were there – actually concerns around demographic inclusivity or representation, in relation to the existing government systems, part – part of your rationale for proposing closer collaboration with the state? Was that the rationale behind it?

Professor Timothy Spector: I don’t think so. I mean, our rationale was that we couldn’t fund this ourselves for much longer, that we wanted it to get beyond just a few million people to the vast majority of the country, to all, you know, socioeconomic groups. It wasn’t specifically targeting, “Well, we’re not hitting these people”, we just wanted it as widely as possible.

We appreciated that our survey, you know, could have been better had it included more ethnic minorities and people in lower socioeconomic groups. But it wasn’t the main rationale for trying to get the government to expand it. We did have some discussions with the London boroughs, interestingly, at one point, the south – nine boroughs, I think it was, that had a lot of ethnic minority groups in them, to see if we could get the app rolled out to those with translations, et cetera.

We talked about it, they were very keen on it. There was ultimately no funding for it. But we were aware of it at that stage. But that was after the Government had said, “No, we’re not interested in working with you.”

Professor Thomas KC: All right. Final question, then, is this: looking forward, because we’ve been told that there will be another pandemic at some point, what would be your advice to ensure that there is greater inclusivity, you know, in this sphere? What would the advice be that you would give?

Professor Timothy Spector: I’d be doing pilots of these sort of apps in different groups now. I would be working with community leaders to say, “Okay, if we give you this app” – you know, you might have some group of non-English speaking immigrants, and you say, “Well, okay, how would we go about this?” Talking to schools in deprived areas and saying, okay, could the teacher be the one that disseminates this to everybody? In the same way that is happening with some general health apps that – in general, you know, a lot of these groups are missing out on some of this digital health revolution. So I think I’d be just integrating this pandemic prevention into those things and make it part of the standard procedures.

But I’m hopeful that, you know, with AI, being able to convert language, this shouldn’t be much of a problem in the future. It’s moving so fast.

Professor Thomas: Thank you, Professor.

Thank you, my Lady.

Lady Hallett: Thank you, Mr Thomas.

Mr Weaver.

Mr Weaver is just there.

Questions From Mr Weaver

Mr Weaver: Thank you, my Lady.

Professor Spector, good morning.

Professor Timothy Spector: Good morning.

Mr Weaver: My name is Christian Weaver and I ask questions on

behalf of Covid Bereaved Families for Justice UK. In

answers to questions from Ms Cartwright KC, you gave

detailed evidence with regards to the issue of taste or smell as key symptoms, and your repeated effort to bring this to the attention of government officials.

You have explained that your app identified loss of smell or taste as a key symptom from late March 2020 yet it wasn’t recognised as a criterion for testing and isolating until 18 May, some six weeks later. And because of this, you write that some people continued to meet elderly relatives or go to work in health settings because they didn’t think they had Covid-19.

With that considered, I have just one further question: you note that 16% of individuals with Covid had loss of smell or taste but no fever, and only minor cough. Given that these people were not isolating, due to the narrow official case definition, would you agree that this was a blind spot undermining the government’s isolation efforts?

Professor Timothy Spector: Absolutely, yes, and these people were at the highest risk. Nearly all had Covid-19. Three times more important than any of the other symptoms.

Mr Weaver: Thank you, Professor Spector.

Thank you, my Lady.

Lady Hallett: Thank you, Mr Weaver.

Professor Spector, that completes the questions we have for you. You described the battles you had very calmly. I bet you weren’t so calm at the time.

Professor Timothy Spector: No, it was certainly an interesting time but I should just say I was surrounded by a very supportive team and everything I’ve been saying here, it’s not me, it was an amazing group of individuals from the university, from the company, and many other people that came and joined the group we were in. So yeah, I definitely wasn’t alone, but certainly an interesting time in my life.

Lady Hallett: Well, thank you very much for all that you did and your colleagues did, and the company did, to enable you to develop the app and distribute it.

The Witness: And the millions of people who have, you know, logged their data every day and I think that’s the other message here, is that, you know, there is a really willing public out there that really want to help in pandemics, and we have got to learn how to really use them and harness them, because they were amazing. And

they gave us all the support and, you know, gave me the

energy to carry on every day.

Lady Hallett: Well, we’re very lucky that so many people

are prepared to help, but particularly of your skill and

ability. So thank you very much indeed –

Professor Timothy Spector: Thank you.

Lady Hallett: – for what you did and tried to do, and

thank you for your help to the Inquiry.

Very well, I shall return at midday.

(11.43 am)

(A short break)

(12.00 pm)

Lady Hallett: Ms Cartwright.

Ms Cartwright: My Lady, please could Professor Molloy be

affirmed.

Professor Christopher Molloy

PROFESSOR CHRISTOPHER MOLLOY (affirmed).

Questions From Lead Counsel to the Inquiry for Module 7

Ms Cartwright: Would you please tell the Inquiry your full name.

Professor Christopher Molloy: Christopher Richard Molloy.

Lead 7: Thank you.

Professor Molloy, you’ve provided a witness

statement dated 10 April 2005. Your signature is on

page 85. Can I ask you to confirm, are the contents of

that statement true to the best of your knowledge and belief?

Professor Christopher Molloy: Yes, they are.

Lead 7: Now you are here to assist us to give relevant evidence you have to test, trace and isolate, in particular to the initial setting up of the Lighthouse laboratories.

Professor Christopher Molloy: Mm-hm.

Lead 7: But before doing that, can we first of all identify your relevant background and expertise, before then moving to the relevant background and expertise of your company.

Now, it’s right, isn’t it, that you are director and chief executive officer of Medicines Discovery Catapult, and have been in that role since November 2016?

Professor Christopher Molloy: That’s correct.

Lead 7: Thank you. Prior to this you had a career in industry, in international life sciences research and development disciplines.

Professor Christopher Molloy: Yes, that’s right.

Lead 7: And you describe yourself as having a 30-year record in industry, including at board and executive level, across a range of life sciences, research and development disciplines, including close involvement with the industrialisation of high throughput discovery based on large-scale biological testing?

Professor Christopher Molloy: Yes, that’s right.

Lead 7: And I think, could we shorten that, high throughput testing –

Professor Christopher Molloy: High throughput screening is the general term that’s used within industry for the testing of many hundreds of thousands or millions of potential new drugs against a biological test.

Lead 7: Thank you.

And finally by way of your background, unless you want to add to anything, you are also an honorary professor at the University of Manchester and chaired the Industry Advisory Board at the National Institute for Health and Care Research Biomedical Research Centre.

Professor Christopher Molloy: That’s correct. And I’m a trustee at the Institute of Cancer Research.

Lead 7: Thank you.

Can you now please assist her Ladyship with telling her about Medicines Discovery Catapult, and the company itself, but also the principle of Medicines Discovery Catapult, please.

Professor Christopher Molloy: Thank you very much. Good afternoon, my Lady.

The Medicines Discovery Catapult is the nation’s innovation centre for medicines R&D. It is there to industrialise and drive the adoption of new tools and techniques for our sector, driving their adoption through commercial services. It is there to work with young companies, making them fit to fund, working through their R&D plans, working through their risks and their opportunities to help them make good investment decisions and be investable. And that’s led to an investment or around about £1.3 billion of private money into companies who we’ve worked with.

And thirdly, and most relevant here for us today, is the work that we do in our international and national R&D programmes, a portfolio of between five and seven of these programmes. And these include, for example, the rollout of total body imaging with the NHS. It includes the international platform for new medicines for antimicrobial resistance. It includes the launch of the national Dementia Goals programme and so on.

These are purposeful collaborations, anchored through to the patient for – often via their medical research charity. And their purpose is to do the things that are hard, to do the things that require combinations of skills, expertise, resources. And that is very typical of what the Catapult has always done, since I helped found it at the back end of 2016 into ‘17, and a very logical starting point for our discussion about the Lighthouse laboratories today.

Lead 7: Thank you.

Perhaps if we’d locate where the company operated from in 2020. It’s right, isn’t it, that Alderley Park that we’ve heard about, based in Macclesfield, was where the company was based?

Professor Christopher Molloy: That’s correct. Alderley Park is the former R&D – European R&D centre for AstraZeneca. AstraZeneca have now relocated their R&D facilities to Cambridge, and Medicines Discovery Catapult was one of the cornerstone clients at the privatised science park at Alderley Park run by Bruntwood SciTech.

Lead 7: Thank you. And we’ll perhaps touch upon Bruntwood –

Professor Christopher Molloy: We shall.

Lead 7: – when we hear the steps you took at speed in March 2020.

Now, the phrase “the Lighthouse laboratories”, in fact we have you to thank for that; is that correct?

Professor Christopher Molloy: Yes.

Lead 7: And perhaps if we identify the principle and why you arrived at “Lighthouse”, you say this in your statement you say:

“I christened the Lighthouse Labs as such because of the totemic image of a lighthouse in dark and uncertain times and because light is generate and measured during the conduct of a PCR test.”

Professor Christopher Molloy: Yes, that’s true. And the Lighthouse was a unique construct designed to bring together NHS, academia and industrial skill in a non-profit manner to serve the nation at a time of crisis. That was its purpose. That was the distinct purpose that held it together, the people together, and the project together, and brought thousands and thousands of people together, as volunteers and then as short-term workers, to deliver that programme of 150 million PCR tests over two years.

So it was a unique construct but one designed with purpose and for hope.

Lead 7: Thank you. And in answering that question you’ve identified not for profit, and we’ll come, perhaps briefly, to look together at what you did and what the company did, but it’s right, isn’t it, for the commencement of the offer of Alderley Park as a Lighthouse laboratory, it was simply being run not for profit?

Professor Christopher Molloy: That’s correct. So the Medicines Discovery Catapult is a not-for-profit group. We have commercial services as part of our offering, as defined by our grant from Innovate UK, but all of the initial Lighthouse group, in Milton Keynes at the UK Biocentre, at ourselves at the Medicines Discovery Catapult, the University of Glasgow, and even AstraZeneca, running under a non-profit model, took that as our first principle: that we were here, at a time of crisis, to lean in, to do what we could, to bring our skills to bear and to make sure that the nation was served. That was one of its founding principles.

Lead 7: Thank you. I’m going to take you now to you leaning in.

Professor Christopher Molloy: Mm-hm.

Lead 7: And I suspect, when you sent this email, you had nothing of Lighthouse in your mind, but let’s look at you leaning in, please.

Can I have displayed, please, INQ000510837, and page 1. Thank you. And it’s the bottom email, please.

This is essentially you leaning in, for the first time, on 19 March 2020, at 9.12 in the morning:

“Dear friends, you are busy. I’ll keep it short. You (like us) will be the recipients of 100s of potential medicines discovery ideas and programmes. We have industry-class skills in coordinating, triaging, diligencing and managing concept-to early-clinical consortia.

“We can be of national use and my team are fully functional. We can scale with our national consulting networks and put money to work well. Please let me know how I can deploy to help you manage the flow, and fill the national pipeline. Call me any time, plug me in, or pull me into the right rooms as needed. We are ready and able. Bandwidth is unknown but let’s find out.”

And that was sent Louise Wood at the Department of Health and Social Care, and Fiona Watt at MRC. Can you just identify who that individual is, please.

Professor Christopher Molloy: Fiona Watt was the then executive chair of the Medical Research Council.

Lead 7: Thank you. And obviously, also, Professor John Bell.

Professor Christopher Molloy: Yes.

Lead 7: And in terms of those being the contacts to send the very call to step up, why was it you went – focused your offer these three individuals, please?

Professor Christopher Molloy: So Louise Wood was at the time running the National Institute for Health and Care Research as part of the Department of Health and Social Care; Fiona running the Medical Research Council; and Professor John Bell a recognised UK life sciences champion with great experience across the NHS, academia, biotech and large pharma. These individuals were part of my network and well known to me, and I to them. So I thought it was a logical place to start and my approach was around medicines discovery, unsurprisingly, as that was what we understood at the time was going to be a national need, a triage of new potential medicines ideas.

The answer I got back was leaning on my prior experience elsewhere.

Lead 7: Thank you. Perhaps if we then look at the top of the page where we can see again you reaching out, the same day, at 4.39 in the afternoon, to Jeremy Farrar, again sharing that message. And it’s clear from this email that you had not met Sir Jeremy. And you say:

“As we have not met, I did not presume to send it to you, but I am putting myself and the MDC at your service. Please let me know how I/we can help manage the multiple streams of translational R&D activity and industrialisation of academic assets that are now flowing. Wellcome supports us to manage and drive these types of R&D consortia but please also feel free to reference check with me and Mike Ferguson and JB if you need to”.

Can you just identify Mike Ferguson, please.

Professor Christopher Molloy: Professor Sir Mike Ferguson of the University of Dundee.

Lead 7: Thank you. And why in particular were you flagging Professor Ferguson?

Professor Christopher Molloy: He had been and may have been at that time a member of the Wellcome board.

Lead 7: Thank you.

Now, can you, perhaps in your words, deal with the response that came back, and what you did to respond in March?

Professor Christopher Molloy: So I received a phone call back from Sir John Bell, who wished to talk to me about the decision that had been taken to provide high throughput testing of PCR across the nation, and could I, with my prior experience and understanding and industry links, and group, the MDC, provide a site at which this may be – at which this may take place. It was clear from that conversation that the site Milton Keynes, which was the UK Biocentre, which had been co-funded by the Medical Research Council, and NIHR had already been alerted and was mobilising to this end, and could I mobilise a centre in the north, or the northwest specifically.

That was the first conversation that occurred on that afternoon.

I was unaware of what Sir Jeremy had either sent or planned to send to universities at the time and I had been unaware that that decision had been taken, but I leaned on my skills, and experience and publications in the area of high throughput screening and the fact that many of my senior staff in the Medicines Discovery Catapult came from the high throughput screening group at AstraZeneca that was also still present at Alderley Park at the time.

Lead 7: Thank you. Now, can you assist, then, as to just a timeline, so her Ladyship understands. It’s very difficult to tell the story through such a detailed statement so I think it’s better that you tell it. Really, what I’d like to capture, please, from the requests then to set up a laboratory, high throughput testing in the northwest, but then how you ended up essentially being the overseer of the three Lighthouse laboratories that were set up in the April 2020, please.

Professor Christopher Molloy: Thank you. And you’ll understand that there was, you know, there was an instant flurry of activity that came after that initial phone call. When I’d put the MDC at the service of the nation, I was introduced through to colleagues in the Office for Life Sciences, who were staffing and running the so-called Pillar 2, which was the non-NHS, ie, the NHS augmentation side of the PCR testing programme. And in conversations over the following days, I was asked by the Office for Life Sciences, by Kristen McLeod and others, if I would coordinate the national programme, leveraging my expertise and industry standing.

So over those first few days some clear decisions were taken around how best to perform high throughput screening alongside NHS resources, but using NHS understanding, skills, input, advice and techniques to deliver.

So the Lighthouse labs were formed on that principle: that we were engaged with the NHS from the very early days, within 36 hours of that initial phone call, at the very highest levels of the NHS and the Royal College of Pathologists and clinical experts, because our purpose here was to provide high throughput testing doing one test at unprecedented pace and scale, to be able to take the pressure off our NHS laboratories who were already harnessed in to Pillar 1, but also we recognised had to provide a wide array of additional testing for inpatients and others that we did not have to.

We could apply our industry-class experience and skills in automation, in scaling, in quality, and so on, in the service of the nation doing one thing incredibly well. And that’s the task we set ourselves to on an industrial scale.

And that needed a mobilisation of industry experience, and so creating the management teams, those very early management teams at Alderley Park, in Milton Keynes, and ultimately in Scotland, in Glasgow, pulling from the industry community those people who had that experience, but blending them, binding them, to NHS experts, clinical virologists, clinical microbiologists, public health experts, so that we could not only align with what the NHS was doing but effectively augment it.

That was, you know, a subject of intense conversation in those very, very early days, and so I’m very grateful to the Inquiry for the ability to set that record very straight this morning.

Lead 7: Thank you.

Can we please display the map of the Lighthouse laboratories. It’s INQ000587456. Thank you.

Now, if we can just put the outer limit on over when you were involved in overseeing the first four Lighthouse laboratories which you’ve already identified –

Professor Christopher Molloy: Yes.

Lead 7: – which were opened by, obviously, Medicines Catapult Discovery (sic) at Alderley Park in Cheshire. You’ve already identified that Milton Keynes, that was UK Biocentre that operated –

Professor Christopher Molloy: Yes, that’s right.

Lead 7: – that operated that site.

Professor Christopher Molloy: Yes.

Lead 7: In terms of Cambridge, Cambridge was operated, that was correct, through the University of Cambridge?

Professor Christopher Molloy: And AstraZeneca.

Lead 7: And AstraZeneca. And Glasgow, was that the University of Glasgow?

Professor Christopher Molloy: University of Glasgow.

