• Kiri Thompson

Latest Update on Mandatory COVID-19 Vaccinations for Care Home Workers in England

Updated: Jul 26, 2021

The Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 were approved by the House of Commons on Tuesday 13th July 2021 by 319 votes to 246. The Regulations were then debated by the House of Lords on Tuesday 20th July 2021, after which the bill was approved by 221 content to 211 not content.

The Regulations will come into force after a 16-week grace period. This ‘grace period’ is intended by the Government to mitigate the risk of an immediate effect on the employment capacity in care homes by giving the vast majority of employees and workers the opportunity to receive both doses of an approved COVID-19 vaccination within that 16-week period.

It is important to note however that whilst such Regulations do usually extend to both England & Wales, these Regulations will apply to England only.

The operation and effect of the Regulations will be reviewed by the Secretary of State every 12 months after they come into force.

What is the intention of the Regulations?

The Regulations amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Government has said that the purpose of the Regulations is to reduce the spread of coronavirus in care homes to protect residents who are deemed to be most vulnerable to the disease.

They require that that “the registered person for nursing and personal care” in respect of the regulated activity of providing residential accommodation together with nursing or personal care in a care home in England, must ensure that no one enters the care home unless they can either

  • provide evidence that they have been fully vaccinated by an authorised vaccine against coronavirus, or

  • provide evidence that for clinical reasons, they cannot be vaccinated.

This includes employees, workers and self-employed persons who will be working in these settings.

Who will be eligible to enter a CQC-registered care home in England?

If the bill is passed, it is anticipated that only people who meet one of the following requirements would be eligible to enter a CQC-registered care home in England:

  • A service user or care home resident

  • A person under the age of 18

  • A friend or relative of a service user who is visiting that service user

  • A person visiting a dying service user

  • A person who can provide evidence that they have been vaccinated with a complete course of an approved and authorised coronavirus vaccination.

  • A person who is able to provide evidence that satisfies they are medically exempt from having been given a complete course of an approved and authorised coronavirus vaccination

  • A member of the emergency services attending a CQC-registered care home in order to deliver emergency assistance at that premises, or in execution of their duties

  • A tradesperson attending to deliver urgent emergency maintenance assistance on the premises

  • Any situations where it is deemed to be reasonably necessary for the person to attend the CQC-registered care home in order to provide comfort or support to a service user in relation to a service user’s bereavement following the death of a relative or friend

The Regulations will, however, cover a wide range of people who will not be automatically exempt which does include all employees, workers, tradespeople and service providers who may need to routinely enter a care home.

When will this change become effective?

The Regulations became active on 22nd July 2021. There will be an initial 16-week grace period to allow employees to obtain two doses of an approved COVID-19 vaccine, and this grace period will end on 11th November 2021 after which time the regulations are legally enforceable.

As highlighted in the House of Lords debate, the Government's full guidance for care homes in England around how employers are to deliver this message to their employees and workers, and the statutory process to follow for anyone refusing a vaccination after the 16-week grace period, has not yet been released.

It is anticipated at present, this much-needed guidance from the Government will be available around the end of July 2021.

In addition, it is anticipated there will be an assessment by Government of the effect on care homes in England should employees and workers become ineligible for work.

Therefore, from 11th November, anyone working in a CQC-registered care home in England for residents requiring nursing or personal care must have 2 doses of a COVID-19 vaccine unless they have a medical exemption.”

Who will be medically exempt?

The Regulations will be drafted in line with chapter 14a of the Green Book on Immunisation against infectious disease and The Joint Committee of Vaccination and Immunisation (JCVI) which reflect clinical advice.

Individuals may be exempt from the requirement to have a complete course of an approved and authorised coronavirus vaccination if they have a proven allergy or condition that the Green Book lists within chapter 14a, on page 16, as a reason not to administer a coronavirus vaccine. One example could be where a person has experienced a prior allergic reaction to a component of the vaccine, including polyethylene glycol (PEG).

Some individuals also have an allergy or condition where the Green Book or the JCVI advises seeking a professional medical opinion prior to proceeding with any coronavirus vaccination, on whether the individual should be exempt.

Both nationally and internationally, no concerning safety signals have been identified so far in relation to the vaccination of women who are pregnant. JCVI is continuing to review data on the risks and benefit of vaccination for women without significant underlying health conditions who are pregnant. As evidence becomes available, the Government states it will be reviewed, and advice offered as appropriate.

The policy will be reviewed if significant obstacles would prevent eligible workers from accessing vaccination in a timely and accessible way, such as due to vaccine supply issues or changes in national clinical guidance. For example, this would mean that if supply issues make it impossible for a member of staff to access a vaccination within a reasonable travelling distance, the requirement will not apply to that individual until the supply issue has been resolved.

The government will also follow JCVI advice, which sets out that at present, as a precaution, it is preferable for those aged under 30 with no underlying conditions to be offered an alternative to the Oxford/AstraZeneca vaccine, where one is available.