RCN position on mandating vaccination for health and social care staff
The RCN recognise that vaccination is a key pillar in infection control and disease prevention in healthcare settings. Ensuring there are high rates of vaccination among staff will be increasingly critical to limiting the spread of COVID-19 as seen in the COVID-19 vaccine surveillance reports.
The fundamental position of the RCN is that all members of the nursing team should have any vaccine deemed necessary to help protect themselves, patients, colleagues, family members, and the wider community. We consider this to be best practice. It is enshrined within the NMC code that getting vaccinated is the right thing to do for professional practice for all registrants.
All RCN members should take up the offer of vaccination. Employers across all settings are responsible for ensuring their staff know how and where to access the vaccine.
The RCN has significant concerns that mandating vaccines will further marginalise those who are currently vaccine hesitant and put further pressure on a hugely depleted workforce by forcing people out of employment. Evidence is already emerging of unvaccinated staff being put at risk of redundancy in care settings following recent changes to the legislation.
Recent surveys have suggested some staff may feel further marginalised if forced to have vaccines. See: COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: A mixed-methods study.
Like the wider population, health and care staff are a diverse group and there are both physical and societal barriers for some vaccine uptake. This needs to be addressed by all organisations and employers, who need to take a proactive approach, which includes:
- Ensuring staff have easy access to the vaccines they need within the working day.
- Providing staff with access to clear information about the risks and how to overcome or manage those risks, as well as information about the value and benefits of vaccination.
- Providing confidential support to staff who have any vaccine related concerns
These measures will help to achieve a high vaccine uptake, as demonstrated by the Tackling Vaccine Hesitancy WHO 2014 report.
Under the Health and Safety at Work Act (1974) employers must ensure, so far as is reasonably practicable, the health, safety and welfare at work of all their employees. This includes, conducting appropriate risk assessments that reflect the specific context workers are operating in. Within the assessment of risk, employers must consider mitigations that will reduce those risks, and this could require staff needing to be vaccinated when working with vulnerable groups and in front-line roles or redeployed to another area. No vaccine however, will provide 100% protection. It is therefore essential that staff are also protected by adequate respiratory personal protective equipment (PPE) and work within well ventilated environments with appropriate provision for breaks and rest as per the RCN healthy workplace guidance.
The requirement to have certain vaccines may be included in contracts of employment for new starters working in some roles and sectors which should be read thoroughly before signing to ensure employees are aware of these requirements as they commence their roles. Every effort should be made to support staff to accept vaccination or deploy them to lower risk areas if this is possible. This is similar to the policy for hepatitis b vaccine for health and social care workers which sits within the wider guidance to minimise the risk for staff in exposure prone procedures and blood born virus.
Changes to legislation on mandatory vaccination in England
The Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 were amended on 11 November 2021 making it a requirement for all staff working in CQC regulated nursing and care homes be vaccinated as a condition of their deployment to work. Following a further consultation the legislation was extended to include all staff working in any CQC regulated health care provision from 1 April 2022.
On 31 January 2022, the Secretary of State for Health and Social care announced that the policy on vaccination as a condition of deployment is being reconsidered. These changes with be subject to a period of consultation, parliamentary approval and will require a change to the regulations already laid.
The RCN response to the consultations for these changes are:
- Making vaccination a condition of deployment in older adult care homes
- Making vaccination a condition of deployment
The devolved administrations currently have no plans to introduce similar legislation, although a separate consultation is being considered in Northern Ireland for staff entering new contracts of employment.
The RCN will continue to lobby the DHSC make sure there is robust evaluation on the impact of changes to the regulations.
The RCN will continue to work with Employers to mitigate previous impact to legislation changes and support members previously affected.
Influenza vaccine: The RCN position on vaccination for staff having the influenza vaccine is clear and available on the RCN ‘Winter wellness’ resources and campaign page.