On the 14 April, the UK government launched a 5-week consultation around making Covid vaccinations compulsory for care workers.

I suppose we should be grateful that there is some consultation around this issue, but what is the likelihood that this government will actually take people’s views into consideration – particularly the views of the care workers themselves?

Throughout this pandemic, we have seen care homes and care for the elderly put at the bottom of the priority list, and people’s lives put at risk. At the beginning, there was a lack of PPE supplies, lack of guidance, the shunting of people from hospitals into care homes without testing. Then, more recently, the government, without warning, announced the easing of restrictions on visiting (effectively handing the problem of safety back to the already beleaguered staff in homes).

So you might think that I’d welcome the prospect of mandatory vaccinations for my staff, as a step in the right direction in terms of prioritising the safety of our vulnerable, elderly people.

But you’d be wrong.

I see this consultation (and who, realistically, believes that they haven’t already made up their minds on this?) as further evidence of the UK government’s lack of understanding of the sector, its position at the bottom of the priority list, and its poor perception of care workers.

It raises questions for me, of which the foremost is: Why is this policy being considered for care home workers only, and not all frontline NHS workers?

If government figures are to be believed, the vast majority of 65+ residents in care homes in the UK have now been vaccinated with at least one dose. We are told to trust the efficacy of the vaccine in protecting them, so why the need to mandate staff vaccinations?

Unlike in hospitals, staff care for the same people, day-in, day-out. They will know who has been vaccinated and who hasn’t, and their daily routines around safety are well-established, even for those residents for whom their conditions (like advanced dementia) make it more difficult. 

What does mandatory vaccination really say to staff?

  • It says: get vaccinated, or lose your job.
  • It says: you are not trusted to make this important decision for yourself.

Let’s look at a potential scenario.

You’re a care home owner/manager and you’ve lost staff due to the first and second waves of the pandemic. Some staff left early on out of fear of working in a care environment, others contracted Covid and are still unable to work, or perhaps even died. You’ve had to recruit, rebuild and retrain your staff. You lost residents in the worst stages of the pandemic, are still under-occupied, and, along with the emotional distress to everyone involved, your business is struggling to survive.

You have a long-standing member of staff who for cultural reasons is reluctant to get the vaccine. She is one of the best, who has been with you for over four years, is well-trained, and dedicated. She’s always there when you need her and she does the job for the love of it, and her dedication to people. She has great relationships with your residents and their relatives, who love her and appreciate the quality of her care.

She’s confused by the need to get the vaccine because of her job. She’s young, fit and healthy, and having worked in a Covid environment for the last year but embraced the safety measures, has never had symptoms and never tested positive. She lives alone, and is stringent in a practice of social distancing.

In her mid-30s, she’s nervous about some of the news about the effect of the vaccine on her age group, and the lack of clear information about its potential impact on pregnancy.

She isn’t refusing to have the vaccine, ever, but she wants more time to consider the options and make an informed decision. 

If the vaccine becomes mandatory, I cannot deploy her.

How am I to replace this valuable member of staff? 

What the government is really saying if it makes the vaccine mandatory for staff like her is: you are dispensable, surplus to requirements and easily replaceable.

Your employer can replace with someone else, who has been vaccinated, just like that.

It is insulting to her, and I resent the idea that I could be forced into making the decision to sack someone so valued in my team.

What if the government tells me I have to do it, and she gets legal advice? 

“You’re going to deprive me of my job. Prove to me how I am a risk to the residents who have now been fully vaccinated.”

The government having made it my call, and effectively passed the buck back to me, who is going to answer the unfair dismissal case?

What if I have to sack several members of my team, leaving me short-staffed? If we ever have a disagreement with the care regulator, Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, is the one that we all have to carefully consider – essentially that you have to keep people safe. 

So I find myself in a Catch 22 situation, where, in an effort to keep people safe, I am not allowed to put staff on shifts because they haven’t been vaccinated, yet that leaves me short-staffed, as (contrary to the government’s apparent belief) care staff don’t grow on trees and I haven’t been able to recruit to fill the gaps. 

What am I to do?

I can’t help but think there is a not so subtly hidden higher agenda here, and that this move is part of a longer term reduce care home numbers. We already know, in my area, that KCC wants to kill some of them off. To my mind, putting homes in a position of being unable to meet staffing requirements is just one way of ensuring some will perish.

As a care home owner, it’s hard to know how much more of this you’re expected to manage. Death is, of course, a fact of life in a care home. But over the last 12 months you’ve watched too many people die, your business has been in danger of going under several times, and now, instead of helping, the government is suggesting making it harder and leaving the burden on you to sort out. 


How much more can the care sector take?

June 4, 2021