OPINION: Why the government remains hesitant around mandatory vaccination


Philippa Shirtcliffe, Head of Care Quality, QCS examines whether coronavirus vaccines should be made compulsory for care home staff.

Should the coronavirus vaccine be compulsory for all social care staff? It’s a question that many of the 5,000 providers, who have chosen Quality Compliance Systems (QCS) for content, guidance and standards, want answered.

So far, however, government guidance has been ambiguous and vague. In February, the Vaccines Minister, Nadhim Zahawi, appeared to suggest that it was “up to businesses to decide”, while Justice Secretary, Robert Buckland, gave an equally unclear response.

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When pressed by the BBC, an equivocal Mr Buckland advised providers not to take “a blanket approach” to vaccination and to have “a clear rationale” behind the decision to make to vaccination a compulsory step.

However, even before Mr Buckland made his comments, two large national care providers – Barchester Healthcare and Care UK – who between them employ over 20,000 professional carers – announced a ‘no jab, no job’ policy for all new starters.

Vaccine take-up

The announcement came after Health Secretary, Matt Hancock, revealed in February that three in ten care workers had decided not to be vaccinated. While it is a controversial subject, it is widely recognised that vaccine take-up is lower in the BAME and Asian communities, who, Skills for Care say, make up one-fifth of the social care workforce.

A survey by the Royal Society for Public Health (RSPH) found that only 57% of respondents from the BAME community “were likely to accept a vaccine”, while just 55% of interviewees of Asian ethnicity “were likely to say yes”.

It’s important to stress, however, that the RSPH survey is not sector-based, and it would be incorrect, therefore, to assume that take-up statistics in the care sector tally with figures quoted in the survey. It would also be wrong to assume that everyone turning down a vaccine is from the BAME community. What we do know, however, is that there are some residential homes – many of them located in large urban areas – that have high hesitancy rates.

Unlawful discrimination and equalities concerns

The obvious worry for many is that these homes or carers become vectors for infection, increasing community transmission. Anecdotally, I have heard service users and their families declining the services of care workers who haven’t been vaccinated – particularly in home care settings. Not only could this constitute unlawful discrimination, it creates a major equalities issue. It may effectively put anyone who refuses to be immunised out of a job – even those, who are unable – for health reasons – to be vaccinated.

Not only is this a moral and legal concern, it could also lead to many professional care workers leaving the sector. In a sector, which has always struggled to solve recruitment and retention challenges – an exodus of workers on top of the 112,000 posts that currently remain unfilled – would be nothing short of catastrophic.

IPC measures, contact tracing and testing will continue to be important

But much more than that, the public’s lack of confidence in services where care workers have not been vaccinated provides a telling insight into the public’s perception of the vaccine. Many see it as the ultimate panacea, which it is not.

The vaccine may be a scientific game changer, but not at the expense of Infection, Prevention and Control policies and best practice, which QCS has supplied to hundreds of thousands of homes throughout the pandemic.

Nor will the vaccine be wholly effective without PPE, face masks and a robust track and trace programme. If you don’t agree, just look at Taiwan, a country of 23 million people. It only received its first batch of vaccine on March, 3, but due to a world-class contact tracing, testing and isolation treatment programme, it has recorded just 976 cases of coronavirus and 10 deaths.

If the UK is going to prioritise vaccinations over everything else, however, governments must, in my view, do two things. Firstly, they must make it easier for all care staff who want a jab to get vaccinated. They could do this by inviting vaccination teams into the home.

Secondly, if care professionals receive the vaccine from their GP, care providers should pay them for the time it takes to receive the jab. In an industry where pay is low, these two single steps, would I believe increase take up.

Education and role models needed

That’s not to say that some care professionals have deep-seated fears regarding inoculation. The only way to combat them is to invest greater sums of money into vaccine hesitancy research instead of placing the burden responsibility on the shoulders of businesses.

This requires a three-pronged approach. More training needs to be given to Registered Managers so they address concerns and allay any fears that care professionals might have. At the same time, the government needs to build on its programme of appointing community champions.

While appointing celebrity role models is a good way of increasing take up amongst the young, the deep rooted respect that many local leaders command – particularly in BAME and Asian communities – should never be under-estimated. Schools too have an important role to play, especially when you consider that according to the BMA, there has been a decline in all routine immunisation since 2012/13.

Freedom of choice

But the flipside to all of this is that in a libertarian society like ours, no vaccine hesitancy programme should ever limit choice, freedom of expression or freedom of speech. If a care professional does not want the vaccine, their wishes must be respected.

With so many effective measures already in place to control the virus, it seems short-sighted that a talented, experienced but vaccine hesitant member of staff should lose their job for refusing a jab. But there’s much more at stake of course. To insist on such a stance, for many, would be a fundamental erosion of the basic democratic rights and values that we hold dearest.

To find out more about QCS, contact our compliance advisors on 0333-405-3333 or email

Tags : CoronavirusQuality Compliance Systemsvaccination

The author Lee Peart

1 Comment

  1. Fence sitting can get awful painful. If you back freedom of choice then also back hard pressed finally strapped care homes being PROPERLY funded to all have state of the art top quality infection control resources in place. Also if care home residents refuse to let “vaccine refusers” provide hands on personal care for them do you charge those residents with discrimination?

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