As a health and social care worker do I have to have the vaccine?
No-one can be forced to have any treatment. In the case of vaccination which serves to protect individuals but also reduce the burden of disease, it can also help stop transmission of infection. Vaccination may be considered necessary to work in some areas and settings to protect vulnerable patients and clients and to help slow transmission of infection. The evidence for the COVID-19 vaccine is emerging all the time and available in COVID-19 vaccine surveillance reports.
The RCN recognise that there may be consequences for you at work if you have not been vaccinated.
Under the Health and Safety at Work Act and the UK Infection Prevention and Control (IPC) guidance, employers must ensure so far as is reasonably practicable, the health, safety and welfare at work of all its employees. This includes, conducting appropriate risk assessments that reflect the specific context workers are operating in. Also, 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. Vaccination however is just part of the overall measures to protect staff and patients. It is essential that other protection, such as adequate respiratory PPE should be in place.
Vaccination against certain diseases may be included in contracts of employment for new starters working in some roles and sectors. Every effort should be made to support staff to accept vaccination or deploy them to lower risk areas. This is similar to the policy for hepatitis b vaccine for health and social care workers which sits within the wider PHE exposure prone procedures and blood born virus guidance.
Employers will need to review risk assessments and those who refuse vaccination may not be offered employment. In some circumstances it may be possible to consider employing staff in a lower risk environment.
For RCN members on existing contracts who decide they do not want the vaccine their employer should explore their reasons with them. Where possible employers should consider redeploying staff to lower risk areas. However, it is acknowledged that for small providers this will not be feasible or practical. Where staff continue to refuse vaccination they may face dismissal.
If your employer is taking disciplinary action against you for refusing to be vaccinated see our guidance on dismissal.
Can a prospective employer demand that I have the vaccination as part of my conditions of employment?
This may be included in contracts of employment for new starters working in some roles and sectors. Every effort should be made to support staff to accept vaccination or deploy them to lower risk areas. 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.
Staff who decline vaccination should not necessarily be denied employment if it is possible for staff to be employed or redeployment to low-risk areas. It is recognised however, that in smaller organisations it may not be possible or practical to facilitate. As a result, where individuals refuse the vaccines recommended, they may be refused employment.
For RCN members on existing contracts who decide they do not want the vaccine, their employer should explore their reasons with them. If possible, employers should consider redeploying staff to lower risk areas. However, it is acknowledged that for small providers this will not be feasible or practical. The change to the legislation in England for staff working in regulated CQC care homes means that staff who continue to refuse vaccination could face dismissal. (see detail below)
What is the situation for staff working in CQC regulated homes in England?
Members who work in nursing and care homes, whether directly employed or providing care through a wider commissioned service in England will be required to be vaccinated from 11 November 2021.
For staff working in CQC regulated nursing and care homes providing nursing or personal care in England, amendments to The Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 come into force on 11 November 2021. The regulations apply to those directly employed within care homes. They also apply to those coming into care homes to do other work, for example, healthcare workers providing care via NHS or other services, tradespeople, and volunteers.
Those who cannot be vaccinated for health reasons, and friends and family visiting a resident, are exempt from the regulations. The regulations do not provide an exemption for religious or philosophical beliefs.
The DHSC operational guidance details the requirements and the exemptions to the regulations, these include:
- people who have evidence of a medical exemption
- people accessing settings in an emergency response, this would include emergency ambulance response, or emergency repairs being required
- friends and relatives visiting residents.
See also Temporary medical exemptions for COVID-19 vaccination of people working or deployed in care homes.
The NHSE/I letter and FAQs to providers details information for NHS organisations in England who provide care to residents in care homes.
The RCN will continue to work with employers to mitigate the impact on members’ employment as far as possible. The RCN recognises however, there may be consequences for members at work, if they have not been vaccinated, and their employer deems that vaccination is necessary (due to the law and/or health & safety risks present in the workplace). Please also see the employers’ responsibilities section below.
The DHSC are now consulting on a wider amendment to the regulation - Making vaccination a condition of deployment in the health and wider social care sector - so the scope of the changes may change to include wider heath care staff.
Can my employer dismiss me if I am not vaccinated?
Under the amended Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 it is a legal requirement for all staff working in care homes to be vaccinated from the 11 November 2021.
The regulations apply to those directly employed within nursing and care home facilities. They also apply to those coming into the facility to do other work, for example, healthcare workers providing care via NHS or other services, contractors, and volunteers.
The legislation currently only applies in England and to staff working in nursing and care homes either as direct employees or providing commissioned care via the NHS or other agencies to residents in nursing and care homes. We recognise however, that this might change to include wider multi-professional team.
The devolved administrations currently have no plans to introduce similar legislation, however, where organisations have provision in England but also have services in the devolved nations they may apply an organisational policy to meet the amended legislation in England. As such this could impact members working for these organisations in other countries.
For RCN members on existing contracts who decide they do not want the vaccine their employer should explore their reasons with them. Where possible employers should consider redeploying staff to lower-risk areas. However, it is acknowledged that for small providers this will not be feasible or practical. Where staff continue to refuse vaccination they are likely to face disciplinary procedures and potentially dismissal.
Those who cannot be vaccinated for clinical reasons, and friends and family visiting a resident, are exempt from the regulations. The regulations do not provide an exemption for religious or philosophical beliefs.
The DHSC operational guidance details the requirements and the exemptions to the regulations, these include:
- people who have evidence of a medical exemption
- people accessing settings in an emergency response, this would include emergency ambulance response, or emergency repairs being required
- friends and relatives visiting residents.
The guidance also includes information for managers and care homes on the process for monitoring of vaccination records of staff and those coming into the homes who are not exempt.
The NHSE/I letter and FAQs to providers details information for NHS organisations in England who provide care to residents in care homes
As set out in the ACAS guide on working safely during coronavirus, if your employer believes your reason for refusing the vaccination is unreasonable, this could result in disciplinary action on the basis you have failed to follow a reasonable management instruction. This will depend on the vaccination policy in place at your workplace and whether vaccination is necessary to do your job.
The RCN will continue to work with employers to mitigate the impact on members’ employment as far as possible. The RCN recognises however, there may be consequences for members at work, if they have not been vaccinated, and their employer deems that vaccination is necessary (due to the health & safety risks present in the workplace).
Also see our guidance on your employers’ responsibilities below.
If your employer is taking disciplinary action against you for refusing to be vaccinated see our guidance on dismissal.
I declined the vaccine and I have fallen ill with COVID-19. My employer says that I will not receive full sick pay. What can I do?
Check your sick pay entitlements as set out in your contract of employment. You should be paid statutory sick pay, but your employer may try to argue that any additional element of your sick pay should be withheld. The RCN position is that uptake of the vaccine is voluntary and should not be connected with any sick pay. You should check your employment contract to determine what sick pay is owed to you contractually. If you are unable to resolve the issue, contact us. A claim for unlawful deduction of wages and/or discrimination may be considered.
