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Covid Vaccines in the Care Sector

Following extensive public consultancy, in mid-2021 the Department of Health and Social Care (DHSC) announced that it was introducing mandatory COVID-19 vaccinations as a condition of deployment in Care Quality Commission (CQC)-regulated health and social care to protect healthcare and social care workers and reduce transmission in care settings.

With existing shortfalls in staff numbers and well-documented recruitment issues, it was feared the legislation would place further strain on an already beleaguered workforce following Brexit and the restrictions implemented during the pandemic.

The move was viewed as a huge blow to a sector with a history of chronic under resourcing at a time when demand for services was increasing. With thousands of existing care workers expected to leave their roles, senior people within the sector had legitimate concerns the social care system might collapse.

A change in policy

At the beginning of 2022, it was announced the DHSC intended to reverse its decision to mandate vaccination as a condition of deployment. The announcement came with only a matter of days remaining before the deadline for mandatory vaccinations was due to expire and was made with increasing pressure on the government to reassess its position due to crippling staff shortages.

Increases in the vaccinated numbers of healthcare and social care workers and changes to the risks to public health from new variants were cited as the basis for the U-turn, but thousands of experienced care workers had already been lost and leading organisations suggested the policy was never in the interests of patients’ safety.

Undermining confidence

Providers of health and social care emphasised that they were already encouraging staff to get vaccinated but forcing them to do so was unwarranted given other elements of society were not faced with the same ultimatum. The view of the DHSC was they had responsibilities based on core principles:

  • To develop the strong foundations of the vaccination roll-out programme
  • To protect people receiving health and social care, including the elderly and vulnerable
  • To protect care teams and support workers for their own health and so they can continue to deliver services

Figures suggest there remains a significant number of unvaccinated health and social care workers and NHS staff. Whilst this can perhaps be seen as a paradox, it may be due to concerns over a new vaccine or to a fundamental opposition to mandatory vaccinations, rather than a reluctance to be jabbed or lack of belief in the need for protection.

Hope for the future?

Jo Wilkins, Head of Care Support Services at Bush & Co, highlights the impact of the legislation:

The sector has experienced significant impact due to the mandatory vaccine legislation, with many staff leaving residential care services for new roles in the NHS or moving away from the sector altogether. Introducing a legal requirement has put further pressure on an already desperately understaffed workforce and undermined the morale of those within the sector, which is at an all-time low”.

Perhaps there has been an erosion of trust from health and social care professionals in the government, with many left frustrated by the passing of legislation and its subsequent reversal before even becoming active.

Care operators spent time and money on plans to mitigate the expected fall-out and invested a great deal of effort and emotional capital trying to convince staff to get vaccinated, only to see thousands leave. Whilst efforts are being made to convince them to return, it is likely their expertise and experience will be lost forever.

In the immediate future care providers will need to backfill the roles now vacant just to reach parity with where they were, which was chronically understaffed. A desperate shortage of staff in social care and the pressure this puts on providers and staff remains the fundamental issue and the cause of much of the turmoil in the sector.

How direct employment can help

For patients receiving care, the mandatory vaccination policy created further confusion and anxiety on top of that already caused by Brexit and the COVID lockdowns. Already reliant on a reducing number of professionals for their ongoing care, care teams were further decimated when vaccine hesitancy saw thousands of support workers leave or get terminated from the sector.

“Following catastrophic injury and the need for a care team within the home, anxieties are always high; people are unsure about the influx of clinical professionals in the home at a time when they are dealing with trauma, changes within the family etc. The increased confusion and anxiety that the mandating of vaccines and the reversal of the decision has brought upon many families means some people want to reduce the turnover of people working for them and receive their care from a dedicated recruited care team.” Jo Wilkins, Head of Care Support Services – Bush & Co

Care agencies are a popular source of health and care support staff, but another option available is direct employment, which uses available funding to recruit dedicated support workers to deliver packages of care.

Direct employment offers consistent and monitored care and places greater control with the patient, making them or a party on their behalf the recognised employer of their care team and allowing them to select and develop relationships with the support workers providing their care.

Bush & Co direct employment

Bush Care Solutions provides a range of comprehensive, cost-effective patient care management services based on the direct employment model, with dedicated Case Managers operating under delegated responsibility to oversee a patient’s care plan and perform a supervisory role over care teams and support workers.

Tailored packages of care can be developed and implemented, providing patients with all the benefits of being an employer and the comfort of knowing the administration is managed on their behalf. Support can be put in place for several areas:

  • Direct recruitment and onboarding
  • Training and supervision
  • Payroll
  • Case audits
  • Care Quality Commission (CQC) compliance
  • Care planning
  • Nursing support
  • Support and nurse led care packages