The care sector in England is reportedly facing its worst staffing crisis ever. The UK government has launched a recruitment campaign to fill over 105,000 vacant posts. However, the government is also mandating from November 11 that care home workers in England be fully vaccinated against COVID-19 unless medically exempt, and this has the potential to make these staff shortages even worse.
Even the government’s own analysis has found that a “no jab, no job” policy could lead to thousands of care workers leaving their jobs. Employers and trade unions too have warned about the likely impact that mandatory vaccination will have on staffing.
Only a small minority of care-home workers remain unvaccinated: by the end of September, 87% were already double-jabbed. To understand why so many in the sector oppose mandatory vaccination, and the likely impact this policy could have on staffing, the low pay and poor conditions that many care-home workers experience provides crucial context.
Care workers typically receive low wages. The median hourly pay) is £9.01. Further, 24% of care workers have a zero-hours contract, meaning they have no guaranteed employment. When your pay is low and you have unpredictable shifts, you simply cannot afford to miss work. Which brings us to the fact that many care workers do not receive sick pay either.
When I went for my vaccine, I knew that if I felt unwell afterwards I would get paid sick leave. Many care workers faced having to take unpaid leave if they experienced any temporary side effects. Some had to take unpaid leave to simply go to vaccine clinics.
By increasing pay and providing paid time off, regular hours and sick pay, employers can effectively help more workers get vaccinated. Employers argue this would require investment and they are right. The care sector has been underfunded for decades. More than a recruitment and retention crisis, this is a crisis of work.
Many care home workers are burned out by the pandemic. When wages are low and the job comes with a high risk of exposure to COVID-19, it is unsurprising that added heavy pressure from employers to get vaccinated might be the last straw for anyone who might be vaccine-hesitant. Research has shown that the way to overcome vaccine hesitancy is not through pressure, but persuasion and reassurance and by removing practical barriers that stop people from easily attending appointments.
In the short term, care providers are warning that their services may have to be rationed if the staffing crisis deepens. Looking further ahead, the way in which care workers’ concerns about mandatory vaccination were ignored has eroded trust between workers and employers and between unions, employers and the government.
This matters because the government has promised wide-ranging changes for the adult care sector. If reforms are to be successful, then everyone involved, including care workers, needs to be involved in their design and implementation, and listened to.
The government has confirmed plans to introduce mandatory vaccination for NHS staff in England, by April 1, 2022. Even if only a tiny percentage of NHS staff were to remain unvaccinated and left their roles, either voluntarily or involuntarily, the acute pressures facing the health system in terms of underfunding, growing backlogs, staff shortages and the ongoing pandemic, could deepen significantly.
Lessons from care will need to be swiftly learned to avoid this nightmare scenario. Persuasion, not pressure, and improving workers’ pay and conditions are crucial factors to help to overcome vaccine hesitancy.
The support of the Economic & Social Research Council (award ES/P009255/1, Sustainable Care: connecting people and systems, 2017-21, Principal Investigator Sue Yeandle, University of Sheffield) is gratefully acknowledged. Tom Hunt is a Senior Fellow of Unions 21. He is a member of the Labour Party.