Mandatory vaccination extends to frontline health staff

November 9, 2021

Health and social care providers in England will be required to ensure workers are fully vaccinated against COVID-19, unless they are exempt, under plans announced by the Health and Social Care Secretary.

The Government has said ensuring the maximum number of NHS staff are vaccinated will help ensure the most vulnerable patients gain the greatest possible levels of protection against infection. Elderly people, those with disabilities, and some seriously ill people in hospitals face a higher risk from COVID-19 than the wider population and are more likely to use health and care services more often.

Findings from the REACT study have shown that fully vaccinated people were estimated to have around 50% to 60% reduced risk of infection, including asymptomatic infection, compared to unvaccinated people.

The regulations will apply to health and social care workers who have direct, face-to-face contact with people while providing care – such as doctors, nurses, dentists, and domiciliary care workers unless they are exempt.

They will also apply to ancillary staff such as porters or receptionists who may have social contact with patients but are not directly involved in their care. This will apply across the CQC-regulated health and social care sector.

The majority of NHS workers are already vaccinated, as over 92.8% have had their first dose and 89.9% have had both doses of a COVID-19 vaccine. In social care, 83.7% of domiciliary care workers have had their first dose and 74.6% have had both doses.

Latest published data shows, however, that over 103,000 NHS Trust workers and 105,000 domiciliary care workers have not been reported as fully vaccinated and the Government is urging them to take up the offer now, to keep themselves and those they care for safe.

The requirements will come into force in the spring, subject to the passage of the regulations through Parliament. There will be a 12-week grace period between the regulations being made and coming into force to allow those who have not yet been vaccinated to have both doses. Enforcement would begin from 1 April, subject to parliamentary approval.

Matthew Wort, Partner at Anthony Collins Solicitors, has outlined what the new rules mean for health and social care providers in a new blog post.

The measure is an extension to previously announced regulations making COVID-19 vaccination a condition of deployment for staff working in CQC-registered care homes in England, which comes into force on 11th November 2021.

It would be the CQC’s role to monitor and take enforcement action in appropriate cases. At time of registration and when inspected, the registered person would have to provide evidence that those deployed to undertake the regulated activity have been vaccinated.

Chief Nurse for Adult Social Care Deborah Sturdy said, 'We know that vaccines save lives which is why earlier this year we set out our plans to make vaccines a condition of deployment in care homes to protect those who are more vulnerable to this virus.

'I encourage anyone working in social care who has not yet had their vaccine to come forward as soon as possible to protect yourselves, your colleagues and those you care for.'

There are currently record numbers of nurses and doctors working in the NHS, with over 304,700 and 126,600 respectively. The Spending Review also committed funding to keep building a bigger, better trained NHS workforce, including support for some of the biggest undergraduate intakes of medical students and nurses ever and reaffirming the Government’s commitment for 50,000 more nurses.

Professor Martin Green OBE, CEO, Care England, said, ‘There must be central guidance, funding and leadership in helping to support adult social care providers in implementing mandatory vaccination for care homes as well as the wider social care and NHS. If we have learned one thing from the process around mandatory vaccination for care homes, it is that appropriate infrastructure support must be in place which includes an impact assessment from the Government. We are facing a workforce crisis and measures need to be put in place to stem this both for the short, medium and long term.’

Dr Jane Townson, Homecare Association’s CEO, said, 'The Homecare Association strongly supports vaccination of the homecare workforce and we lobbied hard, right from the beginning, to ensure it was as easy as possible for homecare workers to access vaccinations.'From the outset, though, we have argued that persuasion is likely to be more effective than compulsion in encouraging uptake among remaining careworkers with genuine fears. We are thus disappointed by the Government’s policy decision; their bullying approach towards the health and care workforce; and their failure to acknowledge the potential risks of losing at least 120,000 careworkers. The Government has no contingency plan for dealing with a potential loss of regulated homecare for over 120,000 older and disabled people. Who will care for them? How will councils and the NHS cope with the fallout?Dr Jane Townson added, 'We feel it's very important to balance the mitigated risk of infection with the risk of unavailability of care at home for highly dependent older and disabled people.'

Despite the challenges, progress has been made and currently 84.1% of homecare workers have had the first dose of vaccine, and 75.4% the second dose. The Homecare Association has said the extension to the 1st April 2022 is welcome, as it strives to encourage vaccine uptake in the remainder of the workforce.

The social care not-for-profit charity, Dimensions said the Government's decision threatens safe care for disabled people right across the country and it undermines the choice and control people have over who supports them. It will also put the viability of many providers at risk.

Steve Scown, Chief Executive of leading social care not-for-profit Dimensions, said, ‘Dimensions fully supports our workforce choosing to be vaccinated, but mandatory vaccination alone will not keep people safe. Already, many good colleagues have left. We will be forced to dismiss more on Friday when the first set of new regulations come into force, and now anticipate yet more dismissals in April.

‘Now is the time for the Government to learn about social care. To address social care in policy terms as an equal to the NHS, not a postscript. Spending a few pounds on a social care recruitment campaign is very far from the answer.’

Karolina Gerlich, CEO of The Care Workers’ Charity, said, ‘We are disappointed in today’s announcement which will make vaccination a condition of deployment in health and wider social care settings which will impact not only healthcare staff, but also former social care workers who were forced to leave the sector to move to the NHS, where they hoped they could avoid the impact of this arbitrary legislation. Moreover, those who moved from care home settings to home care will now have to leave the sector altogether- as they are forced out of their roles once the policy (now covering all CQC registered settings) comes into effect in April 2022.

‘Those in social care know from experience the devastating impact this will have. Despite the deadline for care home workers to have received both COVID vaccinations having not yet been reached (this is Thursday 11th), its impact was felt almost immediately, as care workers chose to leave the sector before they were pushed out of their roles.’

David Kelly, General Manager EMEA at Deputy, the workforce management app, said, ‘Health and social care workers are some of the most committed and hardworking people in this country. These ultimatums from the Government are forcing many to choose between a career they love and their own personal beliefs or health concerns. With staffing already under pressure, losing further workers will now also be a worry for NHS bosses. All eyes are on what happens in the care sector this week.’

In relation to the Government’s new recruitment campaign, David Kelly added, ‘UK care homes are reaching a crisis point. The Government’s new  ‘Made with Care’ recruitment campaign touts the concept of flexible hours to encourage people into jobs in the sector. But as it stands, many workers in care homes have to work 12-hour shifts. A much broader discussion is needed around improvement in all aspects of employee experience in health and social care.’

Visit the UK Government website to read the full Government response to the consultation.

In other news, a care provider, whose homes appear in a new TV documentary on the crisis in social care, has challenged the Government to debate the issues raised in it.


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