University researchers leading evaluation of Liverpool’s COVID-SMART pilot of community testing

A team of experts, led by the University of Liverpool, are evaluating Liverpool’s pilot of community testing to improve COVID-19 resilience and recovery.


On Friday, 6 November 2020, Liverpool City Council, NHS Test and Trace (Department of Health & Social Care), NHS Liverpool Clinical Commissioning Group, Cheshire & Merseyside Health & Care Partnership, and The University of Liverpool, embarked on a national pilot of community open-access testing for the Covid-19 virus among people without symptoms. The pilot aims to reduce or contain transmission of the virus while tackling the mounting harms to health, social and economic wellbeing from COVID restrictions.

Liverpool has been hit particularly hard by the economic consequences of the pandemic, discussed in a recent Liverpool Responds webinar. Although the testing facilities have been deployed for easy access by all residents, the testing programme is being targeted to maximise the value of the tests. The original name of the pilot was changed from MAST (Mass, Asymptomatic, Serial Testing) to SMART (Systematic, Meaningful, Asymptomatic, Repeated Testing), to better reflect the targeted approach.

Liverpool COVID-SMART has three components:

• ‘test-to-protect’ vulnerable people and settings;
• ‘test-to-release’ people sooner from quarantine than the stipulated period;
• ‘test-to-enable’ careful and sustainable return to restricted activities to improve public health, social fabric, and the economy.


Researchers from the University of Liverpool, led by Professor Iain Buchan, alongside experts from the Department of Health and Social Care, Joint Biosecurity Centre, Public Health England, and Office for National Statistics, are evaluating the data on the immediate biological, behavioural and systems integration aspects of testing, then the longer term public health impacts.

The biological evaluation will consider the performance of the test and its impacts on virus transmission. The behavioural evaluation will consider what influences people to take a test or not, and how they respond to a test result. The systems evaluation considers how the different test delivery, data and management system work together across different organisations to deliver the objectives of testing. The public health evaluation will consider observed and projected impacts on health, social and economic wellbeing overall, and on inequalities, including uptake by different socio-demographic groups.

An important public health initiative.

Professor Iain Buchan, said: “The people of Liverpool, and the agencies serving them, have delivered a large and complex public health intervention with remarkable agility and grace. Local authority, NHS and public health agencies have combined data in a live intelligence system, CIPHA, that enables the evaluation team to provide tactical intelligence as well as underpinning the summative evaluation.

“This close working between national and local teams is allowing evidence from the pilot quickly to inform national policy, particularly in how to target asymptomatic testing.”

Professor Louise Kenny, said: “The University of Liverpool prides itself on being a civic university and we are proud to work with our key partners in supporting this important public health initiative.”

Professor Calum Semple OBE, said “Our pilot of COVID SMART in Liverpool is teaching us how best to stop COVID damaging lives and open up our economy. Liverpool has been at forefront of innovative public health measures for many years. We have learnt from past experience that taking public health interventions onto the streets of Liverpool led to huge improvements in health and wellbeing.”

An interim report on the first phase of the pilot, during lockdown, will be published shortly, followed by a full report on the Liverpool Covid-SMART pilot, covering a period in Tier 3 and Tier 2 measures.

The full aims and objectives of the evaluation of the pilot and details of all the partners involved can be found here.