Mandatory vaccinations and medical exemptions of care home workers – government u-turn or a temporary reprieve?

It has recently been reported that care home workers are able to opt-out of the mandatory COVID-19 vaccination requirement by self-certifying that they are medically exempt.

Thursday 16 September 2021 was meant to be the deadline for all carers to have received their first COVID-19 vaccination. This mandatory vaccine requirement for all care home staff has been a source of constant debate since it was announced, with growing concerns that a significant number of care homes may be forced to close and thousands of staff from an already depleted workforce risked losing their jobs if they declined to have the vaccine. The government has been lobbied by both providers and unions that care home workers had been “singled out” and the very real possibility of the doomsday scenario of a mass exodus of care home staff in England, so it perhaps does not come as a great surprise that Whitehall has taken some evasive action (perhaps with an indication as to how many staff had refused the vaccine). However, how effective will this self-certification opt out process be and is it only a temporary fix to what has become a polarising political issue.

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ACAS guidance published – getting the COVID-19 vaccine for work

Our latest blog post commented on the new Government rules coming into effect from 11 November 2021 around vaccination for anyone who works inside a CQC registered care home in England. ACAS has published new advice for care home staff in England setting out how employers can approach the issue with their staff.

Following the suggestion that mandatory vaccination in a care home setting could lead to around 3-12% of care home staff being no longer able to work, the advice from ACAS focuses on helping employers to support staff and to provide strategies to avoid potential disciplinary action or dismissal.

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Mandatory vaccines for care home workers ‘irrational’?

The Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 was made into law on 22 July 2021 and is scheduled to come into force for 11 November 2021.

This development has garnered a lot of press coverage as it makes it a requirement that any worker in a care home environment has to have been fully vaccinated unless they are exempt from vaccination.

Although it  is not yet in force an attempt has been made to judicially review the lawfulness of it.

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Social care funding announcement by the Prime Minister

The Prime Minster has today announced long awaited plans for the funding of the English adult social care system.

This move has been proposed on several occasions by the governments of David Cameron and Theresa May. The present government’s December 2019 election manifesto promised to reform social care but didn’t give any details of how that was to be achieved. 

Today’s announcement confirms that extra funding will be achieved via an increase in National Insurance contributions of 1.25% from April 2022 onwards, rather than further contributions from higher rate taxpayers.  It comes after yesterday’s promise of extra funding for the NHS to tackle backlogs created by the COVID-19 pandemic.  People of a pensionable age who are still working will also have to pay this extra National Insurance contribution.  There will also be a cap on lifetime individual contributions. 

However the majority of the monies raised by the tax raise will be used initially to support the NHS in the first 3 years, although during this period the social care sector is due to receive an additional £5.3 billion per year.  After the NHS backlog is cleared, the government say the majority of this funding will be spent on social care. 

In his statement to the House of Commons announcing the plans, the Prime Minister referred to the COVID-19 pandemic having highlighted problems in social care, saying at the outset of the pandemic that there were 30,000 patients occupying hospital beds that could have been better cared for elsewhere.  However, we have constantly seen that the process of discharging a patient from a healthcare to a social care setting is very complex, and many factors may affect the speed at which they can be discharged from hospital, not just the amount of funding available.   Today’s announcement should not be seen as a quick fix to the complex problems the sector faces. 

With the general population living longer and a larger number of adults requiring social care, especially in later life, funding is clearly desperately needed.  Arguably the lack of investment in the sector over many years has contributed to a rise in claims and statutory investigations against social care providers.   Whilst care providers and their insurers will of course welcome today’s announcement, it will take a long time in our view for any noticeable difference to be seen in the sector on a day to day basis, and for the effect on the claims market to trickle through. 


Written by Jennifer Johnston at BLM jennifer.johnston@blmlaw.com

Personal Data and the Digital Transformation of the NHS

In 2019 the NHS Long Term Plan was published, including the NHS Digital Transformation Plan. It set out the aim of the NHS to change the way in which healthcare is accessed and provided, supplying digital services to patients and digital tools to staff and providing access to joined up patient records.

