How have Government’s U-turns on mandatory vaccines impacted on social care?
How it began
In April 2021, the Department of Heath and Social Care (DHSC) launched a consultation on making COVID-19 vaccinations a mandatory condition of deployment for staff in older people’s care settings.
Despite many in the sector expressing concerns that the proposed legislation changes would exacerbate the workforce crisis, and emphasising the work that providers were already doing to encourage uptake of the vaccination, in June 2021 Government confirmed it would be going ahead with the policy. It was passed into law in July and all care staff working in older adults’ care homes needed to have received both of their COVID-19 jabs by 11th November to continue their work after this date.
In September, Government began consulting on whether vaccination as a condition of deployment (VCOD) should be applied more widely to other health and care staff, including NHS staff. These plans were confirmed in November and the sector was generally dismayed, having already seen an exodus of staff who did not want to be forced into getting vaccinated.
By January, it was clear that VCOD legislation was forcing people to leave their jobs, causing grave issues for providers who had already been struggling with recruitment. Skilled professionals had had to hand in their notice and staff with years of experience and excellent relationships with clients and residents resigned or were terminated from their roles.
Making a U-turn
Pressure from sector leaders and individual providers ensued, almost all voicing their support for the vaccination programme but equally asking Government to hear them when they said this was creating widespread problems.
On 31st January, Government announced it would be consulting on revoking the VCOD legislation, stating that as Omicron was now the dominant variant in the UK, and was generally less severe in terms of its symptoms, the policy was no longer necessary. DHSC formally announced on 1st March that it would be revoking the legislation, with effect from 15th March.
Where we are now
Though the sector is generally glad that the VCOD legislation has been revoked, it remains a difficult situation. Providers are now faced with trying to recruit to fill the gaps of staff who have left or been terminated; some are trying to reach out to skilled leavers who have gone to work in other industries in the hope that they will return.
There is a general sense of frustration as care operators have had to spend time and money on plans and solutions for the inevitable fall-out of Government’s actions. In some cases, this time and money has been wasted as Government has backtracked on legislation before it came into force.
In terms of the impact of the legislation that was in force, it does seem to have had the desired effect – since April 2021, first dose uptake among care home staff has increased from 80% to 96% and second dose uptake from 77% to 95% since the care home VCOD regulations were made. But does this outweigh the pressures that have been put on providers and staff alike?
A damaging and pointless exercise
We know that vaccines have been one of the most effective measures against the impact of COVID-19.
The vaccine’s introduction was hailed as an enormous step forward during a devasting time. Within the care home sector, we saw unprecedented loss of life due to a hasty and ill-thought-out Government policy to empty hospitals into care settings.
Care providers worked hard to support local acute care settings with assurances, which were not worth the paper they were written on, that it was safe to do so.
Nine months on, as the vaccine emerged, care home residents and staff were given priority access and we sensed unease from some of the workforce, but we worked hard to support take up. It was a tough pathway, but we persisted and made progress until the mandatory legislation emerged. A steady stream of staff exits followed, increasing the pressure on providers, already struggling with workforce issues pre-pandemic and post Brexit. Care providers had used all the same mitigations as our NHS colleagues, but they fell on deaf ears.
The sector lost circa 30,000 members, for a policy that lasted less than 10 weeks but has left a devasting impact on the workforce crisis it exacerbated. We lost dedicated people who felt the haste with which they were being compelled to take the vaccine was too uncomfortable; their concerns were being trivialised so soon after a vaccine had been introduced. They felt devalued and invisible in the debate; they felt expendable!
To see legislation revoked just 10 weeks after it was implemented is nothing short of a damaging and a pointless exercise. A U-turn in favour of halting an NHS staffing crisis will at least help social care providers to recruit on a more equal footing.
However, we cannot plan our strategy until we can be sure there are no caveats introduced for a subliminal introduction of this policy and of course, until we can receive the funding required to create parity of esteem for our teams as they exist in the NHS.
Nadra Ahmed OBE, Chairman, National Care Association
Trust has been shaken even further
The NHS U-turn brought our already low trust in the Government’s stewardship of the pandemic to the ground. Trust has been shaken even further – if that’s possible – by the additional U-turn on vaccination requirements for care home staff.
As a result, care managers are facing a range of direct impacts on their ability to plan staffing safely, and well.
Most far-reaching is the significant loss of professionals already from the industry. The Care Workers’ Charity estimates approximately 30,000 workers left the sector as a result of November’s vaccine mandate and, anecdotally, we’re not hearing of people deciding to return.
Hospitality, gig work, remote work and other opportunities opened up by the pandemic have claimed essential staff, who have left an industry already suffering from chronic shortages.
The damage has been done, and a U-turn will not bring people back to care overnight. On the ground, services are now scrambling to provide safe staffing levels via an even more decimated workforce.
Morale is at an all-time low, too. Managers expended a great deal of time and political capital ensuring vaccine coverage in the run-up to November, with many having to let long-serving staff go. The NHS U-turn looks like a bow to pressure that was ignored in the case of social care – plus, the hard work, heartbreak and energy spent enforcing vaccination has come to nothing.
Staff themselves see the U-turn as proof they play second fiddle. Was the vaccine mandate only a failed experiment, using social care workers as test subjects ahead of the NHS? That makes our wonderful staff feel disposable and under-valued.
Surely, a U-turn on this policy means next time there’s a Government mandate surrounding vaccination (or wider issues), there will be significantly less buy-in from care leaders and workers alike – making our workforce problems even more entrenched.
However, a silver lining may be found. This reversal of vaccine law across the NHS and social care could rebalance the recruitment environment. Care leaders can operate in a more level playing field and draw workers back from the NHS, which could help ease staffing challenges going forward.
Charles Armitage, CEO, Florence
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