Mandatory vaccination for NHS workers could lead to job losses.

For years, the NHS has been struggling with staff shortages and underfunding. Covid-19 has only added to these problems. To try and fight the pandemic, health Secretary Sajid Javid introduced the vaccine mandate, requiring all NHS workers to be fully jabbed against Covid-19.

However, with more than 100,000 home care workers, as well as a further 32,000 NHS employees still unvaccinated against Covid, we could be looking at worrying times for the healthcare sector.

With just under five months until the vaccine mandate deadline, there are warnings of up to a quarter of the NHS workforce losing their jobs.

So, what does this mean for the industry? How do employers react to the new vaccine regulations? What staff members are exempt from the vaccine? This article will answer all those questions, providing a complete guide for employers and managers.

What Is The Vaccine Mandate?

For the 1.45 million NHS’s employees in England, Covid vaccination is to become compulsory. This includes health and social care workers and domiciliary care workers. Staff must provide evidence of being vaccinated against Covid-19 to continue in their roles.

If they do not comply with the mandate, they could potentially face losing their job or be placed in an alternative role where vaccination is not required.

When Do Employers Need To Act On The New Changes?

On 11^th November 2021, the new government regulations were put into place. Based on the current vaccination guidance, between the first and second dose, there needs to be a 3, eight-week gap.

So, by the latest, all care home staff must have received their first dose by 16 September 2021. All other NHS England workers are required to be fully jabbed by April 2022.

Employers must act now to ensure they are fully prepared and on schedule to meet the regulations. By acting now, employers are able to:

Understand and document the vaccination and exemption status of staff members.
Actively encourage the uptake of vaccination.
Proactively plan workforce deployment for services.
Ensure that relevant staff can demonstrate they have either been fully vaccinated or are exempt from the requirement.

Which NHS Staff Are In The Scope For The New Vaccine Regulations?

Any NHS employee that has a responsibility of providing service in a care home funded by the NHS are within the scope. This will also include, but is not limited to:

Primary care, such as; dentistry, general practice, mental health, acute teams providing outreach into care homes, optometry and pharmacy, community health, learning disability and autism (MHLDA), end of life community teams, non-emergency patient transport services and staff attending to maintain medical equipment.
NHS and foundation trusts, community interest companies, social enterprises, voluntary organisations and independent sector providers delivering NHS-funded services, including sub-contractors.
Staff visiting care homes, but aren’t in a front-line caring role such as Continuing Health Care or a training provider.
All temporary, voluntary, bank and agency staff.

What Are Current Covid-19 Rates In The UK?

As of 12th November 2021, the statistics for Covid-19 rates and vaccinations are:

Daily Cases	37,243
Daily Deaths	214
Total Deaths	143,159
Vaccinations 1st Dose	75.5%
Vaccinations 2nd Dose	68.6%
Vaccinations 3rd Dose	19.6%

How Should Staff Show Evidence Of Their Vaccination Status?

NHS employees should show evidence of vaccination status by using either:

The NHS app
The NHS COVID pass via the NHS website
An NHS letter.

Who Is Exempt Under The New Regulations?

Under the new government regulations, there are various exemptions for employees to avoid the Covid-19 vaccination. Exemptions relevant for NHS-funded services include:

Employees deployed for emergency response. For the NHS, this is employees deployed as part of an emergency ambulance response, including community first responders.
People who have evidence of a medical exemption.
People who have used the self-certification process to prove they have been vaccinated overseas.
Under 18s.

Health care staff aged 16 or over are eligible for a vaccine. It is important to note they should ensure they get a full course of an MHRA-approved COVID-19 vaccine before they turn 18.

All 17-year-olds can book a vaccine up to three months before their 18th birthday. Visiting professionals aged under 18 can enter the care home without showing proof of vaccination status, however, may need to demonstrate proof that they are under 18.

Who Is Eligible For A Medical Exemption?

