Update on the potential impact of carers refusing vaccination

In our previous blog of 17 December, we considered the potential employment law implications for care homes where staff refuse to be vaccinated against COVID-19.  The vaccination programme is now picking up pace across the country, with the Government announcing earlier in the week that more than 4 million people had received their first dose. However, the daily figures for COVID-19 related deaths reached a peak of 1,820 on Wednesday, amid serious concerns that the vaccination programme is not being carried out quickly enough to stop the increasing number of deaths in care homes in recent weeks.  

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Preventing Future Deaths reports arising from COVID-related deaths

It has been reported that approximately 100,000 people have now died from COVID-19 in the UK. Vulnerable adults are at the greatest risk of the disease and it is understood that close to 20,000 care home residents died in the first wave last year. Recent reports from the Guardian show the deaths in care homes in England have increased by 46%, the highest level since mid-May last year.

The Chief Coroner’s guidance in March 2020 confirmed that COVID-19 is a naturally occurring disease and therefore is capable of being a natural cause of death. This clarified the position that a death arising from COVID would not ordinarily be referred to the coroner, however, such a referral would be considered justified if there were additional factors which meant that a report of death to the coroner would be necessary.

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Government backed indemnity schemes announced for ‘COVID-19’ positive care homes and Community Pharmacies administering vaccines

We have previously written about the UK government’s plan to set up designated settings for persons leaving hospital who require a care home but have a diagnosis of COVID-19.  This was originally outlined in the Adult Social Care Winter plan released in November, and each local authority was required to put in place plans to set up such facilities.  Part of the set up problems was the willingness of the insurance market to provide cover for these settings. 

In a written statement this week (18 January 2021), the Vaccines Minister Nadhim Zahawi has confirmed provision of a temporary government backed indemnity to provide cover for clinical negligence, EL and PL cover in the circumstances where a care provider cannot secure sufficient cover, or cover at all via the commercial insurance market.  The scheme is intended to run only until the end of March 2021 and, as such, has the feeling of a ‘stop gap’ solution.

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Potential impact of carers refusing to be vaccinated

As shown in the BLM Policy blog of 15 December 2020 (link here), COVID-19 (C-19) compensation claims appear to be gathering some momentum although, at this point, the total number of such claims that have been officially registered with the Compensation Recovery Unit of the UK Department for Work & Pensions remains very low.

As we have noted previously, new and untested questions on standard of care and legal causation would likely arise in any litigated C-19 claim. In this blog, we re-visit certain aspects of these potential questions in the context of vaccinations for care home staff.

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The continuing search for answers on COVID-19 and care homes north and south of the border

North of the border

As at 29 November 2020, there had been 2,315 COVID-19 (C-19) related deaths in Scottish care homes. On 27 May 2020, the First Minister of Scotland committed Scottish Government to holding a public inquiry into the handling of all aspects of the C-19 pandemic, including those relating to care homes, however calls are growing for a more immediate inquiry into the care home aspects.

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COVID-19: does the response of the regulators call for a fresh approach?

During the first wave of the COVID-19 pandemic, healthcare regulators reviewed their processes and made a joint commitment to take human and environmental factors into consideration when determining whether a complaint/incident reached the threshold for fitness to practise action.

In addition, the country saw an outpouring of support and affection for healthcare practitioners working hard to treat patients in hugely pressured and trying circumstances.

Alongside the guidance on relevant factors to consider during the life of an investigation, emergency registration was granted to recently retired practitioners under emergency powers granted by the Coronavirus Act 2020. Notably,  the GMC introduced guidance for decision makers on requests to relax or revoke sanctions or IOT orders in response to COVID-19 which allowed those whose registration was subject to restriction to apply for an early review of that restriction.

Do these changes reflect a change in what may be determined in the public interest and can healthcare professionals be reassured that such changes will remain in place once the impact of the pandemic has subsided? It may be more apposite to ask whether they should remain in place.

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High Court gives permission for judicial review into care home policies taken at start of pandemic

We wrote at the end of October about the crowdfunded legal challenge being brought against the UK Government in relation to their response to care homes at the start of the COVID-19 pandemic. Yesterday, in a remote hearing, Mr Justice Linden gave permission for this legal challenge to proceed to a full hearing.

The claimants, Dr Cathy Gardener and Fay Harris, are seeking a judicial review of the policies and related measures which had a bearing upon the protection of care homes between March and June 2020. They first formally brought their legal challenge in June, following the death of their fathers (who were both residents in care homes) from COVID-19 in April and May this year. As we have often reported in this blog, tens of thousands of care home residents have tragically died in care homes from (either confirmed or probable) COVID-19, since the beginning of the pandemic.

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Safeguarding issues for care providers during the COVID-19 Pandemic

The importance of Safeguarding vulnerable adults residing in care homes has never been more important than during the pandemic. Care staff, be they managers, a carer, nurses or personal assistants are all facing this challenge . 

The Care Act statutory guidance (para. 14.7, June 2020) defines adult safeguarding as:

“Protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.”

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Government’s plans to create ‘COVID-19 positive’ homes runs into difficulties

Last month we reported that the Department of Health and Social Care (DHSC) was putting place plans to set up so called ‘COVID-19 positive’ care homes where patients could be discharged to from hospital rather than regular care homes.  This plan was created with the intention of easing pressure on hospitals as well as ensuring residents are not admitted to care homes whilst potentially being infected with COVID-19.   Local authorities had been asked to confirm suitable locations for such facilities by mid-October with a view to having these facilities up and running by the end of November.

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New COVID-19 measures announced for care homes in England

The Department of Health and Social Care (DHSC) has this week written to English local authorities outlining plans to set up specific homes or units for people being discharged from hospital who are COVID-19 positive or are awaiting a test result.  The DHSC has asked local authorities to identify suitable settings by the end of this week, with a view to having these facilities fully operational by the end of November. 

This plan was hinted at in the Adult Social Care Plan that was published in September 2020, and follows existing requirements for all persons being discharged from hospital to a care home to have a COVID-19 test before discharge, and isolate for 14 days in any case upon admission or re-admission to a care home. 

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