Lead 7: And was there any other private initiative support in Glasgow?

Professor Christopher Molloy: No.

Lead 7: Thank you. And you’ve also referenced already the input of virologists?

Professor Christopher Molloy: Mm.

Lead 7: Did each of the Lighthouse laboratories in April 2020 have a clinical lead?

Professor Christopher Molloy: Yes, they did. So the – and the clinical lead – the clinical leads who were suggested to us by NHS leaders were brought on on each site to advise on its build, to advise on quality, to advise on technique, and there was a group, therefore, of clinical experts chaired by Dr Malur Sudhanva, who was the clinical lead for Milton Keynes, across Professor Paul Klapper in Alderley Park, Professor Rory Gunson in Glasgow, and then Nick Brown at Cambridge.

Lead 7: Thank you. Would you like to give her Ladyship some impression in terms of the skills and expertise of those four clinical leads at each centre? Perhaps starting with Professor Sudhanva.

Professor Christopher Molloy: So across this set of clinical leads were folks who had and do run clinical labs within the NHS, who set the National Health Service exams for virology, members of the Royal College of Pathologists, expert microbiologists with decades of experience of clinical labs, of training, of quality, and of how the NHS does their job in this space.

We relied on them every day, and many times every day. They were so deeply involved in this activity all the way from analysing our borderline results through to processing improvements in the laboratories and so on.

We also had early bind-in from former NHS operational managers, Dr Ian Fry being one, who came to visit our centres, and gave us invaluable advice, on how they saw the set-up of these labs. So the binding of NHS into this programme was immediate, and it was deep, and it was sustained.

Lead 7: Thank you.

Now, whilst this is still displayed, it’s right, isn’t it, that you had the oversight role for the first four Lighthouse laboratories until the July 2020 –

Professor Christopher Molloy: That’s correct.

Lead 7: – when Professor Dame Dominiczak –

Professor Christopher Molloy: Anna Dominiczak, yes.

Lead 7: Thank you very much. And can we then just clarify because we can see that during that period up to July, once the four laboratories were set up, what followed thereafter was under Professor Dominiczak’s coverage; is that correct?

Professor Christopher Molloy: That’s right, and Professor Dominiczak was, in fact, the sponsor of the University of Glasgow Lighthouse so had, you know, excellent experience of both the build of that and the running of that from the start, so – and she took over from me in the back end of July/early August.

Lead 7: Thank you. Now, we’ve already identified that the Glasgow Lighthouse laboratory and the Glasgow Lighthouse laboratory had an input from the university sector.

Professor Christopher Molloy: Yes.

Lead 7: And are you able to assist when you were asked to help set up Alderley Park but then oversee the other three, to what extent you were party to discussions about offers that had been made from other academic institutions and universities or other bodies that were offering the ability to do testing, admittedly not through a Lighthouse-type scenario, but can you help inform what thought process was given to other offers as those that could say they could run a quantity of PCR tests?

Professor Christopher Molloy: Yeah, I was aware that those offers were coming in to Pillar 2. It was not my – it was neither my role nor my privilege to make those decisions. The discussion on the location of the Scottish Lighthouse was one that I’d been having with Scottish Government, and that was their decision as to where that was eventually sited.

Obviously, I was aware from very early, from Day 1 or Day 2, that the university sector had been asked if it would lend some of its relevant instrumentation to this centralised approach, and that was really the extent of my, you know, of my involvement in what universities were doing where. The University of Cambridge/AstraZeneca culmination with something those two parties had come to agreement on separately.

Lead 7: Thank you. The Inquiry last week, in fact, saw emails that were sent by Sir Jeremy Farrar on 19 March –

Professor Christopher Molloy: Yes.

Lead 7: – to the academic institutions/universities with medical schools, essentially doing what you just said: asking them to essentially surrender their PCR machines to the national Lighthouse effort. And were you aware of that?

Professor Christopher Molloy: Yes, I was. And that was – and I think it’s correct – it’s to universities primarily?

Lead 7: Yes.

Professor Christopher Molloy: And that message also did go out to some private sector providers and biotechs and so on, which led to the identification of about 400 pieces of equipment, that were then moved in a logistics exercise to our facilities and enabled us to get going extremely quickly. I don’t believe that there was any call ever made to any NHS facilities.

Lead 7: Sorry, my question may have been misleading. I meant universities like medical schools that had connections to NHS. So my question may have been misleading.

Professor Christopher Molloy: This was, yeah, primarily sort of academic – or institutions, yes.

Lead 7: Thank you.

Then can I ask you, because we know that you did not have a bespoke high throughput for PCRs available at Alderley Park, I’m going to ask you to detail practically what you did.

Was there any thought about, by moving PCR equipment from universities that could be running PCRs, that there needed to be careful consideration about when these machines were moved so that they could be being used most efficiently whilst the Lighthouse labs were being set up?

Professor Christopher Molloy: Yes. And obviously all those machines had to be decontaminated, moved, relocated, and then bought back into operational use. And we tried to do that as sensitively as we could, to make sure the instruments went to sites where they could be used as quickly as possible, and engineers from Thermo Fisher and elsewhere were deployed appropriately to make sure they could bring those instruments back into operational use. So that helped us build capacity in a managed way, and it was vital for us to understand what instrumentation was available, so that we could do this and we could load balance.

One of the things that may be important for the Inquiry to hear is that, from the start, we wanted to have sites in different parts of the country and recognise that those sites would need to have failover and load balancing across them, because we didn’t know, in March and April of 2020, if we centralised everything in one place, if that site went down, let us say in a horrible experience that a large-scale infection ran through it, then we would be in a national risk. So there was diversification of place and also to reflect the understanding we had about the need for logistics and the requirement to move things to these laboratories from different parts of the country, from, you know, Southampton to the Scilly Islands.

So there was a requirement to have a small number of centres, and across those centres those pieces of instrumentation were moved in as straightforward a way as we could, and brought up into operational use.

That process takes days or weeks, in some cases. So it needed to be handled – it couldn’t just be moved overnight and made operational the following day.

Lead 7: Thank you.

Can I ask you slightly to slow down. I think between the two if us we are probably causing the stenographer some concern with keeping up.

Professor Christopher Molloy: My apologies.

Lead 7: Now, just to help us understand where the strategy was up to, then, in the March of 2020, we know the four Lighthouse laboratories were set up in the April 2020. You’ve talked about the need or desire to set up other laboratories in regional centres. But did you have any role or input, when you were in the coordinating role that you handed over in the July of 2020 –

Professor Christopher Molloy: Mm.

Lead 7: – for the discussions or thought process around the other Lighthouse laboratories that we can see came on then much later in 2020?

Professor Christopher Molloy: I was aware that discussions were ongoing from about June of 2020 by the Pillar 2 leadership and the – and test and trace leadership, to extend the franchise of the Lighthouse system to other laboratories in different locales, and potentially to NHS-operated large-scale laboratories.

So I was aware that that was going on; I was not actively involved in that discussion, but I did represent to Pillar 2 management the – some of the options that could be taken, if you looked long term. Once the emergency period had had its first run, then it was about the expansion, the long-term expansion of that network, and there were a number of ways in which we could do that. Additional site was certainly one of those ways, and we took some other approaches as well which also increased capacity.

Lead 7: Thank you.

So can you assist, then, who was driving the wider project? Because it seems like, whilst you had some peripheral knowledge, your focus was, up until July 2020, on the first four, to coordinate –

Professor Christopher Molloy: Absolutely. It was on delivery.

Lead 7: Yes. So who was then driving the wider scoping of additional Lighthouse laboratories?

Professor Christopher Molloy: To my knowledge, there was an NHS group and – I think run by Ian Fry, who was doing that. But as – very much as an open part of what Pillar 1 and Pillar 2 were doing. So I was aware that this was going on, that other sites, other locations were being reviewed as potential expansion sites. I was aware that other suppliers, such as PerkinElmer were being talked to about bringing on their own sites, using their own technologies.

So very aware that, while we’d started with this core of these labs, that the modus operandi of those laboratories could be extended through to others to provide additional capacity, as we discovered and modelled what the nation would need over the next 18 months.

Lead 7: Thank you.

Now, you’ve helpfully set out the details of what your role envisaged from the March of 2020 to July 2020.

Please could I ask for paragraph 5 of your statement INQ000587344, at page 4, to be displayed.

Thank you.

At the bottom of the page. Yes. So you tell us that:

“Between March 2020 and July 2020, [your] role was to:

“• Provide executive coordination services in relation to the setting up of the Network and to be responsible to the Department of Health and Social Care … for it.

“• Define and maintain a purposeful, consistent deliverable plan for the Network.

“• Coordinate and drive Network decision-making and problem-solving.

“• Coordinate the Network’s activities across what was then 3 to 4 sites across England and Scotland …”

Professor Christopher Molloy: Mm-hm.

Lead 7: “… and in parallel to the laboratory provided separately in Northern Ireland by Randox.”

Professor Christopher Molloy: Yes.

Lead 7: So, pausing there, can you just assist as to how the four Lighthouse laboratories that were set up were different, or if they weren’t, and how they fitted with the Randox laboratory at Northern Ireland. And is it correct that Randox traditionally provide clinical PCR tests into the sort of healthcare service?

Professor Christopher Molloy: So, in answer to your last point, yes, that’s my understanding. They also produce a wide range of diagnostic tests and technologies. So the Lighthouse system was run in parallel to the Randox approach, which was using their own technology, and had preceded my involvement with this approach, although I was in touch with the Randox team on a regular basis, and they did receive some capital equipment as part of that message that we discussed a few minutes ago. We did not share reagents because the tests were somewhat different.

So the lighthouses were a, you know, non-profit approach using, initially – of those first four, three used the Thermo Fisher approach, and AstraZeneca used one other approach, which they had validated back to back with the Thermo Fisher one.

Lead 7: Thank you.

And then perhaps if we continue through your role, you’ve already identified that you were:

“… responsible to Pillar 2 for the output of the Lighthouse Labs and to the Lighthouse Labs for access to Pillar 2 resources, and

“• [to] Liaise with essential stakeholders (including … the [NHS], the Health and Safety Executive … various industry players, the DHSC, and external supply chain providers.”

Professor Christopher Molloy: Mm.

Lead 7: And can I ask you, can we have clarity about who those industry players were, please?

Professor Christopher Molloy: So we were working with organisations like Thermo Fisher, for example, we were working with a wide range of suppliers of reagents, of plasticware, of instrumentation. I was in discussion with the likes of, obviously, AstraZeneca, with GSK as well. There were numerous biotech providers and others who I was in conversation with on a daily basis, either with offers of help, assistance, staffing, advice. It was a wide array, we could spend a long time going through the entire list, but it was a cornucopia of industry players who provided their skills, their understanding, and their advice.

Lead 7: Thank you.

Now, can you assist, then, as to how you practically and financially were able to repurpose Alderley Park to then become a high throughput PCR Lighthouse laboratory?

Professor Christopher Molloy: So we investigated a number of different sites in the local area, including University of Manchester – and my grateful thanks to Professors Graham Lord and Nancy Rothwell for their help in that.

We identified, however, that Alderley Park, where we are resident, had an available standalone building that we could isolate from the rest of the site. It had class 3 waste disposal capability and incineration, which we knew was going to be a really important part of the build of this facility. And, therefore, we felt that that site would offer us the best opportunity to construct, on a sort of cellular level, the facility that we needed. And I contacted Bruntwood SciTech, the owners of the Alderley Park facility, who immediately made space available, and immediately, without need for money to change hands, to lean in and start converting that facility for our use.

Lead 7: So, in terms of what you were doing in the set-up of Alderley Park, was it underpinned by a contract or were you acting in good faith?

Professor Christopher Molloy: Good faith, at the time.

Lead 7: Can you give us some idea as to how much the company essentially had to lend or sub the Department of Health and Social Care to set up Alderley Park?

Professor Christopher Molloy: So at the time – or by the time we had our first contract with the Department of Health, which was in late April, the – Catapult had already spent over £1.5 million on supporting this programme. And all of the Lighthouse facilities at that time, and by the time that the cash finally started to flow, had invested millions in supporting this programme.

It’s a really important thing that I would like the Inquiry to understand, is quite how much all of these organisations leaned in, in the national interest. Not in their own interest, but in the interest of their fellow citizens and making a programme work effectively at speed and without the barriers of having to contract and, you know, that’s a vital thing that I hope comes through very clearly today.

Lead 7: Thank you.

Now, I think when the first contract was entered into on a not-for-profit basis –

Professor Christopher Molloy: That’s correct.

Lead 7: – it’s right, isn’t it, it was important that there was an indemnity provided to you as part of that contract which enabled you to operate not for profit?

Professor Christopher Molloy: It enabled us to operate. And it enabled us, at a time of great uncertainty, to put into effect the programme that we had created. And I use the term “we” across the Lighthouse network, which is a collective. This was not one company owned by, you know, one individual. It was not a private sector, it was not a commercial deal. This was a collection of non-profit organisations leaning in, paying out, and making sure that the nation was served. It was important to make sure that the department, which they did, understood that, and the risks that we were taking in doing so, and, you know, helpfully helped us manage those risks.

Lead 7: Thank you.

And I know there came a time, as you tell us in the statement, where essentially you moved to the second contract for the services of Medicine Catapult Discovery?

Professor Christopher Molloy: Yes, mm-hm.

Lead 7: Can you just explain to her Ladyship how that contract changed and what one of the issues was that resulted in a different approach needing to be adopted?

Professor Christopher Molloy: So we were asked by the Department of Health and Social Care in the autumn of 2020 to move our services from a non-profit into a commercial standing. And that was for reasons that the Department of Health wished to reduce and/or remove the indemnity, and it recognised at the time that that would need to be balanced with a commercial contract. So that was an approach by the Department to the Lighthouse network.

It’s an obligation for the Medicines Discovery Catapult, under our grant funding agreement, if we are working – if we are working in a commercial sense – and we do as part of our business – to make sure that we do those at market terms and do not undercut the market. So we were then obliged to move from our non-profit pass-through approach into a commercial contract, where we took commercial risk and we were paid a market rate.

Lead 7: Thank you. And I think, having handed over the coordination to Professor Dominiczak, certainly from August 2020, you were then acting as the chief executive officer of the company –

Professor Christopher Molloy: That’s right.

Lead 7: – and maintained the overall responsibility and accountability for the Alderley Park Lighthouse lab?

Professor Christopher Molloy: Correct.

Lead 7: Thank you.

Then, with that having been identified in the five minutes or so we’ve got before we break for lunch, the Inquiry has heard much evidence in respect of the lean-in from the private sector and the various companies that assisted with different aspects of the test, trace, isolate, contact tracing?

Professor Christopher Molloy: Mm.

Lead 7: But in particular, the Inquiry is going to hear some evidence this afternoon from Deloitte. Can you assist in terms of the contribution, when you were overseeing these first four Lighthouse laboratories, that Deloitte were providing in the set-up, please?

Professor Christopher Molloy: So from the start, and I’ve already mentioned that the Milton Keynes mobilisation happened, you know, a few days in advance of my involvement, and Deloitte, the Deloitte group were helping them on, you know, build out their warehouse, build out their systems, and also working with the Department of Health and Social Care on a sort of central framework, and providing a range of different resources through to that UK Biocentre laboratory.

Those resources were taken up by Alderley Park and by Glasgow to different levels, as was needed to fill resource gaps. We also had significant input and resources from our armed services who built our warehouses, and so on, with their logistical understanding.

And the Deloitte group acted as a central resource providing, you know, logistics understanding, demand forecasting, monitoring, reporting certain discrete pieces of software development where we bridged data from the Lighthouses through into NHS systems, and so performed a wide range of functions. But that was the primary – my primary understanding of the interaction.

Lead 7: Thank you. And you’ve mentioned there, I think, a small project – I think that was the phrase – if I’m mis-paraphrasing it.

Professor Christopher Molloy: That’s okay.

Lead 7: But if we could perhaps crystallise the issue of data and the access to data that the Lighthouse laboratories had. Is it correct that when the samples then started to flow through, that there would be the barcode on the sample that was the PCR test, essentially the PCR sample?

Professor Christopher Molloy: Yes.

Lead 7: So can you help us as to what data that you as the operators of the Lighthouse laboratories had access to, and what you needed to have access to, please?

Professor Christopher Molloy: Okay, thank you, and I preface that by saying I’ve spent about 20 years in and around the healthcare data environment and I understand both the opportunities that it has but also the concerns that it raises, and the information governance that’s absolutely required around personal information and health data.

So in the interests of making sure that the Lighthouses were faster to set up and cleaner in their both input and output, and in discussion with NHS colleagues, we chose the following: that the Lighthouse labs would never receive personal health data, even a name. What they would receive is a barcode. That barcode, which many of you may be familiar with from your own experience of testing, was related to information, your personal information that only the NHS held. We would receive that barcode on that tube and report back through existing NHS systems into the NHS network, a result against that barcode.

