The government has launched a consultation today on plans for NHS staff in England to be required to be double-jabbed for Covid-19 and to have received the seasonal flu vaccine.
Workers who have not received both coronavirus vaccinations could be barred from seeing patients. Statistics suggest that as many as one in 12 NHS workers (8%) have not had their first jab. Nationally, 88% of staff have received both doses, but data published today suggests that in some trusts uptake is as low as 78% for both doses.
Health and social care secretary Sajid Javid said: “Many patients being treated in hospitals and other clinical settings are most at risk of suffering serious consequences of Covid-19, and we must do what we can to protect them.
“It’s so clear to see the impact vaccines have against respiratory viruses which can be fatal to the vulnerable, and that’s why we’re exploring mandatory vaccines for both Covid-19 and flu.
“We will consider the responses to the consultation carefully but, whatever happens, I urge the small minority of NHS staff who have not yet been jabbed to consider getting vaccinated – for their own health as well as those around them.”
Workers in care homes must be double-jabbed by 11 November after a similar consultation for social care began in the spring. Unless enforced on a faster timetable, any new regulations emerging from today’s consultation may not come into play until April 2022.
No jab, no job policies
The six-week consultation examines whether requirements should apply for health and wider social care workers: those in contact with patients and people receiving care.
It would mean only those who are fully vaccinated, unless medically exempt, could be deployed to deliver health and care services. It will also seek views on whether flu vaccines should be a requirement for health and care workers.
Matthew Taylor, chief executive of the NHS Confederation, said it was important to make sure those who have yet to be vaccinated against Covid-19 are supported to do so.
“Members will continue to emphasise education and communication with staff, which will be crucial even if the government mandates vaccination for NHS staff. We will also work closely with our trade union colleagues to address the concerns of their members and to ensure that the implementation of any decision is handled sensitively.
“We will need to understand the detail of the proposals, but the focus must remain on increasing vaccine confidence and the approach taken to date to encourage uptake through informed consent remains the preferred option.”
A study led by the London School of Hygiene and Tropical Medicine in May among health and social care workers found that those who felt under greater pressure from their employers to receive the vaccine were more likely to decline it.
Helen Donovan, the Royal College of Nursing’s professional lead for public health, said: “All nursing staff should have any vaccine deemed necessary to help protect themselves, patients, colleagues, family members, and the wider community. This has always included the flu vaccine and more recently the Covid-19 vaccine. We do, however, have concerns around mandating vaccines and whether this will ultimately improve uptake.”
She added: “The focus should be on communicating the benefits of vaccination rather than making them mandatory. Involving staff in this consultation will help them to become further involved in the decision making and it is vital their views are properly taken into account over the next steps.”
Dr Penelope Toff, co-chair of the BMA public health medicine committee, said: “Vaccination programmes work best when people have a chance to get their questions answered and are able to make an informed decision. A thorough consultation is really important and the BMA will be responding to the government’s proposals”.
She added that “a proposal for compulsory vaccination of healthcare staff against Covid-19 and flu has far-reaching implications.
“We know that both Covid-19 and flu vaccine uptake among doctors remains high but that there are also small numbers of staff who are unable or unwilling to have the vaccines. There are a number of reasons for this and it’s important that all views are taken into consideration in this consultation.”
There is a longstanding precedent for vaccination requirement in some NHS roles. For example, occupational health policies are already in place requiring many frontline staff to receive the hepatitis B vaccine.
Flu vaccinations have been recommended for staff and vulnerable groups in the UK since the 1960s. National flu vaccination rates in the NHS have increased from 14% in 2002 to 76% last year, but the Department of Health and Social Care said that in some settings, rates were as low as 53%.
As well as protecting vulnerable patients, the plans would also protect colleagues, helping to reduce sickness absence during busy periods like winter.
The consultation will consider three risks in clinical settings and how they can be mitigated by vaccination: the level of interaction in a clinical setting between staff, patients and visitors; the vulnerability of patients; and high-risk procedures.
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