Published on 20 Aug 2025

Timely Insights Prevent System Overload: Covid-19 PCR Testing Backlog Rapid Review

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4 ANTON 1x1 PORTRAIT 1
Anton Davis Director Consulting (NZ) Contact me
22 NICK 1x1 PORTRAIT 1
Nick Leffler Organisational Design + Change Lead Contact me

The PCR testing system became overwhelmed during the Covid-19 Omicron outbreak. The Ministry of Health wanted to understand why this had occurred and what could have been done to prevent this from occurring in any future outbreaks. This was essential to maintain public confidence in the testing system while ensuring critical health infrastructure could respond effectively to future challenges.

In March 2022, the Ministry commissioned Allen + Clarke to review the circumstances that led to significant delays in COVID-19 PCR testing and an apparent gap between forecast capacity and actual response capability. We found the disconnect between reported capacity and actual capability misled decision makers about the system's resilience. 

Our practical recommendations gave the Ministry a clear path to prevent future backlogs while maintaining testing capability.

Streamlined investigation with short timeframes

We designed a streamlined investigation that would deliver clear findings in a short timeframe. We were able to undertake this review and deliver our findings in just 6 weeks. 

  • Website Generic Icons 1200x1200 GREEN 31 We examined over 700 documents including capacity reports, planning papers, communications, and modelling data to map what happened.
  • Website Generic Icons 1200x1200 GREEN 31 We talked to 57 people through 45 interviews, including Ministry staff, laboratory networks, individual labs, and primary care representatives.
  • Website Generic Icons 1200x1200 GREEN 31 We matched what people told us against written evidence to ensure our findings were based on facts, not just perceptions.
  • Website Generic Icons 1200x1200 GREEN 31 We looked at structural, operational, and governance factors that contributed to the capacity miscalculations and communication breakdowns.
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What we found

  • Unclear definitions led to confusion - Labs reported their capacity using inconsistent definitions. The term 'baseline capacity' was used to mean different things by different labs, creating confusion about the system's true capability. 

  • National figures hid regional problems - reporting capacity as one national figure suggested that busy labs could simply send tests elsewhere. In reality, IT systems weren't connected, and samples couldn't be easily transferred between regions. 

  • Critical warning signs were missed - the Testing and Supply Groups knew that higher positivity rates would make sample pooling ineffective but didn't clearly communicate this risk to decision-makers. 

  • Organisational structures created blind spots - the Ministry separated testing operations (managing demand) from laboratory testing (managing capacity), creating a reactive rather than proactive approach. 

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Clear insights and nine recommendations for practical improvements

Our rapid review gave the Ministry clear insights into what went wrong and how to fix it. We showed that the backlog was predictable and preventable through better risk communication, clearer capacity definitions, and earlier changes to testing approaches. 

We provided nine specific recommendations that created a practical roadmap for improving the testing system. We helped the Ministry understand how much PCR capacity they needed to maintain for future variants, focusing on how to smoothly transition between testing methods during surges. 

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