Mandatory NHS Staff COVID Jabs in England by Spring

Tim Locke

November 09, 2021

Editor's note, 9 November 2021: This article was updated to include additional comment.

COVID-19 vaccination is to become mandatory for frontline NHS workers in England from April.

Health Secretary Sajid Javid has already said he was "leaning towards" making the jabs compulsory following a consultation and confirmed the plans in the Commons today.

Ten percent of NHS staff are not yet fully vaccinated.

"Having considered the consultation responses, the advice of my officials and NHS leaders including the chief executive of the NHS, I have concluded that all those working in the NHS and social care will have to be vaccinated," Mr Javid said. 

The move follows compulsory vaccination in England's care sector.

Mr Javid continued: "We must avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS, and of course protect the NHS itself. 

"Only those colleagues who can show that they are fully vaccinated against COVID-19 can be employed or engaged in those settings. 

"There will be two key exemptions; one for those who don't have face-to-face contact with patients, and the second, for those that are medically exempt."

Flu jabs, he said, will not be mandatory "at this stage". 

Mr Javid said he was "more than ready" to listen to the concerns of doctors and health leaders over his decision, which is subject to parliamentary approval.

He promised that: "No one in the NHS or care that is currently unvaccinated should be scapegoated, singled out, or shamed. That would be totally unacceptable." 

Risk Assessment

The British Medical Association (BMA) opposes mandatory coronavirus vaccination for doctors and health workers saying it could have a "devastating" impact on staffing.

Commenting, Professor Martin Marshall, chair of the Royal College of GPs, said the decision to ignore its views was "disappointing and sets a concerning precedent".

He continued: "The move to mandatory vaccination is particularly concerning at a time when we need as many people as possible working in general practice and across the health and care sectors delivering essential patient care and services. We can ill afford to risk losing staff with personal objections to the vaccine, however unfounded those objections may be, and we are unlikely to be in a better position with workforce pressures come next April."

Health leaders had called for the move to be delayed until April to help avoid worsening staffing pressures during the winter.

The NHS Confederation also wanted the Government to publish its risk assessment of how staffing levels across the NHS might be affected by the mandate.

Mr Javid committed to publishing an impact assessment.

Chief Executive Matthew Taylor, said in a statement ahead of today's announcement: "Mandating COVID-19 vaccinations in the NHS offers a further incentive for staff who are eligible but have not come forward yet to get jabbed at a time when the virus continues to be a threat and the NHS is working hard to deliver its broader services for patients.

"For this reason, we are relieved the Government has listened to our plea to roll out the requirement away from what is expected to be the most challenging winter on record.

"This will also give leaders much needed time to continue to engage and support the remaining staff who have not yet been vaccinated and to understand the possible consequences at a local level."

Staffing Issues

Commenting via the Science Media Centre ahead of the announcement, Danielle Hamm, director of the Nuffield Council on Bioethics, said: "Delaying making COVID-19 vaccination a condition of deployment for all healthcare workers until the spring is to be welcomed. It is important that the Government doesn’t rush into this as the policy could have serious implications for staffing, and health care workers are already in short supply as we head into winter.

"We urge the Government to now spend time exploring more thoroughly the reasons why some are not taking up the offer of a vaccine, and give full consideration to other incentives and interventions that may be more effective without risking serious consequences for staffing and care of patients."

Robert Dingwall, professor of sociology, Nottingham Trent University, said: "Mandating vaccinations is a superficially attractive but simplistic response to a complex problem."

He added: "It is also far from clear what problem is being solved, beyond symbolising that ministers are doing something. Studies have shown that while vaccination reduces transmission risk a bit, it does not fully prevent the transmission of infection in either direction. Health workers are still likely to become infected by patients and vice versa, although they will be less likely to develop serious infections or die. Similarly, patients will be protected, or not, by their own choices about vaccination. If other infection control measures are in place, will vaccination necessarily add very much?"

Jonathan Ives, professor of empirical bioethics at the University of Bristol, said: "This is a genuine moral dilemma – in which we cannot do right without also doing wrong.  I believe vaccination is a good thing, and the more clinical staff who are vaccinated the better the NHS will be able to cope with the coming winter.  I suspect mandating the vaccine will probably, overall, increase vaccine uptake amongst clinical staff, and will help the NHS cope with massive demands on it, which will benefit us all.  But this will come at a cost, and we cannot ignore the fact this kind of decision – even though it may be the right one overall – will also lead to people being both harmed and wronged.

"If vaccines are mandated, it is absolutely essential a conversation continues between the NHS and their vaccine hesitant staff.  Reason and persuasion are still the best way to go about increasing vaccine uptake, and making it compulsory must always be a last resort."



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