Last reviewed 21 April 2021

The Department of Health and Social Care (DHSC) has launched a consultation on making Covid-19 vaccination a condition of work for people who are deployed in care homes with older adult residents in England.

The DHSC said making vaccines a condition of deployment would help to further protect older people living in care homes, who are among the most vulnerable to Covid-19. The proposals make allowances for those employees who can provide evidence of a medical exemption from Covid-19 vaccination.

The consultation is looking at the scope of the proposal, any potential impact it could have on staffing and safety, as well as how it is implemented and who could be exempt. Staff, providers, stakeholders, residents and their families are being encouraged to respond.

The social care Scientific Advisory Group for Emergencies (SAGE) advises that 80% of staff and 90% of residents need to be vaccinated to provide a minimum level of protection against outbreaks of Covid-19. However, only 53% of older adult homes in England are currently meeting this threshold; this means nearly half of all care homes with older adult residents in England do not meet SAGE’s recommended vaccination thresholds for care homes and staff.

Health and Social Care Secretary Matt Hancock said that making vaccination a condition of deployment is “something many care homes have called for”.

Some providers, such as Barchester Healthcare, Care UK and Advinia Healthcare have already made vaccination of care staff mandatory, although there are exemptions such as if the employee is pregnant. Barchester takes the view that “providing safe care for those we care for is our paramount obligation”, supports the Government’s consultation and is encouraging other providers to support the proposal too.

National Care Forum CEO Vic Rayner said the consultation had “very significant implications” for care home residents, their families, the organisations who run care homes and the staff who work in them. She questioned how it could 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”.

She added that the shared aim must remain to “focus on what works to make sure that as many people as possible in social care are able to have the vaccine.”

Care England Chief Executive Professor Martin Green said the care sector was divided on whether or not vaccination should be mandatory but stressed: “it is wholly united in its support for the vaccine and has done everything it can to persuade its residents and staff to have it.”

He said that, should the vaccine be mandatory for adult social care staff working in care homes for older people, it begs the question whether it should not be mandatory for the NHS, those working in other care home settings, supported living, etc as well.

Martin Green also warned that the usual full consultation period is 12 weeks whereas this one is limited to five weeks, which constitutes a “curtailed timescale” for such an important issue where there may be differences of opinion and when care providers are experiencing additional pressures during the Covid-19 pandemic.

Care home workers are, in the meantime, being strongly encouraged by the DHSC to take up their offer of a vaccine now.

The five-week consultation, Making Vaccination a Condition of Deployment in Older Adult Care Homes, closes on 21 May 2021, with a final decision expected in Summer 2021. It is available at https://www.gov.uk/government/consultations/making-vaccination-a-condition-of-deployment-in-older-adult-care-homes.

What is the consultation considering?

Care home managers are ultimately responsible for the safety of people living in their care. Under the proposed change to regulations, it would therefore be their responsibility to check evidence that workers deployed in the home are vaccinated, or medically exempt from vaccination. This means that workers would need to provide evidence to the manager that they have been vaccinated.

As a result, the Government is carefully considering the best way for people to prove that they have been vaccinated to their employer. This may involve, for example, showing vaccination status on a mobile phone app. The Government is also considering the least burdensome way for people to demonstrate to care home organisations that they are medically exempt from vaccination.

Looking at how this requirement would be introduced, the Government is evaluating what would be an appropriate grace period for new and existing care home workers before they are required to be vaccinated. It is likely that care home managers would be expected to keep a record of vaccinations as part of their staff employment and occupational health records.

The intention is to permit care homes to retain a skilled, compassionate and caring workforce, keep the workforce and the people they care for safe, and make working in adult social care an attractive career choice. It is recognised that some people may choose not to be vaccinated, even if the vaccination is clinically appropriate for them. In these circumstances they will no longer be able to be deployed in a care home setting and providers will need to manage this in a way which does not destabilise the provision of safe, high quality care.

Care home managers are being asked to anticipate how they would respond to the requirement, thinking about staff who are not vaccinated. For example, would they expect to redeploy unvaccinated staff or cease employment for unvaccinated staff? These potential options should be taken into consideration.