When the government announced that it was going ahead with mandatory vaccination of staff in nursing homes in England, it was not a surprise. At least 40,000 nursing home residents have died of Covid-19 so far in England and Wales, along with hundreds of brave workers.
Surely we have to do everything possible to prevent these figures from rising further as a result of the Delta variant, or any future variant. There is no doubt that this is what the government is looking to achieve by moving to a mandatory vaccination approach: it is a defensive strategy, based on the fear of a challenging winter fighting the coronavirus, in addition to perhaps the seasonal flu, to come.
However, I know that Age UK was by no means the only organization interested in social assistance that did not express full support for the idea when responding to the recent government inquiry. Of course, the best thing for older people is that everyone who interacts with them is fully vaccinated, whether they live in a nursing home or in their own home. What we were least convinced of was whether vaccinating this particular group of care staff, and doing it now, is the best way to get there.
The big potential problem with going the mandatory path is that it can cause some members of the residence staff to move to other work that they can do without having their Covid-19 hits. There is a huge annual turnover in social care, with up to one in three staff members leaving their duties. Some drop out entirely, but many move on to another company, lured by better terms and conditions. The fact that only members of the nursing home staff are required to be vaccinated means that a worker could move to a nursing home to help disabled young adults or receive home care instead. Or they could become health care assistants in the NHS, where they will find better salaries and prospects to do a nearly identical job – one or many issues affecting recruitment and retention of social services.
The risk that some of the nursing home staff who are hesitant about vaccinations would leave would be much less significant if the health staff were in better overall shape. exist about 120,000 vacancies, so about one in 10 roles is empty. Social care is the consummate “people’s job”, so the quality of care someone receives in a nursing home, for example, depends not only on the skills of the staff, but on having enough people. An older person with advanced dementia may require meticulous individual support to eat and drink enough during the day. If that is impossible due to understaffing, then they are at great risk of malnutrition and dehydration, threatening their health and even survival. One of the strongest arguments against mandatory vaccination, therefore, is that it runs the risk of worsening an already difficult employment situation, with dire consequences for residents. Remember, too, that these new regulations will affect temporary agency staff, on whom nursing homes have previously relied to fill the gaps, as well as permanent workers.
This is not the only recent blow to the welfare workforce. Brexit and the immigration rules that the government subsequently introduced mean that, as things stand, EU care workers will not be able to come here to work in the future. There are anecdotal reports that Brexit has prompted some of the existing healthcare workforce in the EU to return home. Such staff are mostly concentrated in London and other large cities, some of the places where vaccinations among staff are also known to be more prevalent, in part because there are a greater number of black African staff being investigated. Scholars have found it considerably more reluctant to take the vaccine than their white British counterparts. Thus, nursing homes in these areas potentially face a double whammy when it comes to staffing, if mandatory vaccination drives some workers to leave, in addition to Brexit.
I could consider mandatory vaccination as a last resort, but I am not sure that everything that could be done to encourage voluntary acceptance among residence staff has been fully attempted. The NHS has run some great webinars for healthcare workers to dispel the myths, but many will no doubt have been lost. The experience to date is that hyperlocal approaches, based on peer support, really work. With the government announcing a 16 week grace period Before the new regulations go into effect, I hope that nursing homes and councils will work together to encourage all workers who have not yet taken their jab to do so, especially in those areas where it is further afield.
This policy change would have landed much better had it been part of a funded reform package designed to give care workers the professional respect they deserve, and pay and conditions to match. It’s not impossible for this to happen later in the year, but on its own, mandatory vaccination seems to me and many others like too much stick and not enough carrot for a workforce that has given it their all and been through the fire. these last 15 months. , possibly with more to come.
George is Digismak’s reported cum editor with 13 years of experience in Journalism