Covid vaccines are compulsory for care home staff. Will community health and care staff be next?

Staff working in the adult social care sector now need to have had both doses of the covid-19 vaccine by 11^th November to work in Care Quality Commission regulated care homes in England, unless exempt. A final decision on whether all other patient facing health and care staff should be vaccinated against covid-19 and flu is expected this winter.

It’s a subject that has raised a lot of legal and ethical questions and strong responses both for and against from care workers, care home residents and their families.

The NHS has a precedent of requiring vaccination in people in certain roles. The hepatitis B vaccine is already compulsory for NHS workers carrying out exposure-prone procedures and although it’s not compulsory, the flu vaccination has been recommended for NHS workers since the late 1960s. So the idea of making a vaccination mandatory is not a new one. So why is there so much opposition to the covid-19 vaccine which will help protect our more vulnerable people?

There are currently estimated to be 120,000 vacancies in the social care of elderly and vulnerable people sector (September 2021, BMJ). With the vaccine being compulsory for care home staff from 11^th November there is a concern amongst some care home providers they could end up with severe staffing problems as they have to let go of unvaccinated staff. This in turn could potentially lead to a compromise in the quality of care provided and put residents at risk in other ways.

The impact on care homes may not be as disastrous as feared. For example, many care home providers are discovering that individual discussions with care home staff who are unsure about the vaccine are proving to be very successful in helping to answer questions and resulting in a higher uptake of vaccination. One well known large care home provider has said it supports mandatory vaccination and has found that after positive engagement with staff, less than 1% of workers have remained unwilling to vaccinate.

The actual outcomes of making the covid-19 vaccine a legal requirement after 11^th November for care home staff will of course play into the decision yet to be made by the government on whether all care staff and community staff should require compulsory vaccination too. The jury is still out on this.

If the government decide to make vaccination mandatory for all care and community health staff, it will need to consider fully the consequences, including the potential impact on trusts for suspending and dismissing staff who refuse to be vaccinated and redeploying them away from patients at a time when the NHS already has significant staff shortages. However, the consultation currently being carried out may well conclude that the benefits of helping to protect our most vulnerable from covid-19 far outweigh any of the possible negative effects. It does seem the logical next step to make vaccination mandatory for all community health and care staff, but watch this space, it could go either way.