Consultation Starts on Mandatory COVID Jabs for NHS Frontline Workers

Tim Locke

September 09, 2021

Editor's note, 9 September 2021: This article was updated with additional data and comment.

A 6-week consultation has begun on making COVID-19 and flu vaccination mandatory for NHS frontline workers in England to protect patients and colleagues, and avoid staff absences.

Vaccination status would become a condition of deployment, unless people are medically exempt.

Mandatory COVID-19 vaccination is already due to be put in place from 11th November for all care home workers, and anyone entering a care home, including medical staff.

The Scientific Advisory Group for Emergencies (SAGE) advised that there is a strong scientific case to have a similar approach for NHS inpatient settings.

Precedent

The Department of Health and Social Care (DHSC) pointed to a precedent for surgeons being required to have the hepatitis B vaccine.

NHS vaccine uptake is already high nationally with 92% having received a first dose and 88% being fully vaccinated.

However, DHSC said full vaccination rates for both doses varied from around 78% to 94% between trusts.

The national flu vaccination rate in the NHS in England was 76% last year but as low as 53% in some settings.

Clinical Risks

DHSC said the consultation will consider:

  • The level of interaction in a clinical setting between staff, patients, and visitors

  • The vulnerability of patients

  • High-risk procedures

England's Health and Social Care Secretary Sajid Javid said in a statement: "We will consider the responses to the consultation carefully but, whatever happens, I urge the small minority of NHS staff who have not yet been jabbed to consider getting vaccinated – for their own health as well as those around them."

Back Office Roles

Anyone refusing vaccination could be redeployed to 'back office' roles, Care Minister Helen Whately told Times Radio: "You can look at whether there are alternative ways somebody could be deployed, for instance, in a role that doesn’t involve frontline work, or doesn't involve being physically in the same setting as the patient, whether it’s, for instance, working on [NHS] 111, something like that."

Commenting, Dr Penelope Toff, co-chair of the BMA public health medicine committee, said: "The notions of making vaccines compulsory for anyone, including healthcare workers, is very complex and raises many ethical, legal, and practical questions. Vaccination programmes work best when people have a chance to get their questions answered and are able to make an informed decision.

"A thorough consultation is really important and the BMA will be responding to the Government’s proposals on behalf of the tens of thousands of doctors who are our members.

"While some healthcare workers have conditions in their employment contracts which require them to be immunised, for example against Hepatitis B, to work in certain environments, a proposal for compulsory vaccination of healthcare staff against COVID-19 and flu has far-reaching implications. It’s also important to understand that being vaccinated against COVID-19 doesn’t always prevent a person passing on the infection, so that when rates are high, other preventative measure, such as masks would also be needed. However, even if you have had the COVID-19 infection, vaccination is still the best way to protect yourself and others.

"We know that both COVID-19 and flu vaccine uptake among doctors remains high but that there are also small numbers of staff who are unable or unwilling to have the vaccines. There are a number of reasons for this and it’s important that all views are taken into consideration in this consultation." 

Matthew Taylor, chief executive of the NHS Confederation, said: "We will need to understand the detail of the proposals, but the focus must remain on increasing vaccine confidence and the approach taken to date to encourage uptake through informed consent remains the preferred option."
 

NHS Backlog

The consultation comes the day after MPs backed a rise in National Insurance to help fund social care and to tackle the NHS pandemic elective care backlog.

Figures released today for July show the number of people in England waiting to start routine hospital treatment has reached 5.6 million, a new high.

Fifty-two week waits were down to 293,102 from 304,803 in the previous month.

NHS England National Medical Director, Professor Stephen Powis, said: "NHS staff have pulled out all the stops to deliver millions more tests, checks, treatments and operations than they did last summer despite caring for many more COVID patients.

"Caring for 450,000 patients with the virus has inevitably had a knock-on effect on less urgent care and left a backlog but staff are working around the clock to make the best possible use of Government investment to treat as many people as possible.

"We do not know how many of those who held back from accessing care during the pandemic still need treatment, but we expect more to come forward in the coming months."

Siva Anandaciva, chief analyst at The King's Fund commented: "Even before COVID-19, waiting lists for treatment had substantially worsened. The significant investment the Government has now promised is very welcome but will not lead to an increase in the number of hospital beds or clinical staff overnight."

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