Care providers are concerned that mandatory Covid-19 vaccines for all staff in care homes for older people will exacerbate existing staffing issues.
Health secretary Matt Hancock confirmed today (16 June) that coronavirus vaccinations will be made compulsory, with care home employees given 16 weeks to get the jab or face being redeployed away from frontline care. Consultations are also proposed for extending mandatory vaccines to NHS staff.
Vaccination issues
Many care homes already face significant difficulties in recruiting and retaining staff, and fear that requiring employees to be vaccinated could make this worse.
Mike Padgham, chair of the Independent Care Group, which represents care homes in Yorkshire, told the BBC Radio 4 Today programme that he was “frightened that this is going to put more people off coming into social care, and that’s going to be difficult”.
“It feels like we’re fighting two battles, Covid-19… but also the government on many things, who don’t seem to understand social care,” he added.
Professor Martin Green, CEO of sector body Care England, said many issues remained unclear and that greater support would be needed.
“If regulation is the vehicle of choice as we have been led to believe in the press today, it is essential for the issues associated with mandating the vaccine for adult social care staff to be comprehensively addressed prior to its introduction. There must be central guidance, funding and leadership in helping to support adult social care providers in implementing the regulation. In other words, there must appropriate infrastructure support,” he said.
“There are many issues that are unclear, not least who are deemed frontline staff or indeed what vaccinated means, for example will this be a requirement for everybody working in any care home and what is the expectation on regular re-vaccination? It is vital that appropriate HR support is provided to employers.”
Confirming the decision, Hancock said: “After careful consultation we’ve decided to take this proposal forward to protect residents. The vast majority of staff in care homes are already vaccinated but not all, and we know that the vaccine not only protects you but protects those around you.
“Therefore we will be taking forward the measures to ensure the mandation as a condition of deployment for staff in care homes and we will consult on the same approach in the NHS in order to save lives and protect patients from disease.”
While many employers in the sector have gone to great lengths to convince staff of the need to be vaccinated, take-up in some areas has been low. The threshold deemed essential to protect residents is for 80% of staff to be vaccinated (and 90% of residents), but there are significant numbers of sites where this threshold has not been reached.
The Department of Health and Social Care published a consultation in April into whether vaccines should become a condition of employment for staff in residential care homes for older people.
Some care home operators have already made vaccines mandatory for new starters, including Care UK and Barchester healthcare.
At the beginning of the consultation, DHSC reported that 47% of care homes for older people in England still had more than a fifth of employees to take up the vaccine.
The Department is still to confirm its response to the consultation but a spokesperson said it was the government’s priority to ensure care home residents were protected.
“Vaccines are our way out of this pandemic and have already saved thousands of lives – with millions of health and care staff vaccinated,” the spokesperson told the BBC.
The government anticipates that all adults over the age of 18 will have had the opportunity to receive their first dose of the vaccine by 19 July, and almost 42 million have received their first dose so far.
One of the key concerns around mandatory vaccines for care home workers is that it could be considered in breach of their human rights. In January, the Parliamentary Assembly of the Council of Europe (the body that oversees the European Convention on Human Rights) put forward a resolution that vaccination should not be mandatory and that individuals should not be discriminated against for refusing the vaccine, although this resolution is not binding in the UK.
However, the Equality and Human Rights Commission’s response to the consultation indicated it would be reasonable to make vaccines compulsory for staff, providing this was a “proportionate approach” that would “help ease restrictions and allow them to perform their jobs safely, and residents to live more independently”.
Professor Green of Care England added: “It is also not understood whether legal claims will be brought against the government or the employer, the sector needs to be adequately funded and resourced to deal with all scenarios. This must not undermine the fantastic job that providers have done to listen and encourage their staff to be vaccinated.”
Kathryn Evans, partner and head of employment at law firm Trethowans, explained there could be a number of issues around mandatory vaccines. “If the government enacts legislation that makes a Covid-19 vaccination a requirement of a role, then it would follow that an unvaccinated person is not eligible for the role. So, unvaccinated persons could not be offered the job and the contracts of those who are already employed could become ‘frustrated’. This means a contract is void and unenforceable,” she said.
“If, however, the government requires a vaccine via a ‘reasonable management instruction’ from the relevant employer, then a refusal to be vaccinated will lead to disciplinary action rather than the frustration of a contract. This creates a wider employment issue under discrimination law, and in this case, indirect discrimination.” This could prove even more fraught as some groups with protected characteristics are less likely to take up the vaccine, she added.
“If this is adopted, this ‘one size fits all’ approach is fraught with legal complexities and could completely backfire on employers,” said Evans.
Referring to the proposed consultation around extending mandatory vaccinations across the NHS, the British Medical Association said that “compulsion is a blunt instrument that carries its own risks”.
“While some healthcare workers are already required to be immunised against certain conditions to work in certain areas, any specific proposal for the compulsory requirement for all staff to be vaccinated against Covid-19 would raise new ethical and legal implications,” it said.
GMB union national officer Rachel Harrison added: “Carers have been at the forefront of this pandemic, risking their lives to keep our loved ones safe, often enduring almost Victorian working standards in the process.
“The government could do a lot to help them: address their pay, terms and conditions, increasing the rate of and access to contractual sick pay, banning zero hours, and ensuring more mobile NHS vaccination teams so those working night shifts can get the jab.
“Instead, ministers are ploughing ahead with plans to strong-arm care workers into taking the vaccine without taking seriously the massive blocks these workers still face in getting jabbed.”
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A report by the Chartered Management Institute in March found solid support for mandatory vaccinations, however. More than half of managers (58%) it polled said that businesses should be able to make vaccinations a condition of staff returning to work.
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