On 17 June Matt Hancock finally announced the previously leaked information that the UK government would be making Covid vaccinations mandatory for care staff. This information had been previously leaked, and by time of writing (21 June), 50,000 people have already signed a petition against the move.
The announcement came as no surprise to me, as I, like many others, suspected all along that the consultation period was a farce, and that the decision had already been made.
Certainly, our experience at Pelham House was that the government’s alleged public campaign to encourage care sector workers to participate in the consultation was far from prominent. My staff were unaware until I told them, and none of the promotion and education had reached us other than through me.
But the decision has been made, and now care workers have until October to decide whether to have the vaccine, or risk losing their jobs.
How do we feel about that?
I was interviewed by Julia George on BBC Radio Kent about the leaked announcement on 16 June: https://www.bbc.co.uk/programmes/p09k5zgv (10 mins in)
Since then, I have been thinking more about the wider picture, beyond our home in Kent, and understand the reasons for the move. I do understand the concerns, particularly in London where there are larger numbers of staff still unvaccinated, and a greater risk.
I also see that there are some positives to the move.
One good thing about this is that is promotes an enhanced image of an environment of safety in care homes. It is important, particularly after the government’s many failings in the care sector from the first wave of Covid, to show that we are prioritising safety in a world where we remain insecure about our existence.
Safety is a key priority of care for the elderly, and is a cornerstone of what we do. This is not simply an ethical stance, but is mandated in law. Our job is to keep people safe, as well as supporting and improving their quality of life, and protecting them from Covid infection feeds into that.
In that sense, you could argue that mandatory vaccination for front-line staff is a good thing.
But it does present some serious practical and ethical challenges.
What are the concerns about mandatory vaccination for care home staff?
Let’s consider vaccine efficacy.
The UK government’s own figures, published on 14 June say this:
“The analysis suggests:
- the Pfizer-BioNTech vaccine is 96% effective against hospitalisation after 2 doses
- the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after 2 doses
These are comparable with vaccine effectiveness against hospitalisation from the Alpha variant.
Further work remains underway to establish the level of protection against mortality from the Delta variant. However, as with other variants, this is expected to be high.”
What does this really mean?
The key words here are ‘effective against hospitalisation’.
No-one is suggesting that vaccination means that you cannot catch, or transmit Covid-19. Vaccination is effective in reducing the impact of the disease, but the virus, particularly the Delta variant remains transmissible, even with the vaccine.
I’ve had the double vaccine. It’s been fine, and I’ve suffered none of the publicised short-term side effects. It’s a new vaccine, we don’t yet know what the long-term effects might be, but for me, I decided accepting the vaccine was the best choice.
Not everyone feels the same. The reluctance amongst certain ethnic groups has been widely discussed, and the fact remains that many of these groups are widely represented among care sector staff.
What message does mandatory vaccination send to care home staff?
The problem with introducing mandatory vaccination is that it is a blunt instrument, which sends a very negative message to hard-working people in difficult, sometimes dangerous jobs.
The government says. “We’re going to make it law that you get vaccinated, and give you a timeframe (16 weeks) to get it sorted or you risk losing your job.”
The underlying message here is that the government does not have high regard for either the care workers themselves or the care managers. It demonstrates a low level of trust in us to make the right decisions, and suggests to me that the government puts a low economic value on these workers.
As I said in a previous article about this, it tells care workers that the government considers them to be dispensable.
The reality for care home owners and managers is quite different.
The decision leads to a huge amount of pressure for care staff, managers and owners due to the 16-week timeframe.
As a front-line worker, you have 16 weeks to review and digest the information, and decide whether or not to book a vaccination appointment (or two).
If you don’t, when October comes around, if you can’t be redeployed you lose your job.
And what do managers do if it gets to 15 weeks and 50% of your staff can’t be vaccinated? We’ve already been under constant and unbearable pressure for over a year – how to protect our residents and staff in the early days, how to deal with infections and deaths, how to maintain our residents’ quality of life in lockdown, whether and when to allow visiting…and now this.
Recruitment takes time.
At the moment, all my staff are vaccinated. But not every home can say the same, and recruitment needs can suddenly change. If we are forced to lay unvaccinated staff off, we can’t replace them overnight. Some of those staff may have been with us for years, and be mainstays of our homes, with strong relationship having been built with residents and their families.
These relationships are an under-sung, but crucial, part of caring from the elderly, particular people with dementia, as familiarity and consistency are frequently vital anchor points for their comfort and wellbeing.
We cannot replace that overnight, or even in 16 weeks.
Recruitment is hard enough, even at the best of times. I want to be able to recruit from the biggest possible pool of people, but now I will be restricted.
It begs the question, why only care home staff? Why not all NHS frontline workers – hospital staff, GPs, District Nurses? Why not the hospitality industry?
What do care home owners and managers need now?
We need an acknowledgement by the government that there are risks associated with this new policy.
We need the support to manage the government’s decision.
We need more time to review, digest and make informed decisions.
We need time for collective contingency planning across the sector.
We are likely to need to rely more on vaccinated agency staff to supplement our regular teams – these come at a cost, so we will need financial support in the form of grants or loans. (Let’s not forget that many of us will already have had to resort to loans in order to keep going after last year)
We need legal support. It is highly possible that the government could be found to be acting illegally. If a member of staff is sacked and goes to a lawyer, we need to be sure our insurers will cover that.
We need the insurance dimension covered. Insurers have been unwilling to help us over the last year, and have largely pulled out of the care sector. That needs to change.
The care sector itself needs to change. We need a louder, more united voice, and our associations need to bang the drum harder. Our staff need to be unionised – how else can they push pack?
Looking at this from a carer’s point of view – how would I feel?
I’ve seen death after death. I’ve risked my life to keep the residents I’m responsible for safe, whilst being begged by my family and friends not to go to work. I’ve worked through this before there was testing, and once testing was brought in, I’ve never tested positive. I’ve stayed healthy through all of this. I think I’ve done my bit, but now I’m being forced to choose between the risk of having a vaccine I’m uncertain about, and the risk of lose my job.
How would you feel?
Do you think the care sector and its staff are being treated reasonably?