Lead 7: Thank you.

Professor Christopher Molloy: Positive, negative, or void. What that meant is that we could move quickly, we had reduced amounts of information governance that we had to implement, and therefore, that we could speed up the delivery of the Lighthouse labs to the nation, and it was a simpler, easier-to-implement approach.

Lead 7: Thank you. And so you’ve identified, essentially, having run the process of the test, three results – positive, negative or void. Is it correct, then, that that would be communicated, essentially, to the relevant healthcare to notify the patients via a system called NPEx?

Professor Christopher Molloy: Yes, NPEx is the or was the extant system used by the NHS to import data from non-NHS laboratories, and our colleagues at Deloitte wrote a simple piece of bridging software which allowed our own Laboratory information Management System to port data in through NPEx into the NHS systems, at which point that was absolutely under the control and direction of NHS, to use, for whatever means possible, first and foremost, of course, getting the information back to citizens.

Lead 7: Thank you. And as the system that existed pre-pandemic, is it correct that NPEx was already there as a system for a way of – (overspeaking) –

Professor Christopher Molloy: Yes, that was my understanding.

Lead 7: – to get data, patient data across to NHS systems?

Professor Christopher Molloy: That was my understanding and the rationale for its use.

Lead 7: Thank you. And you describe, though, that what Deloitte did was create that simple bridging to allow the results from the Lighthouse labs to be then sent where they needed to be for that result to be processed?

Professor Christopher Molloy: Exactly. And we chose one Laboratory Information Management System to run across all of the Lighthouse labs to make that bridge as simple and as robust as it could be.

Lead 7: And is there an identifiable name for that laboratory management system that we need to know, or is it just the management system –

Professor Christopher Molloy: It was a system then developed and sold by a company called Brooks Life Sciences.

Ms Cartwright: Thank you.

My Lady, is that a convenient moment?

Lady Hallett: Certainly.

I hope you were warned, Professor Molloy –

The Witness: I was.

Lady Hallett: – that we’d be taking a break. I’m afraid I have a meeting, so I have to rush. I shall return at 1.45.

Ms Cartwright: Thank you, my Lady.

(12.45 pm)

(The Short Adjournment)

(1.45 pm)

Lady Hallett: Ms Cartwright.

Ms Cartwright: Thank you, good afternoon, my Lady.

Professor Molloy, we’ll have some specific topics to cover but, before going back to what you were doing on the Lighthouse project, can you just provide details of separately what you did personally around the development of the lateral flow devices, please.

Professor Christopher Molloy: Thank you. As the Inquiry will know, lateral flow came on after the PCR testing had started, and was a test for infectiousness as opposed to whether one was infected. And became, as the pandemic went through its stages, the initial test that many of our citizens took.

It is an important and vital part of the testing process, and the armamentarium that we have as a nation.

My responsibility was to chair an industry consortium which also included PA Consulting, and that was to do a number of things: number 1 was to increase manufacturing capacity in the UK from about 200,000 a week to 20 million a week, which we did in the space of around about six months. And secondly, it was to develop a supply chain of innovation of UK-invented, UK-made tests, able to supply the nation as its demands increased. And those were my activities from about September 2020 through until May 2021.

Lead 7: Thank you. The remaining portion of my evidence, I’m going to be focusing back on the Lighthouse laboratories, but I wanted to give you an opportunity if there was anything else you wanted to say about your efforts in respect of the development of the lateral flow devices?

Professor Christopher Molloy: I will say that is it’s an important part of our preparation to make sure that we have lateral flow ready to go, and it is vital that we maintain a UK manufacturing capacity, and a supply chain of invention and innovation through our diagnostic companies, to make sure that we have sovereign capability for, if this happens again, we can turn lateral flow on more quickly than we were able to last time.

Lead 7: Thank you. Now, Professor Molloy, my next portion of questioning is all going to be about your involvement in the Lighthouse laboratories, so if we can switch over, please.

Professor Christopher Molloy: Understood.

Lead 7: Can we then have displayed, please, paragraph 62 of your statement, please, INQ000587344, at page 15.

And whilst that’s being brought up, I’ll start reading it, it’ll be on you screen. In respect of the Lighthouse laboratories you say this:

“There was never any intention to replace what the NHS was doing, but rather augment it with discrete, high-quality capacity. The remit here was to do just one thing at an impressive, unprecedented scale. We had to put together a production line that was automated, controlled, process driven, highly accurate and scalable. It was industrial scale, with industrial process tools and industrial quality control. This is exactly what I was asked to do.”

Now, whilst you say the intention was not to replace what the NHS was doing, were there concerns that this was the case?

Professor Christopher Molloy: I have no doubt that across the community there were concerns that that was the case. But, you know, in terms of the supply of our instrumentation, in terms of our willing – and that was from an academic callout, not an NHS one. We also used a Thermo Fisher test. The NHS at the time was using primarily a Roche-based test, and we tried as hard as we could to make sure that we did not cannibalise the supply chains there. And in fact, in the early days of the Lighthouse programme, when our capacity was relatively low, and we were asked by the NHS to supply some of our inventory of plasticware and materials, we did so very happily.

So I do understand that there will be, and there remain, misunderstandings about what the Lighthouse was for and how we acted. What we were for was to augment, and how we acted was to run in parallel with NHS advice.

Lead 7: Thank you.

That can be removed from the screen, but we’ll be moving in a moment to paragraph 85.

Just picking up on what you just said about Thermo Fisher, and what we touched upon around the lifting of those devices from universities and other venues, can I ask you: essentially, the Lighthouse laboratories were largely dependent on essential and key testing equipment borrowed from universities and research institutions; was that appreciated when you took on the task?

Professor Christopher Molloy: Yes, very much, it was massively appreciated. Not only was it appreciated that we had to material to go and do our job, but these bits of kit used to turn up with Post-it notes on them wishing us luck. So I think, you know, the language here is really important and the purpose here is really important. These weren’t lifted; they were volunteered. Okay. They weren’t commandeered. And they were gifted in some cases with intense generosity and then they were returned, either as that bit of kit, cleaned and decontaminated, or a new piece of kit back to that academic organisation or private sector organisation in the summertime of 2020.

Lead 7: Thank you.

Now, if we could display paragraph 85 just to expand upon the involvement of the team from Deloitte, please. You say as part of coordination role you were given access to a small group of Deloitte staff.

Professor Christopher Molloy: Mm-hmm, yes.

Lead 7: Can you just help us understand who gave you access to the team, how many the team comprised of, and, perhaps if you can cover it in the same roll-up questions, your general views and impressions of the support Deloitte provided to you.

Professor Christopher Molloy: As I said earlier on, the Deloitte team which was deployed at the Department of Health and Social Care carried out a wide range of different tasks, only some of which I actually touched on or touched me … there was a team resident at the UK Biocentre at Milton Keynes, and there were individuals from the Deloitte team who were allocated to help me in my role, and who then acted as site-by-site coordinators back into the Deloitte group for management information on a daily basis and so on.

Some of the most useful things here were around demand forecasting. It was one of the major challenges we had, trying to understand where demand would fall on any given day and it was the Deloitte team who helped us, very much, understand where tomorrow was likely to be, because of their involvement with the regional test centres and others, which we had no direct involvement with, but we were the recipients of.

So the Deloitte team was very much the broker of information between the Lighthouse team, on a daily basis and often on an hourly basis, and the rest of the programme. I was given access to the Deloitte team by Pillar 2, by Pillar 2 management, and used an array of that group over the weeks that I was involved.

Lead 7: Thank you. And then can I ask you then from your impression, and particularly as to the volume of contractors or supporters from Deloitte at Alderley Park. The Inquiry heard some evidence last week from Professor McNally as to his impression in the early days of the volume of contractors there at the time he worked there; did you have any views on the numbers or whether they were excessive numbers of Deloitte contractors that had been seconded to Alderley Park?

Professor Christopher Molloy: Each site had its own different needs in terms of build, warehousing and so on. Alderley Park had a relatively small requirement for that skill set, as we had a large number of individuals on that site, particularly, and I’d like to extend my thanks to the AstraZeneca group who leaned in really strongly and provided a lot of the access to skills and material that was not present at the Milton Keynes site and therefore, you know, there’s somewhat of a balance in that.

Lead 7: Understood. But I think, to balance from the evidence as to how things operated, and so noting that you had the AstraZeneca lean-in, could you give us an impression, at a high level, as to numbers from Deloitte contractors that would be there?

Professor Christopher Molloy: I’d – I don’t know how many contractors were at Milton Keynes specifically.

Lead 7: Thank you.

Now, the next paragraph of your statement, please briefly, just on classification. At paragraph 86 you say that you reported to Pillar 2 –

Professor Christopher Molloy: Yes.

Lead 7: – as a minimum daily.

Professor Christopher Molloy: Yes.

Lead 7: So who specifically were you reporting to and how, practically, did you report during the time you were the coordinator?

Professor Christopher Molloy: So, initially, as I put in my statement here, to Kristen McLeod who was at that time running Pillar 2, and, you know, I used to, you know, report daily in a written form to, you know, across all of the Lighthouse labs and to Kristen and colleagues to make sure that everyone knew how the build was going. It was really important. And, you know, Kristen would also provide me with access to what the programme wanted of me, and of us, in terms of build, capacity, give some horizon scanning of where the programme may wish to use the Lighthouse labs.

So it was very interactive, it was very data rich, and I think you’ve seen that probably from the extraordinary number of communications that occurred just in that first week. So it was highly engaged, highly interactive communication with Pillar 2, and then Alex Cooper, who replaced Kristen McLeod, ran that programme.

Lead 7: Thank you.

That can be removed from the screen, please.

Now, can I ask you your broad views and impression as to approach to mass testing on a centralised basis. Did you then, at now looking back, can you assist as to your reflections on the value of a more localised approach for testing?

Professor Christopher Molloy: And I appreciate this is an area for great debate and, you know, some controversy. There is a balance to be had between a highly distributed, fast-twitch type of response, of using many, many individuals, small laboratories, and the larger-scale approach. As you have already been through with me today, in order to set up that large-scale approach we needed access to, you know, NHS data bridging. We needed to make sure we had appropriate supply chains and material, instruments and so on, and a consistency of approach which gave quality at its core.

That was hard enough with four laboratories. With the 400, or more, and taking into account that we were absolutely clear that we got NHS validation before we did any clinical testing. Now, it is important therefore to note that whilst a distributed set of laboratories may offer fast twitch, it does not –

Lady Hallett: Fast twitch?

Professor Christopher Molloy: So, a fast twitch-based response to something, something that happens very readily and rapidly. However, the ability for all of those laboratories to go through the NHS validation back-to-back that we did, to make sure that they were connected with the NHS data systems and so on would have been legion.

Lady Hallett: I think you’re assuming, Professor, that the argument was that you didn’t need mass testing. I think the argument from Sir Paul Nurse and – I’ve forgotten the name of the other gentleman.

Ms Cartwright: Professor McNally.

Lady Hallett: Professor McNally, that’s right – was that essentially you do need mass testing.

Professor Christopher Molloy: Mm.

Lady Hallett: But what you also should do is utilise local infrastructure and skills and all the rest of it –

Professor Christopher Molloy: Yes, there’s an argument for that.

Lady Hallett: – whilst you build the sites, and then you transfer the equipment and everything else, having utilised in the early days of the pandemic, when containment is so important, the local infrastructure. That’s the argument. Not that you didn’t need – I haven’t heard an argument you didn’t need mass testing sites, but that’s the argument that Sir Paul Nurse and Professor McNally were parsing.

Professor Christopher Molloy: Yes, you can consider it in a phasic way. I mean, the transfer of actual physical instrumentation does require time, you know, physical time to move things, to decontaminate, to bring them back up, if you like. It’s like putting the clutch in, you know, you don’t get that full power all the way through. So that handover point would have been critical. There was – you couldn’t go and buy new instruments, instruments were not available anywhere in the world, so this was a case of, literally, the number that we had on this island. So there is a good argument for that phasing, but it’s just understanding the constraints in that, that, you know, the quality and the consistency would not have been the same in that very first and early phase as you would have had, and we delivered as part of the Lighthouse approach.

And I think, you know, the Inquiry has just got to understand the relative trade-offs of those two things.

Lady Hallett: Sorry to pursue the point but –

Professor Christopher Molloy: Not at all.

Lady Hallett: – is consistency as important as just getting the tests done? Which is what Sir Paul Nurse is saying: that if you’re getting the tests done, then things like consistency and whatever can come later.

Professor Christopher Molloy: I think it’s a fair argument, having been on the – on the – the recipient of criticism on consistency, I’m not sure that that argument would necessarily have held.

Lady Hallett: Consistency is obviously important, because you need to be able to rely upon it – (overspeaking) –

Professor Christopher Molloy: That’s exactly right, and that’s where we worked really hard with our NHS colleagues to make sure that our results were consistent with theirs. I’m not sure that that was as possible with a highly distributed set of laboratories running separate tests under separate conditions with separate instrumentation, and separate reagents, but I do understand – I do understand the point and that need for speed.

Lady Hallett: I’m sorry to interrupt.

Ms Cartwright: No, not at all, my Lady.

Can I ask, for when you had oversight role, was there any consultation or engagement with local community organisations, networks or leaders to ensure that the approach to testing was suitable to a diverse range of communities?

Professor Christopher Molloy: Our job in the Lighthouse was to provide capacity for national demand. It was not to define where that demand was drawn from. We did have – all the local Lighthouse communities were engaged, whether it was in the University of Manchester and the Greater Manchester Health Authority or in Glasgow or elsewhere, but the demand that we supplied was the national programme’s demand, from wherever in the nation it deemed it right for us to work.

Ms Cartwright: Thank you.

Can I ask you, you’ve been provided I think as part of the evidence pack the statement of Professor Costello, who provides the opinion that the 44, I think, virology labs in the United Kingdom were under-used in April 2020.

Professor Christopher Molloy: Mm-hm.

Lead 7: Do you have any views in respect of that position of Professor Costello?

Professor Christopher Molloy: I don’t have any data for the use of Pillar 1 facilities during that – that was not my concern.

My concern was building to the national demand that I heard through Pillar 2. But, you know, I naturally would have expected and my understanding was that the Pillar 1 infrastructure was being fully utilised.

Lead 7: Thank you.

Now, I’ve already asked you about data, and you’ve told me about the data link, but it may short-circuit a question: did you have any role to analyse the data that was being generated from the testing.

Professor Christopher Molloy: The Lighthouse labs analysed the experimental data to provide either positive or negative, but beyond that point we were not analysing national data, regional data, or so on. We had no ability to do that precisely because all of our samples were anonymous.

Lead 7: Thank you.

Professor Christopher Molloy: We didn’t know from where they were or from who they were.

Lead 7: Thank you. So essentially you had no access to evidence or data about demographics or anything like that?

Professor Christopher Molloy: Absolutely none.

Lead 7: Thank you.

Can I ask you then, please – can we have displayed your paragraph 96 then briefly.

You detail in paragraph 96 that the key constraints in the National Testing Programme, including:

“… Demand forecasting (essentially trying to predict and manage the number of tests that would be taken by the population at any one time or place and the variables affecting that) …”

Did you know whether that took into account geographical and ethnic disparities?

Professor Christopher Molloy: I do not.

Lead 7: Thank you.

Now can I then next as a topic, and appreciating that there’s emails that have been provided in the pack and documents as to, certainly in the early stage of the set-up of the laboratory at Alderley Park – and I think from some of the reports – the early days overview inspection reports identify a number of issues around the testing itself.

Professor Christopher Molloy: Mm-hm.

Lead 7: And so I’m going to deal with them without the underpinning emails and the like, but can – I’m going to summarise the issues as follows: we have seen that there is correspondence about different sample tube sizes, different shaped tubes, barcode stickers being used as sealants around the tube. And so, in terms of those sources issues, can you help understand – we’ve obviously got some emails that suggest that there was an issue as to the quality of how the samples were provided, and issues of multiple barcodes that then would result in a sample being voided.

Professor Christopher Molloy: Yeah.

Lead 7: And there are other quality issues identified in the material that’s been provided to you, in terms of, in particular I think, swabs being sealed in ASDA supermarket bags and other poor quality issues. I appreciate they’re just some emails, but can I have your overview evidence about the quality and the processes that were achieved at the Lighthouse lab, what you had to engage with to perhaps deal with those quality issues, please, as a topic.

Professor Christopher Molloy: Thank you. If you’re developing what was, in effect, a data manufacturing facility, you rely very much upon the quality of your – and the consistency of your input. And we at the very early stage placed into Pillar 2 a specification for what the tubes should look like, what the swabs should look like, how much transfer material should be in it.

Every single Lighthouse lab had a wall of almost – you know, of the variety of these that actually came through the door on any given day from any given location and from any given supply chain.

