NHS jab U-turn: Care sector cries double standards

The “no jab, no job” rule for NHS and social care workers is expected to be scrapped this week after Sajid Javid announced that the government will launch an urgent consultation on ending vaccination as a condition of working in health and social care settings.

A final decision on whether or not to reverse the planned mandatory vaccination policy has to be taken urgently as NHS trusts in England are preparing to start sending dismissal letters to unvaccinated staff from this Thursday – the final date for them to get their first jab if they wish to be fully vaccinated by the 1 April deadline. 

Fears that a vaccine mandate will exacerbate a staffing crisis have forced the government into a re-think. A leaked document drawn up by Department of Health and Social Care (DHSC) officials, and seen by the Guardian, warned that compulsory jabs could force over 70,000 unvaccinated NHS staff – 4.9% of the workforce – out of their jobs on 1 April. In some NHS trusts, the scale of loss would likely be even higher, with an estimated 1 in 10 members of staff yet to receive a single vaccine dose. 

Staffing fears aside, growing evidence of the reduced severity of Omicron – as well as the reduced efficacy of vaccines in preventing transmission of the virus – have made it harder to justify the ethics of denying NHS workers’ bodily autonomy. 

The anticipated U-turn will be welcomed by many health bodies. It comes after warnings from senior health officials such as Patricia Marquis, the Royal College of Nursing’s England director, who said: “Mandation is not the answer and sacking valued nursing staff during a workforce crisis is reckless” – especially when NHS England already has at least 93,000 vacancies.”

However, for those working in social care, the health secretary’s announcement is bittersweet. A compulsory vaccine policy was introduced in care homes back in November, and has already led to the loss of tens of thousands of staff. 

The lack of central staffing data on social care makes it difficult to know exactly how many care staff have left their jobs as a result of the policy. Sajid Javid has suggested that 19,300 staff have left, out of the 1.5m working in the sector in England, where the vaccine rule applies. But Nadra Ahmed, chair of the National Care Association, estimates that social care has lost closer to 40,000 staff since the mandate came into effect, adding that “the impact has been devastating” for the sector. 

Vic Rayner, chief executive of The National Care Forum, says the “no jab, no job” rule has contributed to “the worst staffing crisis we have seen on record in social care” – in an industry which was already struggling with over 112,000 pre-existing vacancies. 

Rayner has welcomed the decision to apply any rule reversal across the wider health and care sector. But, she adds: “The government has steamrolled through a chaotic policy with long term detrimental impacts on those who work in care homes and receive care and support. Care homes have been the unwitting guinea pigs through the implementation of this policy, and the impact on people must not be swept under the carpet.” 

Developments this week have played into a wider theme of the perceived double standards in treatment of hospital vs social care staff. 

Mike Padgham, chair of the Independent Chair Group, said: “We were robbed of thousands of staff back in November when the policy came in for care and nursing home workers and nobody lifted a finger. But when a similar threat is levelled toward NHS staff, the policy is reversed. 

“It is another in a long history of slaps in the face for social care, which, given the services it provides, should have the same respect as NHS care.” 

Even if a system is put in place to re-hire unvaccinated care home staff, the damage done may not be easily reversed. 

The NCA’s Ahmed has said the sector will do “everything it can” to try and encourage individuals to come back. But, she warns: “They will have found other roles and they may be happier in their other roles now and not want to move again.”

Adam Gordon, Professor of the Care of Older People at the University of Nottingham, fears it is “highly unlikely” that social care workers will want to return after leaving involuntarily and starting work elsewhere. Especially since “lots of social care workers have taken golden handshake payments from a logistics firm and now get better pay for a less stressful job.”

Christina McAnea, UNISON’s general secretary, has expressed frustration that the conundrum was “all so predictable.”

“Ministers were repeatedly warned that the vaccination rules would create chaos, but they chose not to listen. This is entirely a crisis of the government’s making.”