Compulsory staff vaccination for COVID-19 ignores the power of respect and persuasion
Mandatory coronavirus immunisation of care home workers is no way to treat staff who have shouldered a huge burden in the pandemic
The government’s regulations on mandatory vaccination in care homes have been approved and will take effect in all care homes in England on 11 November.
Much of the focus of the policy intent has centred on the staff employed in the homes, but it is important to recognise that the scope of the regulation goes well beyond staff.
Scope of the mandatory vaccine rules will be wide
Once enacted it means anyone entering a care home must demonstrate they have had a complete course of doses of an authorised COVID-19 vaccine – this means all staff, volunteers, visiting professionals, contractors and suppliers.
There is a small group of people to whom this policy does not apply, including: family and friends visiting residents and essential care givers; the medically-exempt; those under-18-year-olds, unless they are staff; and people responding to emergencies or urgent building maintenance.
No guidance yet on implementation
As things stand, there is no direct guidance or support available for care homes to support the implementation of this policy. This seems an untenable position for care homes, which have had the most extraordinary year-and-a-half of disruption and distress.
‘It is likely 7% of the workforce will not be deployable as a result of the new regulation… this feels like an astonishing risk to a sector that carries more than 100,000 vacancies on any given day’
To be faced with having to try to consult on and implement significant changes in contracts of staff who are burnt-out and under extreme pressure will have an impact on organisations.
Key government support that members of the National Care Forum – a membership organisation for not-for-profit care home operators – have have told us is vital includes:
- Indemnification against vaccination claims
- Advice and support on employment and HR issues
- Guaranteed access to vaccines
- Occupational health infrastructure and funding
We’re navigating a legal and logistical minefield – and with no support
None of the above has been forthcoming. As I write, thousands of organisations are battling through this legal and logistical conundrum without support.
The mandatory vaccination policy comes at the same time as increased pressure on staffing across adult social care services. Recent survey work with National Care Forum members shows there are high levels of staff resignations, with people leaving to join healthcare, retail and hospitality. Staff are citing stress, burnout and the opportunity for better pay, terms and conditions.
The government has determined it is likely 7% of the workforce will not be deployable as a result of this new regulatory requirement. According to the assessment, this means 40,000 staff are unlikely to be able to work in care homes any longer by the 11 November deadline.
‘People who work in care have been amazing through this pandemic, often sacrificing time away from family and friends – they have shouldered an extraordinary burden’
This feels like an astonishing risk to a sector that already carries more than 100,000 vacancies on any given day.
In addition, the impact assessment identifies an associated cost of £100 million to recruit and train replacement staff.
Yet, this assumption does not take account of the costs of policy implementation, which includes consultation, how to apply the government’s exemption criteria, and addressing individual situations and appeals.
Promoting staff vaccination in a respectful way
I completely understand how important it is we continue to raise the numbers of staff who are vaccinated in the care and support sector.
Our target should be to achieve the best possible coverage across every service – not just in care homes.
Providers have been doing an incredible job, working in partnership with local authorities and health colleagues, to enable staff who are not confident about vaccination to have the information and support they need to make the right choice.
This has been done in a way that is respectful to individual rights while making the case that vaccination is a crucial part in the armoury against COVID-19.
There has been great success with this approach, and there is so much more that can be done to strengthen the infrastructure of this local response to ensure that each and every person who wants to work in care, or is currently working in the sector, can access that support to work through their own concerns and questions.
Influence people comes from being supportive of them
People who work in care have been amazing through this pandemic. They have been consistent, they have often sacrificed time away from family and friends, they have shouldered an extraordinary burden.
Surely we know enough about psychology of influencing to understand that the decision to take up vaccination at this point will be best premised by an approach centred on respect and support – not one underpinned by an imminent threat to livelihood hanging over an individual’s head.
Further information
- Making vaccination a condition of deployment in older adult care homes: government response
- Mandatory immunisation in care sector workforce – government impact statement
- New law on mandatory vaccination
- National Care Forum
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