We all realised, let’s be clear, that there was a global fight for plasticware and swabs and so on. However, it probably – you know, the variety of tubes that came in and the state that they came in with probably reduced our capacity by 30-40% on any given day.

And some of that was rectified through training at the individual regional test centres, and there’s a good volume of data to show the variety of void rates by test centre, many of which were just to do with simple packing and presentation of these tubes, so that we could use them in an efficient way.

It was a massive issue for productivity, it was a large issue for quality, and it became, you know, because of the – in some cases, the tube leakage, an issue of safety for those volunteers and workers at Lighthouse labs.

Lead 7: Thank you.

Can we look at just one of those emails that are in the category of issues flagged as to quality.

Professor Christopher Molloy: Of course.

Lead 7: It’s, please, INQ000510907. Thank you.

If we can go to the bottom of the page, please, on page 1, this in email from Professor Dame Sue Hill, Chief Scientific Officer, where we can see, following a visit – and I think this was in fact the Milton Keynes site on 28 March 2020 –

Professor Christopher Molloy: Yes.

Lead 7: – but I ask you about that because you’re still in the oversight role at this point.

Professor Christopher Molloy: Yes.

Lead 7: Plainly indicating that it was a:

“Very manual process at [that time, in March 2020] with … risks that need[ed] to be urgently mitigated …

“Systems and processes need[ed] to be improved across the whole end to end pathway …”

And that the:

“Staffing expertise – need[ed] more experienced staff …”

Then if we scroll up, please, I think we see your response at 3.13: I think, broadly speaking, that you indicated that the measures were discussed, understood and accepted.

Professor Christopher Molloy: Mm.

Lead 7: And I think you also confirm in that email exchange that many of the optimisation steps identified by her were in plan but not yet in place. And so what I want to ask you as a broad topic, would those optimising steps have been in place and operational in pre-existing labs?

Professor Christopher Molloy: Some, but not all. I mean, some of those were the implementation of large-scale automation systems, which were not needed in very small labs. And – you know, so there are some really important points in here: one, that this is highly engaged with the NHS; secondly, you know, call-outs for staff with the institute of biomedical scientists and so on, that demonstrates that we were both asking for and receiving advice from the NHS throughout.

But let’s also remember, you know, this was day 10 of a 700-plus-day programme, and it’s absolutely to be expected that somebody coming in – you know, and this was prior to clinical testing having been executed, prior to the NHS formal evaluations of site. So this was absolutely right, that qualified and experienced people came in and pointed out where we needed to do things, and they were done.

Lead 7: Thank you.

Now, I think the response also addresses issues of staffing. You talk about streamlining the process and building confidence in the workforce who are research scientists rather than seasoned clinical lab operatives.

Professor Christopher Molloy: Mm.

Lead 7: Again, would there have been those seasoned clinical lab operatives in university and other labs across the United Kingdom?

Professor Christopher Molloy: I think the issue here was more people coming from NHS clinical labs, and that’s the point that I was making here, that our, our approach both to health and safety and to sample handling took a hypercautious approach by those folks who did not routinely deal with clinical samples. And some of the slowness, perhaps, and the deliberateness that was being picked up here was because of that, and so we encouraged, accepted and welcomed any input from NHS clinical staff, which we had, and, you know, those members of the Institute of Biomedical Science who came and joined us who gave that to us too.

Lead 7: Thank you. And then just finally, before I’ll briefly ask you about recommendations, you’ve had provided to you an article that was published in October 2020 that included a joint investigation between the BBC and with commentary from a Dr Julian Harris.

Professor Christopher Molloy: Yes.

Lead 7: I’m not going to ask for it to be displayed but, for the transcript, it’s INQ000228145. Had you any oversight role at that point?

Professor Christopher Molloy: No.

Lead 7: We know that you’ve moved on. So you can’t really assist as to practices at that time?

Professor Christopher Molloy: No. Not at that time.

Lead 7: Thank you.

Professor Christopher Molloy: And not at that place.

Lead 7: Finally, please, I think to crystallise that you have never taken part in or been invited to any lessons learning exercise in respect of your involvement in the National Testing Programme?

Professor Christopher Molloy: No.

Lead 7: But you do provide a large degree of recommendations within the statement, and the statement will be published. It contains all the details, lessons learning and reflections, but can I ask you to touch upon, I think just two topics by way of recommendations that perhaps may assist her Ladyship as to by way of expansion, and perhaps under the topic, first of all, of space?

Professor Christopher Molloy: Yes. We would have been much faster had we had space to move into, and move our people into, and move the process into. Probably four to six weeks, I think, of difference it would have made had we had that space. And the space has gone. And as I put it in the statement and elsewhere, I think the safety light is out, and that’s something that I think would affect us if we had another pandemic. We would have to find that space again. And, you know, that would be inappropriate and, you know, it is possible to keep those spaces working on peacetime activities and have them able, contractually, to be taken over for pandemic-based activities and I’d recommend that.

Lead 7: Thank you. And I think also perhaps, if I highly summarise some of the topics you’ve identified in the recommendations in the latter part of your statement, I think the need for a plan is also something that seems to come up strongly.

Professor Christopher Molloy: Yes.

Lead 7: Is there anything further you’d wish to detail about the need for a plan, which may seem fairly obvious, but that assists her Ladyship as to your views on recommendations?

Professor Christopher Molloy: Each different pandemic will come with a different plan but we need to have a pandemic plan that we can – not necessarily just pull off the shelf – it has to be more alive than that. We have to have regular war rooms, not workshops, which involve NHS and industry, and academia so that everybody knows what the first 50 phone calls need to be. This is about action, and this is about understanding what the nation can give as it leans in. It instinctively leant in last time and people gave of themselves, financially, organisationally, time wise. They moved from wherever they were with the relative safety of lockdown, into these labs to work hard on behalf of other people. And the state cannot rely on that as a plan.

We need those war rooms regularly with that combination of NHS, academia and industry to understand who can give what, who’s going to be able to provide what and where. If we have that, then the next person who has the chair that I had five years ago, will have somewhat of an easier run in, and the nation will have a faster twitch response for high-capacity laboratories, because it does need to be remembered that this combination of NHS, academia and industry, provided something that the UK should be extraordinarily proud of, and it has provided a generation of scientists with training, experience, and the opportunity to serve their nation. And if I needed any respite through the difficult times here, and it was far difficult for others, but I used to walk around some of the Lighthouse labs, and young people with their arms in safety hoods who’d been there for six or seven hours doing the same job over and over would thank me for giving them the opportunity to serve, and I think the Inquiry needs to hear that and I hope you celebrate it.

Ms Cartwright: Those are my questions, thank you, Professor Molloy, and you have been heard –

Lady Hallett: Just a couple more questions from Ms Maragh.

Questions From Ms Maragh

Ms Maragh: Professor Molloy, I’m Thalia Maragh.

Professor Christopher Molloy: Hi.

Ms Maragh: And I ask questions on behalf of the Covid Bereaved Families for Justice. Just a couple of questions from me, really, touching on the topic of the management of the Lighthouse labs. And you were very helpfully taken to a brief timeline of your involvement –

Professor Christopher Molloy: Yeah.

Ms Maragh: – in the oversight role of the labs between March and July of 2020.

Professor Christopher Molloy: Yes.

Ms Maragh: And is it that it was up to the end of July –

Professor Christopher Molloy: Yes.

Ms Maragh: – when Dame Dominiczak took over. And from August 2020, you told us that you moved on CEO role maintaining overall responsibility and accountability for Alderley Park Lighthouse lab.

Professor Christopher Molloy: Correct.

Ms Maragh: Now, if you could assist us, please, with the management and staffing levels, if you can, of the Lighthouse Lab Network, in the period early August, appreciating that you left at the end of July. We have an observation from Sir Patrick Vallance’s diary which references the management of the Lighthouse labs in this term: people changing all the time, for example no one knows who actually is in charge of Lighthouse labs. And that entry is made in Sir Patrick’s diary on 6 August 2020.

Professor Christopher Molloy: Mm-hm.

Ms Maragh: And just for the record, it’s INQ000280061. I’m not going to bring it up.

So bearing that comment, diary entry in mind, and that timeline, having regard to your involvement up to the end of July, and appreciating that your role was a coordinating one up to the end of July –

Professor Christopher Molloy: Mm-hm.

Ms Maragh: – can you assist us with this: was there a high rate of staff turnover in the Lighthouse Lab Network up to early August of 2020?

Ms Cartwright: My Lady, I apologise for interrupting my learned friend, I don’t actually think the Rule 10 permission was granted by reference to that document, so I raise by way of completeness because of the sensitivities that apply to Sir Patrick Vallance’s diaries, but plainly it’s a matter for you my Lady, but I raise because it’s not been given a Rule 10 permission for a question to be asked on that –

Lady Hallett: No, I’m afraid none of Ms Maragh’s introduction had permission. So the question for which there’s permission, and therefore we don’t need to refer to that document again, the question was: was there a high rate of staff turnover?

Professor Christopher Molloy: When the first lockdown was ended, there was – obviously, we had volunteers running the – sort of manning or staffing the Lighthouse. Now, they went back to the jobs that they were being then paid for, and it was the a requirement on the Lighthouse labs which we foresaw from June to go from a full volunteer workforce on to something that had a bit more of a longer-term standing and we needed to hire on each site around about 100 people per week – that means identification, that means sifting, that means interviewing, that means competencies, that means onboarding, that means supervision and so on, all the way through until the, you know, September, October, November time. That was a – so yes, there was, as lockdown finished we needed to completely change our workforce.

At the management level there was relatively little change. I moved on and Anna, who was the sponsor for our – for the Glasgow site, moved into my role and the Pillar 2 management team stayed the same.

But yes, there was, inevitably, as lockdown ended and volunteering ended, we needed a completely different set of staff. So it was a gargantuan activity, a mammoth activity, through that summer as we bulked up each site and made other changes to the efficiency of the site to prepare ourselves for September when there was another significant pulse of activity.

Ms Maragh: Thank you, Professor Molloy.

My apologies in relation to the prefacing, my Lady, and I think that the answer given deals with what would have been the follow-up.

Lady Hallett: Thank you, Ms Maragh. I am afraid I was making a point that applies not just to you but to others: when I give permission for a question, it’s the question, not a lengthy introduction for which I have not given permission, so thank you.

Ms Maragh: I appreciate it. Thanks.

Lady Hallett: Professor Molloy, that concludes all the questions that we have for you.

You rightly recognised in your evidence here today the role played by the volunteers in the Lighthouse laboratories, and you go into more detail in your written statement that will be published, and I entirely endorse what you said. I don’t know if you’ve heard comments I’ve made before about the unsung heroes, the unsung Covid heroes, this country wouldn’t have got through but for the unsung heroes, and so you rightly mentioned those who played their part in laboratories and I’m sure you are one of them and I’m sure you did need the respite even if you perhaps underplayed the need for some respite occasionally, I doubt you got very much.

So thank you for everything you did and your colleagues did and thank you for your help with the Inquiry.

The Witness: Thank you all very much. Thanks, my Lady.

Ms Cartwright: My Lady, I think there’s a short break and then we’ll be starting –

Lady Hallett: I think we’re going to go straight in, thank you. Unless there’s any reason not to?

Ms Cartwright: No, there would be no reason.

Lady Hallett: Thank you.

Ms Cartwright: Could I ask that Mr Cook stand as he takes the oath please.

Mr Dominic Cook

MR DOMINIC COOK (sworn).

Lady Hallett: Sorry to keep you waiting, Mr Cook. I see you’ve been sitting in the hearing room watching anyway I hope you haven’t been waiting for too long.

The Witness: Not at all, my Lady.

Questions From Lead Counsel to the Inquiry for Module 7

Ms Cartwright: Could you please tell the Inquiry your full name.

Mr Dominic Cook: Dominic Charles Jonathan Cook.

Lead 7: Thank you.

Mr Cook, you provided a corporate witness statement on behalf of Deloitte. It’s dated 15 May 2025, please, and can we turn to page 105, where we see the statement of truth. And can I ask you to confirm that the content of that statement is true to the best of your knowledge and belief.

Mr Dominic Cook: Yes, it is.

Lead 7: And perhaps whilst the statement is there, it’s right, isn’t it, that you’ve also a number of significant appendices to the statement that give some great amount of detail about those involved in the various contracts, the nature of the different contracts, to perhaps provide the fullest possible detail, also in appendices, as to Deloittes’s involvement?

Mr Dominic Cook: Yes, we started preparation for this back in 2023.

Lead 7: Thank you.

Can we then, please, get your details and background, please. It’s right, isn’t it, that you are a partner in the Major Programmes Team at Deloitte?

Mr Dominic Cook: That’s correct.

Lead 7: That, prior to moving to Deloitte in November of 2017, you were a qualified lawyer practising at a law firm for 26 years?

Mr Dominic Cook: Correct, yes.

Lead 7: And you have held various management roles during that time, but it’s significantly during Covid you were the Deloitte risk partner across a number of Deloitte Covid-19 engagements, with particular focus on the National Testing Programme?

Mr Dominic Cook: That is correct. And it’s – I should add that my area of expertise on the law firm was on the resetting of broken major projects. So I have a major projects background. And I’ve also taught that up at Oxford, at Saïd Business School as an associate fellow there.

Lead 7: Thank you.

Now, you’ve already identified the audit and consultancy background I think that’s perhaps the main business of Deloitte, but are you able to assist and perhaps give the context as to why it was that Deloitte were approached and then indeed did take forward assisting with the National Testing Programme?

Mr Dominic Cook: Certainly. I’m not sure, if I may, I would characterise it as the main business of Deloitte. Deloitte has some 27,000 people. About ten and a bit thousand are engaged in the audit and consultancy. The other ten, so a significant part are on the consulting and advisory side. And it is on the consulting and advisory side that we were first contracted, because of the breadth of the services that we could bring to bear.

Lead 7: Thank you. And perhaps it’s right to detail that you’ve set out within your witness statement the multi-disciplinary advisory and consultancy services that are provided at Deloitte, but also the diverse expertise and workforce capacity that exists in the major programmes, healthcare, but also the role Deloitte Digital have that’s of relevance to setting up the programme?

Mr Dominic Cook: Yes.

Lead 7: Sorry.

Mr Dominic Cook: Sorry, yes, that’s correct, although day 1 we were not asked to support on the digital side of things. That came very rapidly afterwards, but day 1 we were not asked to support.

Lead 7: Thank you. Could you maybe keep your voice up a little. I know you’ve got a sore throat so it might seem artificial but if you could slightly raise your voice, it might help.

Mr Dominic Cook: Certainly I can be louder.

Lead 7: Thank you. Well, then, can you perhaps deal with and give an overview, in the knowledge that the full detail is within the witness statement, to start with as to the initial contact.

And perhaps we should have in front of you paragraph 41, that deals with the initial contact with Lord Bethell and the Department of Health and Social Care, please.

Mr Dominic Cook: Certainly. We were first contacted, actually, by the chairman of Barclays, Nigel Higgins, who asked us if we would be interested in helping the DHSC and supporting the DHSC on the national testing. We understand that a conversation had first taken place between Nigel Higgins and Lord Bethell, and that Lord Bethell had asked Nigel Higgins for his advice as to an organisation that may be best placed to assist the government. We had worked for – Deloitte had worked for Barclays in the past so I assume the link was made there.

Lead 7: Thank you.

And perhaps if we can move down to paragraph 43, just so we have the dates of the contact, please.

If we could just go down to page 43. Thank you.

Your statement helpfully tell us that two calls took place on the evening of 18 March, the first with Lord Bethell and the second with representatives from Number 10 Downing Street, including William Warr and Kristen McLeod. You say:

“On the Deloitte side, the calls were attended by Mike Standing, Sara Siegel, Rob Parker, and Nick Owen.”

And we can see the detail of what was asked, but perhaps from the best summary you can give, what was asked of Deloitte at that time and what did Deloitte go on to do, please, to assist the National Testing Programme?

Mr Dominic Cook: Certainly. On that initial call on the 18th, it was more a test by those calling us about the capability and capacity within Deloitte, which is why we had those individuals that you’ve just outlined, who between them represented the head of our life sciences business, the head of our healthcare business, the head of our major programmes business, and Nick Owen, who was at the time the chair of Deloitte.

Lead 7: Thank you. And perhaps my summary, but we can see that at paragraph 44 you detail essentially that the government was passing on the message that the NHS was under extreme pressure?

Mr Dominic Cook: That is correct, and that there was a requirement to have a completely separate testing system set up in the UK.

Lead 7: Thank you.

Now, I’m not going to go back to paragraph 30(c) because I want to follow on from here, but you tell us in paragraph 30(c) that it was passed on that:

“The Programme had to be built virtually from scratch, independent from the existing NHS infrastructure, which was not deemed suitable by the Government for national testing at scale due to being fragmented in nature and already under intense pressure in early 2020 due to the emergence of the pandemic.”