The COVID-19 crisis has accelerated this transformation and digital developments have been a key part of the response. Most people will be familiar with the NHS App and the technology that has been deployed in tracking and tracing the infection. Anyone watching Chris Whitty’s slide shows will also be in no doubt as to the part that the effective use of data has played in analysing and responding to the emergency.

Against this background, the Department of Health and Social Care has published a policy paper entitled “Data saves lives: reshaping health and social care with data” setting out its vision of the part that data will play in the digital transformation of the NHS, with the declared mission to “ unleash the unlimited potential of data in health and care, while maintaining the highest standards of privacy, ethics, and accountability.”

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MPs approve compulsory vaccinations in the care home sector

We recently commented on the government’s plans for vaccinations to become mandatory for all care home workers. Yesterday, MPs approved this initiative despite a small number of dissenting voices within the Conservative rank and file. Passing with a majority of 319 votes to 246, anyone working in a care home registered with the Care Quality Commission in England must have had two vaccine doses by October, unless they have a medical exemption.

The feuding within the Conservative party appears to focus on the lack of any published impact assessment of the policy before the vote (Health Minister, Helen Whately told MPs this was being worked on), something which many argue is imperative when balancing risks and imposing such measures on an entire (and already stretched) healthcare sector particularly in a group of workers which has a very low take up of the vaccine.

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Removing COVID restrictions – what will be the effect on the Social Care Sector?

The vast majority of COVID-19 restrictions are set to be removed in England on 19 July.  It’s worth noting that deaths in care homes with the involvement of COVID-19 have reduced substantially in recent months – see here for the most recent ONS statistics on reported deaths from care homes. But will this downward trend continue once restrictions are removed generally across the population, especially in view of rising infection levels? 

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Tort reform ideas outlined in maternity safety report?

Last week the Commons Health and Care Select Committee published what is likely to be a very significant report examining safety issues in NHS maternity care. The primary focus of the report is improving patient safety by learning from well-documented failings in East Kent, Shrewsbury and Morecambe and the report makes important recommendations on this aspect. A second strand of the inquiry was to review the effect that the current clinical negligence claims and litigation process has on improving outcomes and to consider if changes are necessary. The Committee found that they are and this blog summarises its recommendations on that topic.

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COVID-19 vaccinations – the right for healthcare workers to decide and the impact on social care

Most people who followed the press coverage in the UK following the public announcement of an ambitious national vaccination rollout would have foreseen the possibility for tension to exist between the public drive for everyone to be vaccinated against COVID-19 and the right of autonomy to refuse. The number of “anti-vax” conspiracy theories circulating online is simply staggering and some of the farcical claims really do beggar belief, notwithstanding the government’s attempts to allay these concerns. However, whilst many are content for individuals to make their own informed (or otherwise) decision, it becomes a far more emotive subject when the workers concerned are in the healthcare sector. Chances are, the majority of people reading this will have been affected directly or indirectly by COVID-19 and many more will have vulnerable or elderly relatives who rely upon the care and unwavering dedication of healthcare workers but it may not be a particularly comforting thought if the person providing that care to a vulnerable loved one were to refuse the vaccine.

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The Rise of Telemedicine

Telemedicine is a general term that refers to the provision of medical care at a distance through telecommunications technology.

Synchronous telemedicine is performed in real time, such as a video call between a patient and a provider. It can also be provider-to-provider such as when an A&E doctor consults with a remote cardiologist on the best treatment for a patient.

Asynchronous telemedicine includes “store-and-forward” technologies, such as online portals that allow patient–provider or provider–provider communications. It also includes chat bots such as those designed to help a patient decide whether to get tested for the virus that causes COVID-19 and remote monitoring of patients through wearable or implantable devices.

Advantages

Telemedicine comes in many shapes and sizes and offers many advantages over the traditional healthcare visit. Two key drivers of health and social care policy in the UK over the last decade have been related to patient convenience and controlling the growing budgetary pressures.  

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