By Barry Price of QCS (www.qcs.co.uk)
Nobody working in the care sector was surprised when the government announced last month that from October two Covid-19 jabs will be a mandatory requirement for many care workers. The government has been skirting around the issue for some months now and has been happy up until now to let care services adopt ‘no jab, no job’ policies. Many large care providers such as Barchester Healthcare have done exactly that.
But the narrative being played out by the tabloid media doesn’t tell the whole story. It has sometimes painted a picture of a selfish minority, who are reluctant to be jabbed and are thus putting vulnerable service users at risk. In doing so, the red tops have narrowed and diluted the debate. However, the reality is exceptionally nuanced and complex. As a care professional, who has worked in the social care sector for over a 15 years, I want to use this blog to dispel some of the myths and shine a light on what is really happen- ing on the ground.
Firstly, anyone looking in from the outside needs to understand that the social care sector is different to other sectors. It advocates and values person-centred care. Dignity and compassion lie at the very heart of this culture, while the sector champions diversity, equality and human rights for those delivering care and those receiving it. Therefore, this partly explains why many in the sector have been reluctant to enforce a compulsory Covid-19 vaccination programme within their homes and/or services. The National Care Association, for example, has gone on record to say that it does not believe that jabs should be mandatory at this stage.
But, here’s the rub. The care sector is one of the most heavily regulated industries in the UK. It therefore has a responsibility to ensure that service it is providing to the public is safe, effective, caring, responsive and welled. The question that many from outside of the sector are asking is, ‘How can those who refuse to be vaccinated provide a safe service to people to some of the most vulnerable people in society?’
We should remember that care homes employ some of the most stringent, robust and effective IPC measures in the UK to safeguard service users during Covid-19, but even a world-class IPC regime won’t be enough to reassure every service user and their families that they’re safe. This is why many large providers have already taken proactive action and insisted on mandatory jabs.
Me? I sit somewhere in the middle of these two radically differing positions. And I think most people in the sector do too. While those who work in the sector should never be bullied into having the jab, providing safe care in a person-centred environment must always be the priority. Having lost two members of my wider family to Covid-19, I’ve seen this invisible and insidious foe at its worse. Therefore, I do think we – as a sector – need to work harder to debunk myths, conspiracy theories and false information so that care workers come forward voluntarily to have their jabs.
However, as I wrote at the beginning of this piece, there is more to this story than meets the eye. Firstly, it’s important to say that at the time of writing the majority of people working in the sector – around 84 percent – have had one vaccination. By October, when vaccines become mandatory, that figure will be a lot higher.
Secondly, the government’s vaccination guidance is fairly opaque. It states that two Covid 19 vaccination doses will be a compulsory requirement this autumn for anyone working in a CQC regulated care home. However, other settings aren’t covered in the guidance. Domiciliary care services and supported living services are not mentioned. This seems nonsensical to me, as it is customary for care professionals working in these settings to move from one service to another – often on the same day. In theory this could make anybody who is unvaccinated a vector for the disease. In contrast, care homes are isolated environments where an outbreak of Covid can be much more easily contained.
While I don’t want to criticise the government, I do think guidance on Covid jabs needs to be clearer and more inclusive. As somebody who has spent a lot of time working with people with learning disabilities, the current guidance would mean that Learning Disability provision would continue to experience profound health inequalities. That is completely unfair and unacceptable in my opinion. Therefore, it would have been simpler and fairer to extend the protocol to include all CQC-registered settings rather than just care homes.
The question that we should be asking however is why is the government guidance so cloudy? I can only speculate – but when you consider that booster jabs are probably going to be needed in the coming months and years to keep Covid-19 at bay – it probably has something to do with a shortage of funding. Anyone who has worked in care will know that the ‘Cinderella service’ (as our sector is often nicknamed) receives much less funding than the NHS. However, if we are serious about containing Covid and providing other essential vaccines free of charge to care workers who need them, a properly funded and a joined-up social care system must be a priority.
Take the Hepatitis B jab, for example. It is freely available to NHS front line workers, but not for care staff supporting those with learning disabilities in the social care sector. While this disparity and many others like it need to be urgently rectified, I fear that if further Covid-19 variants lead to a booster vaccine being rolled-out across all age groups in the future, the narrative being played out may be very different. It may shift to one where the majority of care workers want a booster shot but many of them won’t be able to access it. If social care workers don’t feel protected, there is a danger that many will walk away. In a sector where there are over 100,000 vacancies each day, that really doesn’t bear thinking about. That is why pumping more money into our beleaguered but beloved care sector this summer must be top of the new Secretary of State’s in-tray.
Over to you then, Mr Javid…
Barry Price is a Specialist in Adults with Learning Disabilities and Complex Needs.
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