And so when the ask was coming for something to be created from scratch, was it any part of Deloitte’s role to question or understand why it was starting a system from scratch, or what else existed to create a system for testing?

Mr Dominic Cook: We understood that the capacity of the NHS at the time was in the region of 5,000 tests a day, and that the NHS was severely stretched at the time and therefore it needed that capacity for itself, thereby underscoring the need for a completely separate national testing system.

Lead 7: Can I perhaps with you explore something that’s detailed throughout your statement about the role of Deloitte. You I think – I don’t think you’ll need to go to the document, just for the moment, Mr Cook.

You describe in a number of places that Deloitte were the “how” rather than, my summary, the decision maker. Is that perhaps a fair summary of the Deloitte position?

Mr Dominic Cook: Yes. I would it perhaps phrase it slightly differently. We were the “how” not the “what” or the “why”. The “how” relates to the operationalising of the requests that were made of us. The “what” and the “why” really relates to the strategy and decisions that were made elsewhere. Perhaps a good example, which we may come on to, I do not know, is: how do we get the students home for Christmas? Our response to that was to work out the operationalising of that – the answer to that question, and many others.

Lead 7: Thank you.

Can we then look at the briefing document that was provided to give some context to the requests that were being made. It’s the INQ000055915. Thank you.

I think this is a briefing document we’ve not yet heard evidence about, I think Lord Bethell will tell us a little bit about it, but is it correct that this was the request and the context that was being made of Deloitte at that time as to what the government wished to achieve?

And perhaps if we just scroll down. Thank you.

Mr Dominic Cook: Yes.

Lead 7: So, essentially, for Deloitte to assist increasing the lab-based testing capacity from 5,000 to 25,000 per day?

Mr Dominic Cook: That was in relation to the NHS. I think one of the paragraphs a little further down really relates to the creation of the mass testing and the need for a much more scalable system.

Lead 7: If we scroll down we should see this, and we’ll be exploring this document with Lord Bethell.

Thank you.

And there we go:

“Urgent and specific antigen testing for protecting frontline staff …”

And then further down, at bullet point 3:

“Mass marketing testing for ordinary people using pregnancy-test-style pin-prick blood tests.”

And then if we could scroll down again, just to complete this document:

“Extend our national mass population surveillance.”

Thank you.

So, having received that briefing document, can we move back to your witness statement, please, and take up the chronology at your paragraph 47, please, Mr Cook.

If that could be displayed, please, on the screen.

That’s INQ000587306. Thank you very much.

Mr Dominic Cook: Yes, this would be 19 March, so the day following those phone calls, when a number of the Deloitte partners representing the range of disciplines I’ve just touched upon all attended at Victoria Street, the DHSC headquarters.

Lead 7: Thank you. And then if we can scroll down to the next paragraph, please, paragraph 48. You can see there that it was made clear by the Department of Health and Social Care that their overall mission was for testing and initial ideas at DHSC about how to approach scaling up testing, and we can see that it was to look at, expand on this meeting, and topics discussed, but also the overall mission and initial ideas for how to approach scaling up with a number of other private contractors being referenced, and also for the engagement of Deloitte.

So we can see the summary there but can you, sort of, detail how, following on from 19 March, what Deloitte had been asked to do and what Deloitte went on to do, please.

Mr Dominic Cook: Yes. The quote unquote “business problem” that we were given was how do you create a mass testing capability throughout the UK whilst protecting the NHS? We understood that the government had already contracted with some suppliers, Amazon, Boots, Thermo Fisher and the like, and we were asked to work with those partners in order to come up with a plan to develop a National Testing Programme. It’s at this stage I ought to emphasise that Deloitte’s involvement although this module is test, trace, and isolate, we were very, very headily weighted, deliberately so, on testing, and indeed only had one minor engagement on each of trace and isolate.

Lead 7: Thank you. I think with you making that point clear, perhaps if we can just clarify. In terms of the other individual private contractors that we see named here, did Deloitte have any role in the identification of those to whom the government had also decided they wanted to procure their services as part of the National Testing Programme?

Mr Dominic Cook: No, no, we didn’t. They were all contracted in or contacted at least before our involvement.

Lead 7: Thank you. And then you’ve just indicated that whilst you had a role for testing, I think you’re clarifying that Deloitte had a very limited role in respect of contact tracing?

Mr Dominic Cook: Yes, and that was a deliberate decision on the part of Deloitte to keep it like that.

Lead 7: Thank you. And can I then ask for your comment and clarification, the Inquiry heard some evidence in Module 5 from Lord Agnew who talked about the numbers of individuals who essentially were performing the task of contact tracing at call centres with numbers of 25,000 or like, and essentially about 50%(?) of that number of contact trace is really being utilised efficiency.

I think it was said that Deloitte were responsible for that contract and the contact tracing. Can you clarify, is that correct?

Mr Dominic Cook: It is incorrect. We had no hand in the setting up of that call centre, or indeed – this was the track and trace call centre – that was let by Sitel or Serco, nor did we have a hand in either of those contracts, so I can only assume Lord Agnew misremembered.

Lead 7: Thank you. And so you said a limited role, so can we just clarify, then, in terms of us being test, trace, and isolate in Module 7, we’re going to look at what you did to support the testing programme, but in terms of other things that Deloitte did, and I know there’s a detail and a schedule about the different contracts, but can you just summarise at a high level to assist with the context of the evidence we’re going to come on to, as to the other things that Deloitte assisted with, please?

Mr Dominic Cook: Yes. As regards the small element in trace, we were asked to develop an inquiries feedback and complaints platform so that citizens could ring 119 and do what it says on the tin: make enquiries, give feedback and make complaints about TTI-type activities. We created the platform and then we handed it over to the DHSC. We had no access to any of the calls, call data, or information relating to the then ongoing running of that platform.

Lead 7: Thank you.

Lady Hallett: Before we go on, can I just go back to timing, Mr Cook. It may be that being discreet as I’m sure you are, you probably won’t want to answer this question, but we’d ended community testing on 12 March, yet they don’t contact Deloittes, whoever is going to put this mass testing system into operation until the 19th –

Mr Dominic Cook: The 18th was the initial contact.

Lady Hallett: The principle surely, of major programmes, is if you’re going to need them urgently, get them under way as a matter of urgency.

Mr Dominic Cook: Slight nuance. Well, get the planning of it under way. Get the preparation of it under way. I would agree with that, yes.

Lady Hallett: Did anybody say at that first meeting as to what steps they’d taken to get mass testing underway? You knew about the contracts with Boots, Amazon and –

Mr Dominic Cook: Thermo Fisher.

Lady Hallett: – Thermo Fisher. Did they tell you how they were going to do mass testing? Everybody knew that we had to test.

Mr Dominic Cook: I think, my Lady, that was the exam question put to Deloitte? How? How are we going to do this? It was put to us what needed to be achieved. I do not think – well, I know there was not a plan at the time on how it could be achieved.

Lady Hallett: Did you detect any thinking, even if there wasn’t a concrete plan, had there been any thinking before they came to you?

Mr Dominic Cook: I must assume yes, my Lady, because the contract with Thermo Fisher related to type of testing, test kits and the like. So there must have been some, at least, embryonic thinking in that direction. But I have no firsthand knowledge of that.

Lady Hallett: Thank you.

Ms Cartwright: Thank you.

Mr Cook, I’m going to display the helpful table you’ve provided in your witness statement at page 13 of INQ000587306 to just give the overview of the different areas where Deloitte assisted.

Now, perhaps in doing so, can you just clarify for her Ladyship’s benefit, I think fundamentally you describe the streams of work as falling under either the Cube aspect or the Tesseract. Can you just, first of all, describe what Cube is and then give us a summary of Tesseract, please?

Mr Dominic Cook: Certainly. Cube was the internal Deloitte name given to our mainstream testing activity, by which I mean everything related to testing bar that of a digital nature. Tesseract picked up on everything of a digital nature which came along about a week or so later after we were first instructed on the broader Cube national testing related subject matter.

Lead 7: Thank you.

And we can see below that also the stream of work as to the Covid-19 PMO support with the client of NHSX, and providing a service team to support NHSX in the domain of projects and portfolio management.

Did that relate to the NHSX app?

Mr Dominic Cook: No, it was a broader PMO, project management office, support across a range of NHSX activity. It is probably worth saying, though, there may well be – or there are – eight entries in this table. I would say 90-plus percent of our activity related to the first two entries.

Lead 7: Thank you. Well, perhaps we’ll just scroll down to show it and I won’t ask anything else about the other topics. If you can just move down, please, just so they’re seen and over the page, please, just to give some context.

And again, the statement will be published and has the attached schedules also.

If we can go back up then, please, having identified the Tesseract, thank you, to 2, thank you, you’ve already headlined that the workstream to assist with digital solutions came on later than the testing, and so what were the digital solutions that Deloitte were asked to assist with, please?

Mr Dominic Cook: If I may just take a slight step back. When we were asked about the national testing it was very clear that we would not be able to get to a scalable solution in the pace that the country required unless there was a very considerable digital underpinning of the system. So effectively, how do you track the digital journey from the time a citizen picks up the phone to book a test, where they are going to get tested, how they are going to be identified, how that test then goes to the lab, how the lab then gets it into what we heard earlier in the evidence, this NPEx, which is the National Pathology Exchange that’s owned by the NHS and then that information not only back to the citizen, but into the broader NHS machinery for which to make informed decisions and, indeed, on that individual’s GP record.

Lead 7: Thank you.

The table can be removed from the screen. Thank you.

Now, you have helpfully provided a 168 – plan that, I think in some granular detail, gives assistance as to the streams of work that Deloitte were involved in, and we’re going to look at it together in a moment. But before doing that – that is dated June of 2020, but thank you for providing also, I think, the earlier iteration that fed into that broader piece of work. And can I ask very briefly for that to be displayed, for you to just give overview evidence in relation to the draft end-to-end process that has the date of 25 March 2020.

And it’s INQ000587598, please.

Now, as her Ladyship has already identified, the ask came in on 18 March, and meetings that followed on the 19th, and by 25 March, is it right that Deloitte had created a draft of an end-to-end process that was the start of the thought process around how to deliver or contribute to the testing programme?

Mr Dominic Cook: That is correct. So, from the 19th, a day after the phone call, we had a small team that landed in Victoria Street with the DHSC, and so by the 25th we had an initial – initial thinking – that’s what this document was – which evolved into the one which I think you’re about to take me through as to: how do you create a national testing capability?

Lead 7: Thank you. And with the assistance, please, can we just move through the slides. Because I’m not going to spend time – we’ll look at what then became the plan, the end-to-end plan, but it just gives some idea as to the thought process as to how you would assist the end-to-end process.

If we could just keep moving through, please, because it’s helpful to look at this as to how it evolved into the 168-day (sic) plan.

Is there anything, Mr Cook – thank you – you wish to say by way of a high-level overview about where you’d got to by 25 March, speaking to this document, please?

Mr Dominic Cook: Yes. I think we found it very helpful to break the activity needed into, you know, citizen flows, logistics flows and, indeed, data flows, which then led into analysis. So breaking it down into bite-sized chunks was very helpful. And it was during this period that Deloitte Digital, through a team that had just been made available by virtue of another client standing it down, developed a proof of concept to show to NHSX and DHSC how you would need to track a system – sorry, a citizen from the phone call to the test centre, give the QR code, and eventually the front end IT, so to speak, that would speak to the back end IT after the lab had done the test and uploaded the test results, by virtue of the barcode, to the NHS.

And then there was a – which we’ll go through, a marrying up of that barcode to the original QR code. So back end and front end then spoke to each other in the NHS NPEx system.

Lead 7: Thank you. We’ll look at the end-to-end approach that was the June one, but – perhaps, sorry, could that be displayed for a moment. I do apologise for the confusion, but could we just display again the draft from the March – because I think it’s helpful – on the screen that we just displayed. Thank you.

We’ll see this picked up in the bigger document.

You can see that there is essentially four streams. We’ve got the green Thermo Fisher kit stream, the blue NHS stream, then the digital platform stream, and the Randox stream.

Mr Dominic Cook: Correct.

Lead 7: So this is quite helpful. And then, for reasons that will be apparent to everyone else a moment when we go to the 158 plan (sic), can you just help her Ladyship with why there’s a Thermo Fisher kit stream and then the Randox stream at the bottom, please.

Mr Dominic Cook: Yes. As I mentioned, Thermo Fisher had already been contracted by the DHSC to provide its own test capacity and test kits, and they were different to the Randox test kits. Randox operated what was known as a closed loop system, in other words their own kits could only be tested in their own labs, which is why there were two completely separate streams.

Lead 7: Thank you.

And just using this with how we’ll look on the 168 plan, why do we have the NHS and the digital platform streams then running through the centre? What are you trying to show with the plan in terms of how it all works together, please?

Mr Dominic Cook: Certainly. As regards the NHS, at the time these plans were developed, this was testing of key workers, and very often then the key workers had to be referred into the testing portal. And so the NHS at this stage were identifying those that should be tested, so that was their part, really, at the front end.

They played a much bigger part at the back end in relation to their national pathology system and informing citizens of the results, because, as was given in evidence earlier, individual Lighthouse labs did not process personal or clinical data, so we had to keep it separate.

Lead 7: Thank you. Can we then look at the more evolved version which you’re going to speak to, please.

It’s INQ000561552.

And perhaps – my Ladyship, this, what we’re looking at now, exists as a very lengthy document that as seen in its original form and its paper form is much easier to follow, but we are having to use the digital version to ensure that everyone is able to see this in the way that we have to present exhibits, but I know that the preference for Deloitte would have been a physical copy of the document. And I think, out of fairness, it’s important I make that point.

Lady Hallett: It’s so big, I’m afraid, that, trying to look at it with lunchtime, we didn’t have enough people with long enough arms, I’m afraid, but it is a very impressive document in hard copy.

The Witness: Well, it is horrendous, my Lady. It’s 9 foot by 3 foot.

Lady Hallett: I said impressive, you said horrendous, fine.

Mr Dominic Cook: I’m talking about the scale. It’s 9 foot by 3 foot, in order to make it legible, actually. So it’s very difficult, but –

Ms Cartwright: Thank you. And certainly these long arms were assisting in the process.

Let’s then, please – and I’m very, very grateful to the assistance of Lawrence – can we first of all, please, expand the first three boxes, thank you.

And –

Mr Dominic Cook: Ms Cartwright, may I just have a brief overview, just to explain what it is that people are looking at? You don’t necessarily need to read the boxes at this stage.

Lead 7: Mr Cook, perhaps – can you assist us all, looking at – it’s a complete piece of work – the description that you’d wish to give to help us when we look, and, certainly when others can, expand the boxes to give an overview about what we’re looking at and what we see, please.

Mr Dominic Cook: Yes, certainly. This, in major programme speak is very much the architecture of the programme. What is it that needs to come together in order for the end result to be achieved? The end result being a National Testing Programme.

Very early on we identified the expertise that would be needed in order to bring together so many different component parts to this testing programme. We had the four horizontals that we’ve just been through, but there are also on this chart, which we’ll see in more detail in the next slides, there are ten verticals as well.

But we identified very early on the expertise that we would need to bring to bear: healthcare and pharmaceutical expertise, including regulation – a good example there is looking at the instructions for the test kits; supply chains; digital strategy and transformation; cyber security; data analysis, logistics; sourcing and procurement; operational design; project management; real estate; and workforce planning.

Some 11 – and there were subsequently more – disciplines – 11 different disciplines.

So we drew those teams from across Deloitte’s public and private sector practices in order to come together to formulate this end-to-end plan. And we also formulated right at the start the principles we needed to work by.

And if I may, we very much adopted a build, run and improve approach to life. We stressed the importance of cyber security and data protection, and we knew that everything that was created needed to be scalable, resilient, and modular.

So the last point I would – or perhaps the penultimate point I would make on this slide is the module nature of it. We knew things were going to happen and changes would need to be made, this plan would need to evolve.

A good example of that, my Lady, is at this stage there were regional test sites, the drive-through things, but the local test sites, the walk-through sites, had yet to be developed.

So we were able to neatly introduce the local test sites into this plan.

It had a number of benefits –

Lead 7: Mr Cook, we’ll come back to make sure we cover everything, but can I, just in looking at this as a sort of bird’s eye view, the Randox stream at the bottom, would it be fair to say that that almost mirrors by way of the process the Kingfisher stream at the top, but when we look at this, in reality, Deloitte were not involved in the Randox stream; is that correct?

Mr Dominic Cook: That is correct.

Lead 7: So whilst it’s there because the system has to be interoperable, Deloitte were not involved in the Randox stream.

Mr Dominic Cook: Save and to the extent at the end, where the app that was spoken about earlier, the link between, or I think it was referred to as the bridge, but the link between the laboratory information management systems and the NHS NPEx system, needed to be created. So, at the end, we created the bridge back into the NHS.

