Staff in care homes could be required to have a Covid-19 vaccination, the health secretary Matt Hancock has confirmed, as he warned only around half of the facilities have enough people vaccinated to provide minimum protection against the virus.
Inoculation could become a condition of employment from this summer, Hancock said, as he announced a five-week consultation and revealed staff vaccination rates are still below 70% in 27 different areas of the UK, despite care workers being in the highest priority category for jabs.
“We have a duty of care to those most vulnerable to Covid-19, so it is right we consider all options to keep people safe,” Hancock said. “Older people living in care homes are most at risk of suffering serious consequences of Covid-19 … Making vaccines a condition of deployment is something many care homes have called for, to help them provide greater protection for staff and residents in older people’s care homes and so save lives.”
Close to 29,000 deaths in English care homes have involved Covid since April 2020, figures from the Care Quality Commission show.
However, care home operators are divided on the issue, according to Care England, which represents the largest operators. Barchester, one of the largest private operators, has already said it will make vaccines a condition of work under a so-called “no jab, no job” system starting on 23 April.
Barchester’s chief executive, Pete Calveley, said: “It is a professional duty for care home staff to accept the vaccine unless there is a medical reason they should not. As time has progressed, the safety, efficacy and transmission-reduction evidence has become ever stronger, which supports our initial view.”
But other associations, including the National Care Forum, which represents smaller operators, warned it could worsen existing staff shortages and leave care home owners open to legal challenges.
In February, the prime minister’s official spokesperson said: “Taking a vaccine is not mandatory and it would be discriminatory to force somebody to take one.”
Care England responded to the announcement on Wednesday by asking why the government is not considering making vaccines mandatory for NHS workers as well. Vic Rayner, chief executive of the National Care Forum, which represents not-for-profit care providers, said: “It is not clear how it can be possible to focus mandatory vaccines on only one cohort of staff working with older people, when older people are very likely to experience care and treatment interventions from health staff and a range of other professionals.”
Unison, the trade union which represents care home workers, described the plan as “the wrong approach”. Christina McAnea, its general secretary, called for persuasion rather than coercion of care workers, many of whom have cited fears, albeit unfounded, that the vaccine could affect pregnancies. Others have cited religious concerns, according to operators, while practical issues of not being on shift when GPs arrived to deliver doses have also been highlighted.
“Too heavy-handed an approach could backfire badly,” McAnea said. “Some staff may simply up and go, leaving a poorly paid sector already struggling with thousands and thousands of vacancies in a terrible state.”
Take-up of the vaccine among care staff in homes for elderly people in England has been considerably lower than among residents.
The latest NHS England figures show 94% of eligible residents have been vaccinated with at least one dose, compared to 79% of staff. Some areas, notably in London where the average is 68%, have considerably lower level take-up.
The Department of Health and Social Care said that the social care working group of the government’s Scientific Advisory Group on Emergencies believes 80% of staff and 90% of residents need to be vaccinated to provide a minimum level of protection against outbreaks of the virus. It said only 53% of older adult homes in England are currently meeting this threshold.
The staff vaccination rate is below 80% in 89 local authority areas – more than half – and in all 32 London boroughs, it said.
Hancock told parliament in a written statement that despite communications campaigns and attempts to tackle misinformation, “vaccine uptake amongst care home workers is not consistently at the level we know from SAGE advice is needed to minimise the risk of outbreak”.
Nadra Ahmed, chief executive of the NCF, supported the principle of 100% vaccination for care staff but said: “We have to be mindful we can’t be losing people from the workforce at a time when we don’t have people clamouring to join.”
She also highlighted the potential requirement to rewrite hundreds of thousands of staff contracts and the cost of fighting potential legal challenges.
There are an estimated 122,000 vacancies in social care, a sector which employs about 1.5m people.