Home Home Care Homecare Association’s response to vaccination as a condition of deployment

Homecare Association’s response to vaccination as a condition of deployment

by Lisa Carr

The Homecare Association, the professional association for homecare providers in the UK, supports vaccination of the homecare workforce as it helps to protect those receiving and giving care from serious illness. From the outset, though, we have argued that persuasion is likely to be more effective than compulsion in encouraging uptake among the remaining workers with genuine fears about vaccination, without losing vital workforce capacity.

We are disappointed that the government has failed to recognise the risks of losing up to 25% of the regulated homecare workforce, between 120,000 and 140,000 careworkers as a result of imposing this policy. This could result in over 120,000 older and disabled people losing access to homecare. Unmet need is already high, and rising, at the same time that recruitment and retention of the homecare workforce has never been more difficult.

Councils are unable to help all those who need support in the community. NHS hospitals are reporting challenges in discharging people back home with support, due to inadequate capacity in homecare and other community services. This is contributing to ambulance queues and difficulty in reducing waiting lists, leading to unnecessary harm.

We are also disappointed that, once again, the government appears to be favouring unregulated care by exempting the 130,000 careworkers (20% of the homecare workforce) that work outside the regulated care system, from vaccination as a condition of deployment. If the government’s motivation is to ensure safety of older and disabled people, it is hard to understand why Ministers would choose to exempt unregulated care, which is not subject to oversight, requirements for careworker training or other checks and balances.

It will be of some comfort to the homecare sector that implementation of vaccination as a condition of deployment has been delayed until 1 April 2022. This buys time to attempt to persuade the remaining 25% of the homecare workforce that vaccination against COVID-19 is beneficial to them and the people they support, before it is too late.

We are grateful to colleagues in the NHS and local authorities for agreeing to support us with tailored approaches to persuading homecare staff to be vaccinated. Low uptake is a particular issue among young women, fuelled by internet misinformation on effects of vaccination on fertility and pregnancy. It is also an issue in some minority ethnic groups, whom for historic reasons have a strong mistrust of government. Both groups are disproportionately represented in homecare.
The Homecare Association continues to call on the Government to:

  • Provide proactive and targeted funding and support for the providers and regions most affected by vaccine hesitancy in the workforce as well as resources to support the whole sector.
  • Develop a credible contingency plan about how care will be provided if staffing shortages are exacerbated in April 2022.
  • Fund social care adequately so that homecare workers are paid fairly for the skilled roles they perform, and at least on a par with equivalent public sector roles.
  • End the practice of councils and the NHS of purchasing homecare “by-the-minute”, alternatively focusing on achieving the outcomes people want.
  • Support development of an expert-led workforce strategy for social care and a 10-year workforce plan, aligned with the NHS People Plan.
  • Consider adding careworkers to the Shortage Occupation List.
  • Create a professional register for careworkers in England, covering all paid social care workers in both regulated and unregulated care services. Registration of careworkers needs to be adequately funded and carefully implemented.

Commenting on the news, Dr Jane Townson, Homecare Association’s CEO, said:
  “The Homecare Association strongly supports vaccination of the homecare workforce and we lobbied hard, right from the beginning, to ensure it was as easy as possible for homecare workers to access vaccinations.

From the outset, though, we have argued that persuasion is likely to be more effective than compulsion in encouraging uptake among remaining careworkers with genuine fears. We are thus disappointed by the government’s policy decision; their bullying approach towards the health and care workforce; and their failure to acknowledge the potential risks of losing at least 120,000 careworkers. The government has no contingency plan for dealing with a potential loss of regulated homecare for over 120,000 older and disabled people. Who will care for them? How will councils and the NHS cope with the fallout?

We feel it’s very important to balance the mitigated risk of infection with the risk of unavailability of care at home for highly dependent older and disabled people.

Vaccination is a key line of defence against serious illness but was only ever part of a wider set of infection prevention and control measures. During the first phase of COVID-19, when there was inadequate PPE, no routine testing and no vaccines, homecare workers kept people safe and deaths from COVID-19 of people at home were very much lower than those in care homes. Data suggest that vaccinated people may be able to spread the delta variant of COVID-19 as readily as unvaccinated people. Careworkers have thus continued to follow guidelines on PPE, regular testing, ventilation, cleaning and other IPC measures.

Despite the challenges, good progress has been made and currently 84.1% of homecare workers have had the first dose of vaccine, and 75.4% the second dose. The extension to the 1st April 2022 is welcome, as we strive to encourage vaccine uptake in the remainder of the workforce.

We continue to believe that persuasion will be more effective than compulsion at encouraging vaccination of those with genuine fears, without losing vital workforce capacity

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