Lead 7: Thank you.

Now, you plainly indicated that it went through a process of refinement and change. We know this document has got a date of 17 June 2020. And so is it fair to say that it was around 17 June, this was the first time, in reality, where you’d have this 168 plan end-to-end process, or if there was an earlier date, can you help us be clear about when this 168 plan was effective for the first time?

Mr Dominic Cook: Well, I would say from 25 March onwards. The first iteration that you showed, clearly thinking evolved but that was the initial plan, and we needed to – in order to mobilise the required supply chain, we needed to act on that as a plan immediately.

Lead 7: So there’s no ambiguity, the first plan we looked at, the draft, that was effective as of 25 March. The process of refinement was taking place, but this was the process as at 17 June with the 168 end-to-end plan?

Mr Dominic Cook: That was the process for PCR testing, yes.

Lead 7: Thank you. Now, in the last few minutes before we take our break, can you, using this bird’s eye view, just give the clarity, then, as to how the NHS stream and the digital stream then works together with the stream that you did have a role in, namely the Thermo Fisher kits?

So, in reality, the top green stream is what’s happening in the Lighthouse labs. Can you just assist us in understanding at a high level how the Kingfisher stream of work of the end-to-end processing of the tests in the Lighthouse labs, the places where it connects with the NHS stream, and the digital platform, and we’ll look at the individual slides, but I’d just like a top-level description about why we see it as streams, please.

Mr Dominic Cook: Okay, certainly. The green boxes relate to things the citizens or subjects needed to do. And so the first set of green boxes in the blue horizontal, which is the NHS one, related to what I touched upon: key workers being referred into for testing. Referred into testing in the next lot of green boxes in the yellow background is the digital horizontal, and that’s where citizens would ring up, they would give their details, they would be able to book a test, and all of that digital infrastructure was linked in to all of the test sites. So we were aware what test sites had what capacity and when, and that enabled the citizen to book the test site at a particular site where there was capacity, and then be issued with a QR code.

The NHS then gets reinvolved and re-engaged towards the end of the horizontal, in the light-blue boxes, which relate to data, and that’s where the data from the tests then gets reintroduced to the NHS.

Lead 7: Pause there. Is that right at the end of the NHS stream and the light blue in the blue stream?

Mr Dominic Cook: There’s a – sorry it’s difficult. There’s a little bit of light blue in the yellow boxes but there is the turquoise in the NHS stream and that relates to the analysis, because the analysis was all for the local decision making and for the putting of the test result on to the citizen’s GP record.

Lead 7: Thank you. And with that – thank you, that could just be highlighted then, please. Thank you.

Just so we understand the practical process, particularly in the context with the helpful evidence we’ve had from Professor Molloy, his evidence is they scan the barcode and get the result whether it’s positive, negative or void. But then a thing has to happen to get the result through the NPEx system to the individual that’s then going to notify the patient. So can you just help us as to the process, using this plan, as to the role Deloitte had for getting the results back to the patient, and then what that meant for contact tracing also, and what would happen next?

Mr Dominic Cook: Yes, when a citizen went to a test site, a citizen went to a test site, they showed their QR code – people in the room may recall this – to the operatives at the test site. That was then married up to the barcode on the test that the individual was asked to take. The test then went off to the lab. The lab registered the barcode on the test. That barcode and the result from the test then got uploaded to that lab’s, called LIMS, lab information management system, which, in turn, through the Deloitte app, got uploaded into NHS NPEx system.

The NPEx system then moved that result to something called NHSBSA which is the Business Services Authority, basically the arm in the NHS that pumped out the emails to the citizens.

Ms Cartwright: Thank you.

My Lady, is that a convenient place?

Lady Hallett: Certainly.

Ms Cartwright: We will be doing more analysis of this plan but perhaps now is the time to take a break. Thank you.

Lady Hallett: Thank you very much, I shall return at 3.15.

Ms Cartwright: Thank you.

(2.59 pm)

(A short break)

(3.15 pm)

Lady Hallett: Ms Cartwright.

Ms Cartwright: Thank you, my Lady.

Please can we return to the end-to-end process, please, INQ000561552. Thank you.

Mr Cook, unless there’s anything by way of overview evidence you wish to give, I intend now to work through the top stream and go through the slides to hopefully help illuminate on the process. Is there any other overview evidence that we need to understand before looking at the individual slides?

Mr Dominic Cook: Oh, one quick thing, if I may. This process, this plan, was very important because it provided a structure to integrate the material flows, the citizen flows, and the data flows of information. All of these aspects are incredibly important to building a supply chain.

I talked about the molecular aspect of it –

Lead 7: Mr Cook, sorry to interrupt, I think I’m going to interrupt you just to be absolutely clear, so there’s no cross-purposes, what you mean, first of all, by a material flow?

Mr Dominic Cook: Yes, all of the kits.

Lead 7: Thank you.

Mr Dominic Cook: The testing kits and the infrastructure that goes with testing, be it the labs, be it the regional test sites, local test sites and the like.

Lead 7: Thank you. And just so there’s no ambiguity, when you mean a “citizen flow”?

Mr Dominic Cook: What the citizen has to do in order to go from booking a test to swab to it being tested and receiving the result.

Lead 7: Thank you. Sorry, I then interrupted you. You were, I think, going to make another point before I stopped you.

Mr Dominic Cook: Yes, and it was also good because it was the map around which efforts would coalesce, and it was also, as it turned out, a very powerful communications tool within Victoria, the headquarters of the DHSC, to show people, including ministers, what it is we were seeking to collectively achieve to build the national programme.

Lead 7: Thank you. And so you’re referencing the description assistance you’re giving us and the Inquiry with this plan. When was this plan presented at Victoria, can you give us some idea? And also to who was it presented?

Mr Dominic Cook: Because it was a – it’s – it was a living artifact, and so almost anyone who came in to visit Victoria, if they had – were, you know, a stakeholder with an interest in understanding shorthand to the mechanics of the national testing, we would show them this plan and then they would understand the four horizontals and the ten verticals and how they all came together.

Lead 7: Thank you. And so we’re all absolutely clear, it’s right, isn’t it, that Deloittes had essentially rooms or a space within Victoria itself when you were running the National Testing Programme?

Mr Dominic Cook: Um –

Lead 7: Or part of it. I should say, I don’t want to –

Mr Dominic Cook: We were very much a part of it, and we were integrated as one team, with civil servants, the NHS, the military – there was a military cell embedded there – broader civil servants and other private sector contractors. We were but one part.

Lead 7: Thank you. So the Inquiry is going to hear evidence from Lord Bethell and Mr Hancock, and so we can be absolutely clear in our understanding that they would have seen and understood the 168 plan end to end?

Mr Dominic Cook: I mean, I can’t comment firsthand but I’d be very surprised if it hadn’t have been explained to them or it had been explained to them there was an end-to-end plan to develop the thing that became the National Testing Programme.

Lead 7: Thank you.

So let’s now, please, expand the first three top horizontal boxes, please. Now, the text can be read at this font size, I hope. So can you just explain this first aspect of the plan, please.

Mr Dominic Cook: Certainly. This is the Kingfisher kit top aspect, and the blue boxes all relate to the logistics.

May I ask for it to be made slightly bigger, please.

Lead 7: Can it be expanded, please? Thank you.

Mr Dominic Cook: Thank you.

So, going left to right – I mean, it broadly says what it does on the tin, in terms of the manufacture of the test kits. There is a misconception that the test kit came from the manufacturer all boxed ready to go. This was not indeed the case. Very often test kits comprise anywhere between seven and nine component parts, and that varied from channel to channel.

So sometimes test kits came with multiple parts, you know, together. Other times, all the parts were single.

We were – hence the reference to assembly of test kits, consumables, and then once they had been assembled, they were transported to the particular warehouse, which is the next box along, if we could then move to the next –

Lead 7: Just pausing there so we can understand practically, is it that Deloitte are ensuring that all the parts that are needed are in place and working together, because I want to just understand it, is Deloitte actually, for example, procuring the test kits, and just so we are absolutely clear, exactly what of these slides we can say, rather than the logistics and the flow, that Deloitte were doing?

Mr Dominic Cook: Certainly. It was absolutely the logistics element, but in addition, we had teams who were working with the Lighthouse labs where you heard earlier in evidence there were issues with some of the kits. So yes, we did have a hand in making sure that the kits came together, but we didn’t at any stage have a hand in the regulatory approval of those kits. That wasn’t our role.

Lead 7: Thank you.

Can we then expand the next slide along, please, thank you.

Mr Cook, do you want to speak to this part of the process, please.

Mr Dominic Cook: Yes, once, obviously, the manufacture had happened and the kits had been put together, they then went to particular either warehouses, and packed up for bulk delivery. They could have been delivered to institutions. They may have been organisations, care homes, or indeed prisons, and then the bottom three boxes relates to kits being sent from the warehouse to the individual test sites, which are these sites, this time were predominantly the regional test sites, the drive-throughs.

Lead 7: Thank you. So we can see the process but I think the slides make clear that in terms of delivery partners, warehouse, and the like, that these are separate contracts that individuals are doing for that, but you’re making sure that it all fits together and works and flows?

Mr Dominic Cook: Correct, and we had a hand in assisting the DHSC put those contracts in place. We did not put them in place.

Lead 7: Thank you. I think that is the first three horizontals. Can we then move to boxes 4 and 5 on the Kingfisher flow, please. Thank you.

So we’ve got step 3, Mr Cook. Do you want to speak to step 3?

Mr Dominic Cook: Yes. Step 3 relates to the kits being delivered to either individual’s homes or individual organisations. Again, that could have been a care home, a prison, or the like. And then moving into the green flows, and the green, as I mentioned earlier, was what the citizens were doing. They would actually be – administer the test either themselves or by institution of staff, depending on where the kits had actually ended up, all against agreed protocols.

Lead 7: Thank you. And can I ask you perhaps, then, to assist with practical examples, please, Mr Cook.

The Inquiry has, through the Every Story Matters record, examples of individuals saying how far they had to travel to get a test and being offered tests a long way away from where they lived – again, this is a summary – and it is part of some of the evidence that has been heard or seen in the statements from the bereaved. Is what Deloitte is doing is essentially looking where you had tests or slots at regional test centres and then allocating those available slots to the members of the public? Is that what you were doing?

Mr Dominic Cook: If I may take a step back.

Lead 7: Please do.

Mr Dominic Cook: We were identifying the location of the regional test sites and subsequently the local test sites, and in terms of identifying the locations, we had our real estate team conduct some geospatial modelling as to percentage of the population catchment you would get between a 15-minute, 30-minute, 45-minute and 60-minute drive. So that in one part drove the location of the regional test sites. There were other characteristics that had to be met as well.

Lead 7: Thank you. And I’m sorry, I interrupted you before you were going to move on to the step 4 and the green boxes on the end-to-end testing process where we’ve got the test having been administered, and perhaps do you want to speak to that slide of programme of works, please?

Mr Dominic Cook: Yes. Certainly. There was a system whereby the subject either conducts them, the test at home, for the top layer of boxes, and then makes sure that it gets sent back per the instructions in each of the test kits to the test site, or indeed a member of staff at the institution may conduct the test on them. A good example of that would be care homes for the elderly or those with other issues that may give rise to difficulty in testing.

Lead 7: Thank you. Just as we’re seeing this process as to how it’s meant flow in practice, and we’ve referenced test sites, can I ask you, were Deloitte part of the workstreams that ensured that test sites were fully accessible? Because, again, in the Every Story Matters record and in the impact video we heard, we’ve had examples of individuals who were given slots at particular test sites and we’ve had certain disabilities or access requirements. And then, when they got there, they were not able to access testing because the testing site did not accommodate their particular needs, and then, having flagged those as part of the booking of the test.

And so are we able to understand, was that something that Deloitte practically were managing through this end-to-end process?

Mr Dominic Cook: Very much so. Accessibility was one of the core principles in which we looked to build into the design of the test sites, both regional test sites, the drive-throughs, and the local test sites for the individuals. And I believe we have submitted in evidence the handbooks and the mobilisation handbooks we produced for those sites, which underpin the importance of accessibility.

Lead 7: Thank you. So can you perhaps then help us understand, in those examples we’ve already heard evidence from at the beginning of the Inquiry, what will have fallen down in the process if an individual, when booking a test, is asked for – to go to a site where it was accessible, understood that when they arrived there they’d be able to access a test, but, because of their disability, the site actually wasn’t able to even accommodate the needs and adjustments, having been told they were? So where had it fallen down then in the booking process?

Mr Dominic Cook: One of the particular accounts was of a chap in a wheelchair with cerebral palsy –

Lead 7: Is that in the impact video? I think that was Dean, yes.

Mr Dominic Cook: Yes. And where the place he was taken wasn’t wheelchair accessible and he was not assisted in the taking of the test. I think the system fell down there in the making sure there was step-free access and wheelchair accessibility in the particular location, and all locations were supposed to have individuals trained to assist those who were unable to take the test themselves. With a particular focus on the local test sites, less so the drive-ins.

Lead 7: Thank you. Is there anything else you want to say about this slide before we move to the next boxes, the last three boxes?

Mr Dominic Cook: No, thank you.

Lead 7: Thank you.

Can we move along then, please, to the last three boxes on the Kingfisher row, please. Thank you.

Now Mr Cook, can you please assist us with any particular expansion you wish to give us about step 4b.

Mr Dominic Cook: Yes. That’s where the regional test site, which were the drive-through test sites, you went along and you showed your QR code, which you’d got from the front end of the digital streams, as I explained earlier, and then you conducted the test yourself. It could be conducted on you if you needed help. And you conducted the test if you had children, which was another benefit of the drive-through sites.

Lead 7: Thank you.

Then if we look at step 5, please. Thank you.

Mr Dominic Cook: Yes, that is where the kits were then transported and boxed appropriately from the place where the tests had taken place, be it a test site or an institution, and then that was sent off to the labs, which is the next step.

Lead 7: Thank you. And then if we can go to that next step, please, step 6.

Mr Dominic Cook: This is the central laboratories, basically the Lighthouse labs that we’ve heard a fair amount on today.

Lead 7: Thank you. And then if we could please then display the digital platform boxes 5 and 7, please. I think the third horizontal.

Mr Dominic Cook: Thank you. This shows the tracking of again thought the citizen needed to do, or indeed key worker, at this stage, in terms of booking a test and having their identity verified at the test centre.

Lead 7: Thank you. And I think you identified before we broke, what was the name of the digital system that Deloitte created for managing this process?

Mr Dominic Cook: Well, there were a number of systems, but we were calling it the testing portal.

Lead 7: Testing portal. Thank you.

If we could move along, please, to the third horizontal in the digital platform boxes 5 and 7.

Mr Dominic Cook: Again, this is where you get the registering of your particular test through the scanning of a QR code when you arrived at the test site.

Lead 7: Thank you. And then I think finally, please, could I ask for the vertical of the last two boxes of horizontals 2, 3 and 4 to be displayed?

Mr Dominic Cook: This is very important because this is where there was a – excuse me – a hand off to the NHS, so – of the result from the labs. All of the Lighthouse labs, as we heard earlier, had the same information management system. That then went through the Deloitte app, to the existing NHS NPEx, National Pathology Exchange, that then downloaded to the BSA, which is an NHS organisation, Business Services Authority, which then communicated not only to the citizen but – and that was the green boxes to the right, but the turquoise above it – related to some of the analytics that was then undertaken for that data in terms of the type of results, the geographical locations, and also that was where the GPs were informed of the citizen’s result.

Lead 7: Thank you. And just leaving this displayed, and in particular having followed the data flow, was there any mechanism or system that enabled the results and the data that maybe identified hotspots, and the like, for the directors of public health, who operated in local authorities, to access the data being harvested as to the results and what they may show –

Mr Dominic Cook: Yes.

Lead 7: – particularly locally?

Mr Dominic Cook: Deloitte developed another digital platform, which is the Operational Information Management Platform (sic), OMIP, which is summarised in the back of my statement. That operational management platform was, I would say, the single source of truth, and that had all of the data relating to the testing activity, including results, locations, regions, and the like. Access to that platform was granted by the DHSC, and typically the – obviously the DHSC, government departments, the devolved administrations, and some local authorities. There were over a thousand organisations in the end that could access OMIP and a series of reports on that platform.

Lead 7: Thank you. And so can you help us as to who would have to give permission to the local authorities to access the data on the OMIP system?

Mr Dominic Cook: Someone in the DHSC. I’m unsighted as to who, I’m sorry.

Lead 7: But they didn’t automatically get access to OMIP?

Mr Dominic Cook: No. No, that wouldn’t have been wise.

Lead 7: Then can I ask you, because you’ve been identified OMIP being the single source of truth, is it correct that the OMIP system has been essentially – it no longer exists?