Those working or volunteering in care homes will need to provide evidence of a medical reason why they are unable to have a COVID-19 vaccine. While this list of exemptions is not exhaustive, here are some medical exemption examples from COVID-19 vaccination:

Those receiving end of life care where vaccination is not in the individual’s interests.
Those with learning disabilities or autistic individuals.
Those with a combination of impairments, resulting in the same distress
Those who find vaccination and testing distressing because of their condition and cannot be achieved through reasonable adjustments such as the provision of an accessible environment.
Those with medical contraindications to the vaccines such as severe allergy to all COVID-19 vaccines or their constituents.
Those who have had adverse reactions to the first dose (for example, myocarditis)

How Will Medical Exemption Be Obtained And Certified?

Those who are medically exempt from the Covid-19 vaccine can self-certify their medical exemption until 24 December 2021. However, from 25 December 2021, they can no longer self-certify a medical exemption.

By the 25^th December 2021, they must have applied for and obtained proof that they have a medical exemption. Then, they must use the NHS COVID Pass system to show they are exempt. We recommend immediately taking action and applying for proof.

Can Staff Who Are Exempt Still Be Deployed Into Care Homes?

Staff that have a medical exemption can continue to work in care homes as part of their role. However, there should be a health and safety risk assessment conducted and if necessary, advice from Occupational Health to assess whether any adjustments are needed.

What Should Employers Consider For New Staff?

Only once evidence of vaccination status or an exemption status has been provided can newly appointed members of staff start working in care homes.

During the recruitment process, employers are encouraged to insert a provision about vaccination. When recruiting staff that will likely work in care homes, candidates should be asked about their vaccination status.

How Can We Ensure NHS Service Disruptions Are Avoided?

Employers should proactively plan their workforce, only deploying employees that are fully vaccinated or exempt. Commissioners and systems should be informed of any service disruptions.

Providers must ensure care homes are aware of any changes to NHS service provision and employers are encouraged to continuously assess the impact on recruitment and retention activity, and patient care.

Are Commissioners Required To Update Contracts?

No. In accordance with the applicable law and guidance, providers must perform their obligations under The NHS Standard Contract.

Are Organisations Required To Update Policies And Procedures?

Unless exempt, all staff working in care homes are required to be fully vaccinated. Local organisational policies are required to be updated to show these changes in legislation.

Are Organisations Required To Keep A Record Of Staff Vaccination And Exemption Statuses?

All NHS-funded services must keep a record for every member of staff whose work requires them to go into care homes. The records must show whether they are fully vaccinated or have a medical exemption.

When it comes to the exemption, there is no need to record the clinical reason, only recording if a member of staff is medically exempt or not.

For the purpose of GDPR, an individual’s vaccination status will be ‘special category data’. Data must be securely stored, with access limited to those who ‘need to know’ for recruitment or deployment purposes.

What Steps Should Organisations Take If Employees Refuse To Be Vaccinated Without Exemptions?

When it comes to employees that are refusing to have the Covid-19 vaccine, it is recommended that employers, in partnership with local staff-side representatives take these steps:

1. Take time to have a supportive, understanding one-to-one conversation with the employee, establishing reasons for being hesitant about the vaccine.

2. Carry out a risk assessment for staff and services impacted.

3. Consider offering an alternate role or temporary redeployment within the organisation or wider health service. 4. Follow local employment-related policies and procedures, ensuring staff are supported to remain working in the health service.

Are Employers Required To Collectively Consult With Staff And Trade Unions?

With there being no change to the terms and conditions of employment, for this matter, there isn’t a requirement to consult.

Mandatory vaccination is a statutory requirement and employers are encouraged to engage with unions. They should collaboratively agree on methods to encourage staff to get vaccinated, as well as the most supportive processes to inform staff, discuss concerns and consider options.

Employers should refer to local partnership agreements, as well as consider taking their own independent legal advice.

What Happens If An Employee Doesn’t Want To Disclose Their Vaccination Status?

Any member of staff that enters a care home, unless exempt, must be able to provide evidence of a complete course of their COVID-19 vaccination.

To deal with employees not disclosing their vaccination status, employers can refer back to ‘What Steps Should Organisations Take If Employees Refuse To Be Vaccinated Without Exemptions?’, take a look at the DHSC operational guidance, or find more information here.