UK government plans new vaccine requirement for frontline NHS staff in England

The UK government has announced plans for new rules requiring all frontline NHS staff to be fully vaccinated against Covid-19 from spring next year.

The regulations would apply to all staff, including volunteers, who have direct contact with people while providing care, such as doctors, nurses, dentists and domiciliary care workers – unless they are medically exempt.

The rules also apply to all ancillary staff such as porters and receptionists who may have social contact with patients.

The requirements are planned to begin enforcement from 1 April 2022, subject to approval of the regulations by parliament.

The planned changes are intended to ensure that ‘the maximum number of NHS staff are vaccinated’ which ‘will help ensure the most vulnerable patients gain the greatest possible levels of protection against infection’.

The government also claims that it expects the strategy to safeguard the resilience of the NHS and protect workers, ‘which is important for hospital trusts where extensive, unexpected absences can put added pressure on already hardworking clinicians’.

Mandated vaccinations for healthcare staff are controversial

According to government data, the overwhelming majority of NHS workers are already vaccinated. Over 92.8 per cent have already had their first dose and 89.9 per cent have already had both doses of a Covid-19 vaccine. In social care, 83.7 per cent of domiciliary care workers have had at least one dose, and 74.6 per cent have had both doses.

However, approximately 103,000 NHS trust workers and 105,000 domiciliary care staff are still registered as not fully vaccinated.

Despite data suggesting that Covid vaccination is broadly popular among NHS workers, most staff consulted during the development of the proposed vaccine policy were opposed to enforced vaccination for ‘direct treatment’ staff.

According to the consultation, 65 per cent of respondents did not support the policy of Covid vaccination being a requirement for staff undertaking direct treatment or personal care ‘as part of a CQC regulated activity in a healthcare setting’. Twenty-nine per cent said they were supportive or slightly supportive.

Healthcare and social care service managers were most likely to support the policy and were the only respondent group to be more supportive of the policy than unsupportive.

‘A longstanding precedent for vaccine requirements’

Support differed by type of respondent. Managers of healthcare or social care services were the most likely to support the policy, 57 per cent either fully or slightly supporting the measure, and were the only respondent group to be more supportive of the policy compared to unsupportive.

The ordinary healthcare and social care workforce was substantially less supportive of the measure at only 35 per cent support, with members of the general public surveyed by far the least likely to express support, and only 13 per cent being in favour of the measure.

Organisations providing health or care services were fairly split in their support, with 46 per cent supportive or slightly supportive and 48 per cent not supportive or slightly unsupportive. The variation in support by type of respondents was similar for Covid-19 vaccination if providing social care services.

However, the government state that there is ‘a longstanding precedent for vaccine requirements in NHS roles’, with ‘workplace health and safety and occupational health policies already in place for those undertaking exposure-prone procedures against Hepatitis B, such as surgeons’.

Additionally, NHS Chief Executive, Amanda Pritchard said: “The NHS has always been clear that staff should get the lifesaving Covid vaccination to protect themselves, their loved ones and their patients and the overwhelming majority have already done so.

“Working with NHS organisations, we will continue to support staff who have not yet received the vaccination to take up the evergreen offer. Vaccines are available free of charge and from thousands of vaccine centres, GP practices and pharmacies.”

Vaccine mandate for care home workers

The announcement follows the introduction of new rules mandating full Covid-19 vaccination for care home staff at all Care Quality Commission (CQC) regulated care homes in England, which came into force on 11 November.

Care home workers who fail to be fully vaccinated by the deadline could now lose their jobs under the new regulations.

The vaccine policy for healthcare is intended to be an expansion of this current policy, according to Health Secretary Sajid Javid.

However, the policy has drawn heavy criticism due to statements made by Javid on 9 November that approximately 32,000 care sector workers would not be fully vaccinated by the deadline.

The threat of job loss for these care workers could accentuate an already strained social care sector in England. According to the Department of Health and Social Care, the sector already faces a shortage of around 105,000 workers.

According to Mike Padgham, Chair of the Independent Care Group in a statement to the Financial Times: “If care homes do not have enough staff, in the worst-case scenario the facility would have to reduce the number of residents and if it wasn’t able to deliver care properly, would have to close entirely.”