Mr Dominic Cook: It was decommissioned in, I believe, August ‘22.

Lead 7: Thank you. And is, essentially, the data, the information which sat on the OMIP system, was that retained before it was decommissioned?

Mr Dominic Cook: I would be very surprised if it was not retained by NHSX. Deloitte did not retain a copy.

Lead 7: And can you assist as to why Deloitte did not retain a copy?

Mr Dominic Cook: It wasn’t our data.

Lead 7: Thank you.

Now, is there anything else on the end-to-end process, I appreciate that a lot of care has gone into the production of the document, but is there any aspect of that end-to-end process that you wish to illuminate before we move on to another topic?

Mr Dominic Cook: No, perhaps just to underscore the importance of very early on, going to what you said, my Lady, of having a plan around which all efforts could coalesce.

Lady Hallett: Some poor soul or souls in Deloitte had to produce this very complicated document. How was it used? So a plan I understand, and I’m quite used to a narrative rather than graphs. I’m not – or pictorial representation. How was it used then for the plan to be developed? Was it informative? Was it trying to get people to focus on – what was the purpose of it?

Mr Dominic Cook: I think the primary benefit, actually, related to the testing project Cube at this stage, and indeed Tesseract, was broken into a series of workstreams. And so at its height there were 42 workstreams on Cube which married to areas within this plan. And we had – we arranged a stand-up meeting for all of those concerned to understand how this end-to-end plan was coming together every day at 9 am, every day at 9 am, where you had representatives from the NHS, the DHSC, there were Deloitte folk, other private sector suppliers, representatives from the devolved nations, to understand what the activity that had gone on the days before, and the planned activity for that day, and how it married up to this plan.

Ms Cartwright: Thank you.

Can I please remove the 168 end-to-end plan from the screen, please.

And having already asked you about the ability for access from the relevant directors of public health to the data, could you assist with a further document you’ve helpfully provided – and thank you – which is the spreadsheet which was the Deloitte London Engagement Local Testing Tracker, please.

It’s INQ005867599. That may be a rogue reference. I’m sorry, INQ000587599. Maybe if we could zoom in, please. Or maybe not.

Perhaps we’ll look at the detail in a moment but, Mr Cook, can you just give us some context as to what we’re looking at and what the piece of work that was done, particularly in London around engagement and a local testing tracker, please.

Mr Dominic Cook: Yes. This was in relation to both the number and location of local test sites. It was important that we engaged with local authorities and local charities, to understand the requirements of particular populations.

And so this particular tracker tracks by borough all of the population issues and challenges that local authorities had, and they made recommendations, the local authorities that is, as to both number and location of local test site.

Now, there are some quotes as to the rationale, but it really related to where elements of the population in that borough had particular vulnerabilities and therefore it was sensible to site a local test centre as close to those population sites as possible.

Lead 7: Thank you. We can see the objectives there and goals being helping testing to be more demand led, by communicating the testing options to directors of public health, and on so on.

But can we scroll down, please, because I think – pausing there, thank you – we can see that the “Total [directors of public health] engaged”, it says – so we’ve got 153, and we’ve got 100 per cent as the comment. But can you help me understand this document, because if we scroll down, it actually looks like it was only London that was engaged. We’ve no other data for other directors of public health beyond the London regions. So –

Mr Dominic Cook: This was our London engagement tracker. We had individuals by region appointed to do a similar exercise as this, but I suspect not quite to the same level of granularity, borough by borough, for every major city. But not all cities are clearly demarcated there.

Lead 7: No, and that’s what I want your help with, because certainly this spreadsheet suggests we’ve got total authorities engaged, we’ve got 21% out of – so 33 out of 155 authorities.

And what I want to understand is whether in fact it was only London boroughs that were consulted, in the directors of public health, or whether that would be an unfair assumption?

Mr Dominic Cook: That would certainly be an unfair assumption. And the reason for that is that we had – Deloitte team members liaising with local authorities throughout the nation to understand where these test sites should be located, and I suppose the proof point of that would be a lot of the local test sites were actually located in local authorities buildings, be they leisure centres and libraries and the like.

Lead 7: Thank you. And are you able to assist, then as to why only the London data was input into this spreadsheet rather than a piece of work that gives essentially the engagement across directors of public health and all of the authorities?

Mr Dominic Cook: Certainly. This was an addendum to the evidence request that I received from the Inquiry, relatively late on. So we thought it was helpful to give an example, and it is only an example, of the level of engagement with local authorities. The team that we deployed were all ex-local authority or social care workers.

Lead 7: And you say “the team that we deployed”, so can we –

Mr Dominic Cook: So in London we had a local engagement team, as it was called, to support the work of the siting of the local test centres, and those people between them had often ten, 20 years’ experience working with local authorities, so they could get the value from the local authorities as to the needs of their population.

Lead 7: Thank you. And then expanding that beyond London, was there local engagement teams then with each of the local authorities as to where to site their regional testing centres?

Mr Dominic Cook: There were teams by region, not necessarily by city.

Lead 7: Can I then ask you for some evidence that the Inquiry has already heard, linked to the setting up of a testing centre in Cardiff, where you’ll be aware of the evidence, I think, that was given, where it was said that the local public health had no knowledge that the testing centre was being set up in Cardiff, just to, first of all, get your perspective or evidence on behalf of Deloitte about that – or then, if that information is then accurate from Deloitte’s position, as to how it could be that a testing centre was set up in a major city without the local authority knowing that it was being sited there?

Mr Dominic Cook: Yes. To answer that question I would briefly go into the process around how one of these regional test centres was – test sites was actually opened. Our real estate team, I talked about the geospatial modelling and the drive times and the like. This was inner city, so we therefore – rather than drive times, we were looking at population density around particular sites. There were also other prerequisites such as, you know, area, space and the like, and traffic issues that also had to be taken into account.

That resulted in a one-page recommendation document being produced for every regional test site and every local test site. That one-page document then had to be approved by the DHSC. Communications with devolved nations was the purview of the DHSC, and not Deloitte. The local authority in Cardiff was aware of this, because they actually owned the site. This is the local authority, not the health authorities. They owned the site because they signed off on a variation of the sublease.

Lead 7: Thank you.

Can I then, please, ask you about the regional testing sites. Perhaps if we could have displayed, please, from your statement paragraph 86, please and sorry the INQ, I do apologise, is INQ000587306. Thank you.

You also touch upon the regional testing sites a little later at paragraph 98, but essentially you explain Deloitte’s role in setting up these regional testing sites and the local testing sites. And just pausing there, essentially the regional testing sites would probably need a car; is that a fair summary?

Mr Dominic Cook: Absolutely, yes.

Lead 7: Whereas the local testing sites were those really to cater for the individuals that didn’t have transport and would be able to access them on foot?

Mr Dominic Cook: Correct, and as part of – if one looked back, I am not suggesting we do, but if we look back at the tracker, part of the local engagement was to understand also the percentage of population that owned a vehicle.

Lead 7: Thank you. Now, essentially, this paragraph and the later one talks about how – that Deloitte had identified the need to increase test site availability and population coverage, and it’s also said that Deloitte conducted data modelling to analyse the number of sites that would be required. Can you assist us, please, with understanding how were locations for testing sites selected, and was consideration given to identifying and targeting areas of likely poor access or otherwise low uptake, and was any data analysis undertaken to facilitate this?

Apologies that there’s four questions rolled up but I hope, essentially, it can be considered under the theme of accessibility and consideration for sites.

Mr Dominic Cook: Yes. Hopefully, I will get them, perhaps not in the right order. There were three primary types of testing: the regional test sites I’ve just touched upon. Really there was a set of criteria that had to be satisfied in order for a location for a regional test site to be recommended including the drive times and the percentages of population.

Again, that resulted in a one-pager being sent to the DHSC for either agreement or a request to find a different site.

On local test sites, both the number and location were always recommended by the local authorities. That then fed into the equivalent one-pager and, obviously, many of these were going to the DHSC, certainly for local test sites regularly.

And then there were the things called the MTUs, the mobile test units, of which eventually there were over 500, and they were sent to areas of sparser population.

Lead 7: Thank you. And then can we just understand, you’ve obviously described that they would go to the DHSC, and so when they’re going to the DHSC, who is it, essentially, that is part of the DHSC team that’s getting this input? Is there a set team? Are there set individuals?

Mr Dominic Cook: There would have been a set team but I’m unsighted as to the identity or the name of that team.

Lead 7: No, thank you.

And then can I ask you just on the same topic, did data modelling take account of the demographics of populations to analyse levels of uptake amongst different communities and target interventions accordingly?

Mr Dominic Cook: Yes, in terms of a number of different demographics, certainly you will see some examples. There’s the rationale on the tracker, in relation to BAME community. Those who were digitally excluded. Those who were disabled. A number of demographics were considered in the siting certainly of the local test sites, the ones that you didn’t need a vehicle to get to.

Lead 7: Thank you.

Could paragraph 119 of your statement, it’s page 35 of INQ000587306, be displayed, please.

You’ve given evidence in this paragraph and the following one around mobile testing units and you tell us that Deloitte’s role is setting up mobile testing units to test key workers. Can you assist any further than that which is detailed in your statement as to any specific efforts made to improve the accessibility of testing for and encourage uptake amongst ethnic minority healthcare workers, please?

Mr Dominic Cook: There was a separate work stream called satellites and vulnerable communities, and there was a concerted effort to speak with NHS organisations so that they could identify key workers. I don’t know whether they did it by particular demographic, but the key workers that needed to be tested.

Lead 7: Thank you.

Now, can I ask you some specific questions around the Lighthouse labs. And can I display, please, within your statement the very helpful table at page 37 in paragraph 126, where you’ve identified essentially the location of the Lighthouse lab, the owner, operator and the launch date.

And if we scroll down, please – thank you – over the page, we see the Lighthouse laboratories that came online later.

Now, the Inquiry has already heard some evidence about certainly the early setting up of the Milton Keynes Lighthouse laboratory, about evidence that was given last week from Professor McNally essentially that indicated that there was a large volume of Deloitte consultants that were present, and so can I ask for your evidence about the numbers of contractors that would be physically present at the Lighthouse laboratories as they were being set up?

And I appreciate from the evidence we’ve heard today from Professor Molloy it may have depended on requirements, because he’s talked about the lean-in from AstraZeneca at the site in Cheshire.

Mr Dominic Cook: Certainly. May I just distinguish between Deloitte resources and third-party contractors? They are different, but if you’re asking the question how many Deloitte resources, which I think you are, were at Milton Keynes, I read that evidence and I believe the figure that – the word used was “enormous”.

Lead 7: Yes.

Mr Dominic Cook: I didn’t recognise that, and will not surprise you that we have trackers as to who’s deployed where and when, and our team at Milton Keynes varied as between four and five people, with the occasional one-off day visitor by Deloitte – or from Deloitte to undertake a particular task. So I didn’t recognise the word “enormous”.

Lead 7: So the full context of that answer is given. Can we please display the spreadsheet that’s been provided by way of the workstream roster.

INQ000587602, please. Thank you.

Mr Dominic Cook: There is another tab before that.

Lead 7: Perhaps if we go to the roster first, please. Thank you. Is it right here that we’ve got – “MK” is for Milton Keynes?

Mr Dominic Cook: Correct.

Lead 7: “Manc”, would that essentially to reference the Cheshire site, the Alderley Park –

Mr Dominic Cook: Yes, correct – (overspeaking) –

Lead 7: – “Glasgow” obviously the Glasgow site. And then is “London” intended to be for the Cambridge site?

Mr Dominic Cook: I can’t answer that.

Lead 7: Let’s leave those aside, but certainly I think this roster makes the point as to the number of staff at Milton Keynes, and essentially we can see five names attributed to Milton Keynes over certainly very early stage of the setting up of the Milton Keynes Lighthouse lab. And is this what you’re talking about, is more the number of individuals operating at the Lighthouse laboratory that fits more with your understanding?

Mr Dominic Cook: Absolutely. But one additional point which is relevant is that Milton Keynes was very much the prototype for Lighthouse labs, and so we had people who were at Milton Keynes but doing pan-Lighthouse-type work in terms of looking at standard operating procedures and the like.

Lead 7: Thank you.

And perhaps, then, if we can move now to output because again, it’s helpful to see, certainly across the Milton Keynes site and the Cheshire site, we’ve got a first-hand look at how the number of tests during these early stages were scaled up during this relevant period.

I don’t intend to ask you specific questions, I think the document speaks for itself, but is there anything additionally, Mr Cook, you wish to say about what we see as to the increasing and scaling up of the testing at the sites?

Mr Dominic Cook: No, other than to note that the scaling happened very rapidly.

Lead 7: Thank you.

That can be taken down, please.

Can I ask you some questions where criticisms have been levelled at Deloitte, potentially by way of practices at Lighthouse laboratories.

And you’ll have reviewed as part of your evidence preparation the article by Sarah Bloch-Budzier, which is at INQ000228145 and with contributions from Dr Julian Harris. And have you had an opportunity before giving evidence, Mr Cook, essentially to see the various criticisms that were levelled as to the operation of – this being October 2020, about – at the site?

Mr Dominic Cook: Yes, I have.

Lead 7: Essentially, inexperienced colleagues, unaware of hazards, workers having limited lab experience, recruiting young people from the local area to work long shifts, concerns being escalated about training. And do you recall issues like this being raised with you relating to the Milton Keynes Lighthouse lab?

Mr Dominic Cook: Those issues, they would not have been raised with Deloitte because that was all within the confines of the lab itself and we had no oversight or responsibility. That was the oversight and responsibility of the operational lead and, as we heard this morning, there was a clinical lead appointed by the NHS for each of these labs. We had no clinical oversight at all.

Lead 7: Thank you.

Can that be taken down, please.

Now, I highly summarised with Professor Molloy some issues as to the state of tests when they were received from the testing sites, being in a poor state, perhaps multiple barcodes, caps not being on, a leakage. And so can I ask you for Deloitte’s perspective and I appreciate, also, Professor Molloy gave us context for that evidence as to early stages, but can you assist with Deloittes’ view as to whether there was a problem across the Lighthouse labs being – relating to unsafe and voided tests?

Mr Dominic Cook: I think initially there were issues and some issues both in relation to design of some of the swabs and vials before a common design was hit upon, which took a few months. Where there were tests that were voided because – for that reason, we reported that to NHS clinicians, Dr Fowler, and then there were secondary issues where the tests themselves were presented poorly, you’re right, caps not screwed up properly, barcode stickers, either multiple barcode stickers on one vial or stickers put across the top of the vial. That resulted in us being able to identify the particular test site from which the test came. We then went out to each of those test sites to give additional training and support, and as I think the evidence from this morning, the situation improved.

Lead 7: Thank you.

Can I ask, then, for any expansion you wish to give around the issue relating to the Immensa laboratory. And can I ask your assistance by reference to the paragraphs you’ve helpfully provided in your statement.

It’s paragraph 157 I’d like to take you to. And there’s a portion of your statement where you deal with the Immensa issues, and so perhaps we don’t need one, necessarily, to highlight, but essentially from paragraph 157 to 163 you address the issues.

At paragraph 157 you say:

“It was not part of Deloitte’s scope to track or monitor these concerns, and we do not know whether any such formal responsible existed in the Programme.”

Are you able to expand upon that and why that wasn’t within Deloitte’s scope?

Mr Dominic Cook: I can’t really address why it wasn’t in our scope. Our scope was set centrally within the DHSC and it evolved over the phases. So unhelpfully, I can’t tell you why it wasn’t within our scope.

Lead 7: Thank you.

Can I ask you, then, we can see at paragraph 160, and as we’ve looked at with care today, essentially Deloitte had the oversight for the end-to-end process. But to what extent did Deloitte have the responsibility for monitoring the performance of the end-to-end process?

Mr Dominic Cook: I’m not sure I fully understand your question.

Lead 7: Well, perhaps it’s just to ensure that there’s, where you have the – you have essentially commissioned and procured to ensure that the process flows in the way we’ve looked at on the 168 plan. To what extent is there an audit function or a review function of Deloitte that’s built into the contracts? And if that’s not the position, particularly where there are issues that are identified, like at Immensa, so we can understand, did you have a role in that identification, or is it your position: no, that was for those that were operating that particular site and those particular contracts?

Mr Dominic Cook: There were multiple layers of quality assurance over the Deloitte activity, both at the DHSC level and internally within Deloitte we had significant governance, of which I was a part, over all of our activity and then there was the clinical oversight as well. Anything of a clinical nature, we had no hand in. And again, that was a deliberate decision on our part.

Lead 7: Thank you. And so, then, can I be clear, did Deloitte have any responsibility for the – what some would say, relating to Immensa, were poor management and inadequate systems and oversight?

Mr Dominic Cook: That would relate to the activities within the confines of a lab, so no, we would have had no oversight.

Lead 7: Thank you.

Thank you, that can be taken down from the screen.

