Are government plans for compulsory vaccination of anyone working in a CQC registered care home in England a good idea?
The government’s regulations on mandatory vaccination in care homes take effect from 11 November, and the policy goes well beyond staff: anyone entering a care home must demonstrate that they have had a complete course of an authorised covid vaccine unless they are family and friends of residents, among other very limited exceptions.
All this is extraordinary. Even the government’s SAGE advisory group only recommended that a minimum of 80% of staff and 90% of residents be vaccinated. The Department of Health and Social Care’s own impact statement says the policy may result in the loss of 40,000 staff at a cost of £100 million.
There is a notable silence on the resources and funding needed to operationalise the policy. Currently it feels completely unworkable; care homes have limited powers to force the vaccination of those beyond their immediate workforce and volunteers. While they can renegotiate the terms of their contracts with suppliers, they cannot force vaccination on visiting health professionals, whose presence is essential to the health and wellbeing of residents. And it is not clear what the regulator will require in terms of evidence.
Care homes have been working hard to achieve the highest possible vaccine uptake in staff and the people we support. As I write, 77.4% of staff in older adult care homes have had both vaccines – in light of this, is the policy a good idea? Perhaps the reader can decide.
Liz Jones is policy director at the National Care Forum
I’m currently sitting on the fence, as I’m struggling to find a rock-solid argument either way. Initially, it felt easy to compare it to other walks of life.
Most people won’t hesitate to get jabbed before jumping on a plane to an exotic country with yellow fever, for example, and these jabs can have just as severe adverse effects as the Covid-19 vaccines. Indeed, I’ve seen someone go almost psychotic on anti-malarials they willingly ingested on a jolly to south-east Asia. So, on the one hand, it doesn’t seem too unreasonable to expect people to get vaccinated.
On the other hand, though, people have a choice when they travel. Anyone worried about the risk of a vaccine for a holiday could go to Scotland where the midges are mostly harmless. The government plans would be taking this choice away from people, which seems at odds with the pro-choice approach of the care industry, as well as the government’s insistence that care homes should risk assess every other aspect of Covid-19.
But, while I find myself thinking that perhaps we should just individually risk assess anyone who chooses not to be vaccinated, a niggling question keeps popping into my head: do I really want people working in our care homes who are willing to put others at risk based on unlikely odds of a risk to themselves? Some may argue this question isn’t fair, but it might just be enough to make me jump off the fence into the compulsory camp.
Charlie Hoare is managing director of the Huntington & Langham Estate care homes in Surrey
My charity exists to champion the rights of older people needing care or in care and we have heard the despair, loneliness and grief of many residents caused by restricted visits. Even now, when so much has been relaxed, large numbers are isolated and cut off from those who mean most to them.
Too many visits are still limited and timed, often without privacy plus PPE and masks. People are still left bereft in their rooms for two weeks after outside appointments. This distress and trauma adds to the confusion and desperation of residents with dementia, who often have additional disabilities including sight and hearing problems.
The prospect of vaccination for residents and staff seemed like a miracle. Sadly, though, vaccine hesitancy is prevalent in many settings. Before threatening compulsion, a well resourced and publicised national campaign was needed with a 24-hour helpline to listen to questions, answer doubts, provide data and reassure those still feeling hesitant.
Not everyone knows that there are now clear data showing that vaccination not only protects the pregnant woman, it is also very effective in protecting the unborn child. Our first duty, however, is to protect those who are often too frail and unable to speak up for themselves.
Perhaps some care workers will resign, but there must be something attractive about working in an environment which is made as safe as possible for everyone at such a worrying time.
Judy Downey is chair of the Relatives & Residents Association
In a free democracy no one welcomes the idea of supporting compulsory measures which appear to challenge either our personal beliefs or behaviours. However, there are times I feel when we need to think outside of our own mindset and consider the needs of others before ourselves, some of whom will be known to us but often in this case not.
Putting aside for the moment pressure from the media, I feel it important to consider the enormous impact covid has had on the care home sector, especially upon residents and staff, many of whom have been enormously affected by the pandemic. If all agreed willingly to be protected by the vaccine, then compulsion would be unnecessary.
But leaving legitimate health reasons that could be a reason to decline the vaccine to one side, one person’s choice to decline could potentially not just put them at risk but those entrusted to their care – not to mention colleagues who trust them to take responsible, considerate action.
It does appear that covid is not leaving these shores any time soon, and we therefore have as a society to support each other by using the means at our disposal to keep everybody, primarily the most vulnerable, as safe as possible. This will happen through everyone, wherever one works, being vaccinated.
Keith Oliver is an Alzheimer’s Society Ambassador and member of the 3 Nations Dementia Working Group Steering Group.
There can be no denying that the past 18 months have challenged everyone, particularly those of us supporting vulnerable, older people living with dementia in care homes. Yet the success of the vaccines and the percentage of the adult population “protected” far exceeds anything we could have expected in March last year.
There is no question that vaccinations are essential in protecting the health and safety of those living and working in care homes. However, how can enforcing a law that requires the social care workforce to be vaccinated but not health care staff be “a good idea”? Surely this further divides and devalues what should be two tightly integrated and essential services.
Why should a nurse or care assistant working in a care home lose their job for making an informed choice about not having the vaccine, although they would run no such risk if they were employed in a health rather than social care setting?
While I and my colleagues are in favour of anything that strengthens our defences against the virus, and agree with mandating the vaccination in our homes, I have to question the logic of enforcing vaccination for social care but not health care staff. After all, hundreds of vulnerable care home residents are treated by the NHS both as inpatients and outpatients each month.
Only by making the system fair across all health and social care settings will we be able to work effectively together.
Suzanne Mumford is head of nursing, care and dementia services at Care UK