Growing number of care providers are making it mandatory for new staff to have Covid vaccine

A growing number of care home providers are taking the plunge and making it a requirement for any new staff to have the COVID-19 vaccine, so they can offer greater protection to residents.

The virus has ripped through thousands of care homes during the pandemic causing the deaths of over 30,000 residents. So it is no surprise that the vaccine has been warmly welcomed by residents, with around 95 per cent now having received the jab.

However it is a very different story when it comes to care home staff. The latest data from NHS England reveals three in 10 care home staff have not been vaccinated against the virus, with figures showing over 444,200 staff in care homes for older people are eligible but only 322,534 have had the first dose.

NHS England revealed that in London, only 52 per cent of care home staff have had the jab, with the number rising to 75 per cent in the south west of England. It is similar for NHS staff, with London having the highest refusal rate, with 24 per cent turning down the vaccine. Ninety-one per cent of NHS staff across the country have had the jab.

Vaccine is expected to 'reduce risk' of transmission'

Care providers are doing their utmost to encourage staff to have the vaccine as UK’s deputy chief medical officer, Professor Jonathan Van-Tam, has said even though it is too early to know whether the vaccine will stop transmission of the virus, “we do expect it to reduce this risk”.

The National Care Association has revealed some care workers are refusing the vaccine for ‘cultural reasons’ while others are doing it on health grounds or are worried it has been fast-tracked and not been tested on enough people.

Dr Farzana Hussain, a GP in London, has found people have a whole range of concerns including misinformation around infertility and the use of animal products. Others have raised concerns on religious grounds, such as an uncertainty around whether it would break fasting during Ramadan.

In order to boost the take up, some care providers have decided to go that step further and make it mandatory for all new staff unless they have a medical reason. This includes Barchester which has 239 care homes and Care UK which has 129 care homes.

A spokeswoman for Barchester told carehome.co.uk “Overall, we are seeing strong uptake and positive engagement with COVID-19 vaccination. As of 24 February, we are delighted that 90 per cent of our residents and 82 per cent of our staff have now had at least the first part of the COVID-19 vaccine, and many more are awaiting their vaccine following being COVID-19 negative for 28 days.

“Following staff engagement and a full risk assessment, we have introduced a new policy in which we expect all staff to have had the vaccine by 23 April 2021, although we are prepared to delay that date if there is any data regarding safety, efficacy or effect on transmission which requires further review. We have set out a number of acceptable exemptions, including, at this stage, pregnancy, and exempted staff will operate with enhanced PPE.”

'Concerns around possible discrimination' is not our intention

The spokeswoman added: “We are very aware of concerns around possible discrimination which is in no way our intention. We are doing everything possible to ensure fairness whilst also delivering on our duty to protect our residents, patients and staff.”

Care UK is another big care provider going down the mandatory path, with a spokeswoman telling carehome.co.uk: “For new recruits, we now ask at both the application and interview stage whether they have had, or would be willing to have, the vaccination. This means, right from the outset, that they are fully aware of the need for new colleagues to be vaccinated as a requirement we make to keep residents in our homes safe. So far this has not proved a barrier for those keen to build a career with us. This approach is becoming increasingly common across the care home sector.

“For existing employees, we’ve found the vast majority of team members have been very keen to be vaccinated and have been coming in on their days off to do so. GPs and vaccination teams have been fantastic in talking them through any concerns. We are also offering colleagues a comprehensive suite of information about the vaccines from reliable, unbiased sources so they have the facts to make an informed decision. This has included video messages from respected senior nurses and other colleagues talking about why they’ve been vaccinated.”

Advinia Healthcare, which runs 36 care homes, is also adopting this stance. Dr Sanjeev Kanoria, its founder and chairman said: “As he UK looks to welcome visitors back into homes, it is essential that we have as much vaccine take up amongst care staff as possible. At Advinia, most of our team are now vaccinated, and we are addressing any concerns that are preventing uptake on an individual basis. We have also revised our recruitment and employment policy and expect all new staff to have been vaccinated or to participate in the vaccination programme before joining us.“

Mario Kreft, chair of Care Forum Wales, which represents care homes in Wales believes: "It is clearly sensible that care homes should be allowed to refuse to recruit anybody who has not been vaccinated."

He said: "I think everybody who works in social care should, unless there's a very good reason otherwise, get the jab and importantly be ready for a culture where we might have to have this each year for some years to come."

'NHS and care home staff have 'professional responsibility' to get vaccinated'

Prof Chris Whitty, the chief medical officer, has said NHS and care home staff have a "professional responsibility" to get vaccinated and ministers are currently said to be in discussions over plans to make it compulsory for NHS and care home staff to have the vaccine.

However the union Unison has said “forced vaccinations are the wrong way to go”.

Currently some NHS trusts do require some of their staff to have the hepatitis B vaccine if they work in a high risk setting.

James Sage, head of the health & social care sector team at Royds Withy King, has said the low take up of the vaccine by care workers “creates significant operational challenges for care providers”.

However he points out “there is currently no legal basis in the UK to make vaccination for Covid-19 mandatory. In fact, the Public Health (Control of Disease) Act 1984 specifically precludes any government regulations from ‘requiring a person to undergo medical treatment’ which includes vaccinations. He says: “Requiring care staff to have the vaccine is unlikely to be a reasonable management instruction. Dismissal for refusal to have the vaccine is unlikely to be fair.

“Making it a requirement for staff who refuse because of a protected characteristic such as disability, pregnancy or religious/philosophical belief could lead to potential discrimination claims, which may be difficult to objectively justify.”

The MHRA has said people with a history of significant allergic reactions should not have the Pfizer/BioNTech COVID-19 vaccine, after two people suffered adverse reactions. While the World Health Organisation (WHO) advises pregnant women not to have the Covid vaccine unless they are at high risk of exposure.

'Requiring new staff to be vaccinated could be lawful in some cases'

However with the huge number of deaths in care homes being one of the biggest tragedies of the pandemic, care providers are under pressure to make their care homes as safe as possible.

Mr Sage does add that “requiring new staff to be vaccinated could be lawful in some cases; however, care needs to be taken where an applicant for employment does not want to be vaccinated because of a protected characteristic.” He warns that “refusal to offer a job in those circumstances could give rise to discrimination claims”.