Can I ask you, then, in terms of the design and rollout of the digital contact and trace app, did Deloitte have any role in respect of that?

Mr Dominic Cook: No.

Lead 7: No. Thank you. Can I ask you, then, in respect of the Wales perspective, please. And I think as – part of the material you’ve been asked to consider included the joint corporate witness statement that identified how Wales tested – utilised dry throat swabs through investigating respiratory viral infection.

And perhaps if we can display your paragraph 339, please, in your witness statement.

Which is INQ000587306, please, paragraph 339.

Oh, I do apologise, it’s the wrong reference. So that reference is to the context to, sorry, the identification that Wales had a different test. But can I ask you, were Deloitte aware that Wales used different swabs to England? And if – first of all –

Mr Dominic Cook: No.

Lead 7: No. Okay. Well, I won’t ask a follow-up –

Mr Dominic Cook: Again, that is a clinically – clinical-related question.

Lead 7: Thank you.

Can I then ask to be displayed, please, INQ000511010. And again, I think, as part of the preparatory material, I think this is the field visit laboratory site checklist, and this one I’m taking you to is the Glasgow mass testing site. And again, these are early in the establishment of the Lighthouse laboratory. There’s a similar one in relation to Alderley Park.

Have you had an opportunity to review these reports?

Mr Dominic Cook: Yes, I have.

Lead 7: And when one looks at the reports, we can see a number of concerns were raised. Were those concerns relating – for this scenario, with the Glasgow Lighthouse laboratory, shared or presented to Deloitte?

Mr Dominic Cook: I don’t know, is the short answer to that, but even if they were, this related to inspections of the labs themselves and the clinical processes being undertaken within the labs, and therefore was not within our remit.

Lead 7: Thank you.

And so then it may be that’s the same answer to the follow-up questions. Again, these site visits identified staff training and, again, issues relating to PPP.

Would they have fallen then for Deloitte to ensure they were improved or was that for the operator?

Mr Dominic Cook: That is an operational issue and I would have expected both the operational lead and the NHS clinical lead of those labs to be on top of those issues.

Lead 7: Thank you.

Could I next seek your view again – I’ve given you an opportunity to clarify where others have made criticisms or levied them against Deloitte, where you’ve clarified where it was not within the responsibility or Deloitte. The Inquiry has now received a witness statement from Haroona Franklin.

And can I just ask for paragraph 4.10 of the statement of Haroona Franklin, which is INQ000587606. Thank you.

So – it’s at 5.10. Please, I do apologise, can we go back up to 4.10.

Mr Dominic Cook: Yeah.

Lead 7: Thank you.

This suggests that:

“… there was a lack of data analysis to support Trace and … therefore a … project was created to improve this sitting alongside the day-to-day operations. [And that] Deloitte were the consultants brought in to deliver this. They created and managed the operational management information reporting to support the optimisation and continuous improvement of the test and tracing contact centres including case creation, isolation advice and follow-ups policy.”

I have already asked you about to what extent did Deloitte have responsibility for the contact tracing apps – centre, sorry. To – this is another criticism that suggests – being levelled to Deloitte in respect of contact tracing. Is this accurate in terms of any role that Deloitte had for contact tracing, please?

Lady Hallett: Is it a criticism or is it saying that there was a problem and Deloitte were brought in to solve it?

Ms Cartwright: Well, perhaps that’s –

Mr Dominic Cook: My Lady, thank you –

Lady Hallett: I’m sorry, have I got there –

Mr Dominic Cook: – I couldn’t have put it better myself.

Ms Cartwright: Can I say, I fully agree with that.

So can I ask you to answer her Ladyship’s question. Did you have any input in terms of being brought in to address a contact tracing issue?

Mr Dominic Cook: I wouldn’t have characterised it as it’s been characterised in this statement, because it suggests that we set various things up, had a management system of a type.

The NHS had already had something called a Microsoft Power BI system, which was actually the business intelligence. That’s what the “BI” stands for. What we were asked to do was extract some data and run some reports. That was it.

Lead 7: Thank you.

Thank you. That can be taken down, please.

Excuse me for just one moment. I do apologise.

Can I then, please, have displayed – again, back to your witness statement, and it’s paragraph 298, please.

That’s INQ000587306.

This is a portion of questions I just want to ask you to see if you can assist us with any further evidence about vulnerabilities and considerations of issues of inequality.

At paragraph 298 you detailed that:

“Deloitte was not involved in defining what ‘vulnerable’ meant, however [you] understood the term to have been interpreted more broadly than just those groups protected under the Equality Act 2010 …”

You detail that when making testing policy decisions, the government took into account, for example, protected characteristics, geographical and socioeconomic differences, occupations and/or immigration status.

So could I ask you, did Deloitte deduct or have sight of any quality impact assessments in relation to Deloitte’s role in building the National Testing Programme?

Mr Dominic Cook: As I understand it, it’s the responsibility of the local authorities to run such impact assessments, although we did support, on some of those impact assessments, in some locations.

Lead 7: Thank you.

Can we then have displayed, please, your paragraph 300 on the next page at page 79, please.

Can it be expanded – thank you.

You detailed that – the National Testing Programme having initiatives such as community-led testing, the design of an anonymous testing journey for asylum seekers and refugees, and designing a testing journey for the digitally excluded.

Could you assist at all, Mr Cook, with how success was measured in respect of these initiatives, and the follow-up question would be: was the data monitored and evaluated to implement targeted interventions?

Mr Dominic Cook: I am unaware of any statistics that we ran as to the success, and that would have been left to the local authorities to feed back to our local engagement teams.

Lead 7: Thank you.

Can we then move to the next paragraph, paragraph 301, please. Again, you identify that:

“Deloitte consulted with the local authorities to seek advice and guidance on how to approach the needs of vulnerable communities …”

And that:

“This assisted Deloitte in its thinking as to how to make testing more accessible to these vulnerable groups.”

Can you assist or provide any further description as to the measures taken to engage with and involve representatives from ethnic minority organisations and communities, to understand their needs, address their concerns, and build trust?

Mr Dominic Cook: I think that the best way to answer that is some of the rationale in the London Borough Engagement Tracker that tracked where percentages of the community from a BAME background were located, and we then worked closely with the local authorities to understand the needs of that particular community and other communities in the siting and the number of sites, test sites.

Lead 7: Thank you. There’s then a portion of your statement just following on, if we could go to the next page, please, at page 80, and if it could perhaps be left rather than zooming in, because it’s the paragraphs 304 through to 309 on page 80.

So you’re detailing within this run of paragraphs Mr Cook, please, that the Department of Health and Social Care’s Population Engagement Study managed by Deloitte considered behavioural issues and the impact those behaviours may have on the rates of testing.

Are you able to assist any further, please, on how the considerations around health inequalities, particularly those affecting ethnic minority communities, were factored into this study?

Mr Dominic Cook: We looked at a number of datasets and worked closely with local authorities. I can’t give you any more information than that.

Lead 7: Thank you.

That can be taken down, please.

Again, a few more questions, please, Mr Cook, to explore, see if you can help any further. In light of the impact of the pandemic on ethnic minority communities, were there specific strategies developed or actions taken to ensure that testing services were tailored to the needs of these communities, especially those with higher levels of vulnerability or systemic barriers to accessing healthcare?

Mr Dominic Cook: All questions and issues of strategy and approach were made by others. It goes back to the “how” not the “what” or the “why”, as I said when I started my evidence. So if they were communicated to us, and with a “how” question at the end of it, we would have addressed it.

Lead 7: Thank you.

Has Deloitte learnt any lessons that assist the Inquiry’s consideration of the unequal impacts of the testing regime on ethnic minority communities and the actions that should be taken to prevent such inequalities in a future testing programme?

Mr Dominic Cook: Certainly as far as Deloitte is concerned, we worked very hard through our local engagement teams, to make sure that we understood the demographics of populations, and that test sites were located in the most convenient places for those populations.

Lead 7: Thank you. And can I ask just building on that, did local community views and economic factors such as cost of travelling to testing sites inform the location of the testing sites and facility layout?

Mr Dominic Cook: I’m unaware that cost of travel specifically was. We did look at percentage of car ownership by thousand of population.

Lead 7: Thank you.

Can I ask to be displayed, please, INQ000148405, which is a statement of Professor Fenton, I think that’s been provided to you. That’s INQ000148405.

Apologies if that’s a rogue reference. Thank you. And can we move, please, to paragraph 31 within the statement.

Can I just check, Mr Cook, you’ve had an opportunity to consider Professor Fenton’s statement?

Mr Dominic Cook: This was in my evidence pack.

Lead 7: Thank you. Can we move then to paragraph 31 on page 9. Thank you. You can see there:

“In the early weeks of the pandemic, local public health teams under directors of public health put in place structures key to containing infectious diseases such as contact tracing. As numbers increased, this was taken away and put on to a national digital platform which was inconsistent, leading to ambiguity and individual decision making. As this was scaled up, there was a lack of public health specialists involved in large-scale test and trace operations.”

I think the reality is you were not involved in the contact tracing app so you cannot assist any further with this particular question.

Mr Dominic Cook: That’s correct.

Lead 7: Thank you.

Thank you, that can be taken from the screen, please.

Can I then move to my penultimate topic before recommendations, and it is to address the issue of costs. As you’re no doubt well aware, there’s been much detail about cost linked to the contractors and the testing programme. And I think you detail within your witness statement the total cost of the various and many contracts, but can I thank you and Deloitte for the provision of a more detailed breakdown of the finances of these contracts.

Can that be displayed now, please, which is INQ000587597. Thank you. And if it could just be expanded, please.

So if we go to the bottom figure, first of all, where we see the total cost of Deloitte’s involvement in the various contracts is the 395,477,576, but it’s right, isn’t it, that you’ve helpfully assisted with the breakdown of the cost of the individual contracts.

And can we go to the top of that, please. Thank you, which is the – we’ve heard a little evidence, I think, in terms of the first three months of setting up the national testing workstream which is the three-month period we can see for 19 March 2020 to 19 June 2020, where 32 million was charged for that three-month period.

Can I ask you to give whatever relevant evidence you’d wish to give, please, Mr Cook, so we have a proper context to the figures we see here but also the rates at which the Deloitte contractors were performing their role, please.

Mr Dominic Cook: Certainly. Very early on in our engagement, I believe, on 25 March, Deloitte suggested to the Cabinet Office that we use an existing Crown Commercial Service framework, MCF2, as it was in those days, and we used those rates against which we applied a very significant discount as a suggested way forward, as we had already started work without the contract, Day 1, and without agreement as to rates. The Cabinet Office came back and responded, and our offer for that discount was until May of that year, because at that stage, no one sort of knew of the longevity of the pandemic.

That – they agreed with the level of discount but we didn’t keep it until May; we kept it until, with one adjustment, until the end of our involvement.

Lead 7: Thank you.

That can be removed from the screen.

And perhaps out of a fairness point to evidence the Inquiry is going to hear, I know you’ve had an opportunity to consider the statement of Professor Pillay, who we’ll hear from on the last day of the Inquiry, but I think it’s a criticism that others have made, that it’s to the effect that Deloitte did not have relevant expertise in respect of the involvement in the testing programme, and is there anything you’d wish to say for when we hear those later criticisms about Deloitte’s absence of relevant expertise, please?

Mr Dominic Cook: Well, I wouldn’t agree with the characterisation of that relevant expertise. Did we deploy virologists? No. That was not our role. We look at a lab operation more as a lean manufacturing process. We had a number of very directly relevant skills, as I believe I highlighted. I highlighted 11 different skills that helped create the 168 plan.

There was criticism that some of the scientific community had to explain the science to some of the Deloitte people. Frankly, I would have been appalled had our people not asked those questions. We were involved in some workforce planning. We needed to know that the workforce that was needed for each of the satellite labs, we needed to know what health and safety aspects needed to be built into the workflow and the supply chain. So I would have been very surprised had those conversations not taken place.

Lead 7: Thank you. And then for my purposes, please, Mr Cook, there’s been a good degree of lessons learning and recommendation that –

Lady Hallett: Unless there’s – given the time, Ms Cartwright, sorry to interrupt you – unless there are any points that you wish to highlight or Mr Cook wishes to highlight, if they are just coming from the written statement, I can read them.

Ms Cartwright: There are, and that’s what I just wanted – I wasn’t going to go to them but just if there was anything else that Mr Cook would like to expand upon.

Mr Dominic Cook: I would just like to end on one final point. This was an unbelievable national effort. Colleagues from the NHS, the DHSC, other civil servants, the military, academia, other private sector suppliers, all came together as one team. Deloitte was but one part of a monumental national effort.

Ms Cartwright: Thank you.

Thank you for answering my questions, thank you.

Lady Hallett: Thank you, Ms Cartwright.

Ms Parsons, I don’t know how much of your thunder Ms Cartwright has stolen.

Can you see Ms Cartwright (sic) from around the pillar?

The Witness: I can, yes.

Ms Parsons: My Lady, most of the thunder has been stolen, but I do have a couple of brief matters, if I may?

Lady Hallett: Certainly.

Questions From Ms Parsons

Ms Parsons: Thank you. Good afternoon, Mr Cook. I ask questions on behalf of the Covid-19 Bereaved Families for Justice Cymru. I want to ask you about the regional testing site in Cardiff City Stadium, which has been touched on so we can deal with it very briefly, I hope.

You say in your statement at paragraph 86 that Deloitte was involved in the identification and building of the regional testing sites.

Whose instruction was it, please, to get it set up in Cardiff City Stadium?

Mr Dominic Cook: We were asked to identify nationally sites to cover as much of the population as possible. We had a set of criteria that we were working to, in terms of location, hardstanding area, parking and the like.

Once we found a site that met those criteria, as I mentioned, we created this one-page recommendation, which went to the DHSC, and it was either signed off or we were asked to find alternative sites.

So were we told Cardiff City precisely? I would very much doubt that. We were scouting sites that were available.

Ms Parsons: And if I may, who did it go to in the DHSC?

Mr Dominic Cook: I think I mentioned earlier, I – there would have been

a team there, because, the number of these things, these

one-pagers, requests for both regional and local test

sites went to, I don’t know the names of the

individuals. I’m sorry.

Ms Parsons: Thank you. We know that Public Health Wales and the

Welsh Government first heard about the centre having

been set up on 1 April. That was one day before it was

due to become operational. You said in your evidence

that DHSC was responsible for communications with the

devolved administrations.

Do we take it that you can’t help with why there was

no apparent engagement with the Welsh Government or

Public Health Wales?

Mr Dominic Cook: I’m afraid I cannot help with that question.

Ms Parsons: Lastly, please, Mr Cook, we know from Public Health

Wales’ witness statement to the Inquiry that the

Deloitte model, as they called it, was not fit for

purpose initially in Wales, and so it was stood down on

2 April, albeit later again stood up.

There were a number of problems that were

identified. One of them related to the swab

methodology. You’ve already touched on that. But

I wanted to ask you about another couple of problems

that were identified.

Test results would not be available on patient records in Wales and, as a result, there was a lack of visibility of test results such that the Welsh Government could not manage the disease in the population.

So as to those more operational issues rather than clinical issues, did Deloitte have any discussion with Cardiff City Council about those type of issues? And if not, why not?

Mr Dominic Cook: The results, if I may take you back to that, that end-to-end 168-step plan, would have been communicated right at the end through the NHS’s NPEx system. So by that time Deloitte had no hand in where that data went. That was an NHS responsibility, as neither the test sites nor Deloitte were going to process that data.

Ms Parsons: Thank you very much, Mr Cook.

Thank you, my Lady.

Lady Hallett: Thank you, Ms Parsons.

That concludes the questions we have for you, Mr Cook. I hope you won’t consider it an insult, but dare I say it that the care with which you gave your evidence betrays your lawyerly beginnings and qualification. I don’t consider it an insult, because I’m proud of being a lawyer, but other people may.

Thank you very much for the help you and your team

have given to the Inquiry. I appreciate the amount time

it must have taken for the Deloitte team to prepare your

witness statement and to be here today.

And also, thank you to the Deloitte team who worked

on this programme. I do understand what you say about

this huge number of people who were involved coming from

all sorts of different groups, and I do understand, of

course, that technically the Deloitte team weren’t

volunteers, but I bet you they worked even harder, and

I’ve no doubt Deloitte worked them pretty hard. I bet

they worked even harder when they were working on this

programme, because it was so worthwhile. So, thank you

for everything they did, and the team at Deloitte did.

The Witness: My Lady, thank you very much for those

observations. I will certainly pass that back, but

thank you.

Lady Hallett: But not the bit about you working them too

hard in the beginning?

The Witness: No, I might ignore that.

Lady Hallett: Thank you very much. I shall return at

10.00 am tomorrow.

Ms Cartwright: Thank you, my Lady.

(4.22 pm)

(The hearing adjourned until 10.00 am the following day)