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William Lee, Policy and Parliamentary Executive of the British Healthcare Trades Association

Following the UK Government’s decision to suspend its plans to introduce mandatory vaccination for frontline health and social care workers, William Lee, Policy and Parliamentary Executive of the British Healthcare Trades Association (BHTA), highlights the challenges around clarity of guidance for businesses and the NHS that now must be addressed.

If a week is a long time in politics, what constitutes a long time in policy?

Eleven-and-a-bit weeks, apparently – that’s the elapsed time between the UK Government’s 09-Nov-21 decision that all frontline health and social care workers in England must (from 01-Apr-22) be fully vaccinated against COVID-19 as a condition of deployment (VCOD) and their 11th-hour reversal: the Department of Health and Social Care (DHSC) announced on Monday, 31-Jan-22 that the legal requirement for vaccination will be revoked (see also Sajid Javid’s statement to the House of Commons on the same day). This change will be subject to public consultation, the approval of Parliament, and – crucially – will require a change to the previous VCOD regulations already laid (more on this last point in a moment).

At the time of the government’s original decision, we expressed conditional support – we understood the desire to take all necessary steps to protect healthcare workers and the public – but we stressed that mandatory vaccination was only 50 percent of the solution. BHTA outlined four key areas of support, from both the financial and policy perspectives, that government needed to address to forestall potential economic fallout from the decision. And BHTA, its member companies, and other health and social care representatives highlighted to government one of the most foreseeable negative effects: complex issues arising from workforce deployment.

The BHTA can’t but be pleased by the relief this reversal will bring to the health and social care sector. The NHS and its delivery-partner businesses (many of whom are BHTA members) were facing redundancies among those who remained unvaccinated, with dire personal consequences for employees and serious, costly workforce implications for employers. Now is not the time to lack for any frontline health and social care workers for any reason, nor to introduce more stress, complexity, and expense for those working so hard to deliver for patients in the third year of the pandemic.

We do, however, note the frustration of nurses, NHS administrators, and businesses at the route that has led to this last-minute reversal, and we are very concerned about the risks that mixed messages present for BHTA members (businesses trying to provide the very best for patients as partners with the NHS across the health and social care landscape).

Most important now for the NHS and its delivery partners is immediate, clear, easy-to-follow guidance from the centre. Only this will allow the maximum number of health and social care workers back onto the frontline to serve patients, both COVID-19 patients and those affected by COVID-induced backlogs. Previous VCOD guidance on planning and deployment was both vague and lacking in detail – especially with regard to which categories of employees were and were not in scope for VCOD. As well, the guidance was a minimum standard, beyond which individual NHS Trusts were able to set their own rules and apply their own interpretations.

This was – and is – unhelpful. It creates too much opportunity for delay, confusion, and “one-size-fits-none” customisation-complexity for delivery partners who work with many NHS Trusts and are faced with a different set of rules for each one. Now, after having pulled out all the stops in an effort to comply with the original, mandatory VCOD regulation, individual NHS Trusts are being told by government in a 31-Jan-22 letter: “we’ve removed the legal requirement for vaccines, but you’re in a holding pattern when it comes to frontline staff deployment.”

And indeed, a legal change to the previously-laid VCOD regulations is a necessity – but NHS Trusts and their delivery partners need direction now on who can work on the health and social care frontline. Surely, with all else that has been possible during the pandemic, clear, detailed, centre-led guidance – equally applicable across the health and social care landscape, and flexible enough not to require interpretation on a Trust-by-Trust basis – is in the UK Government’s gift. At times “Levelling Across” (something that should be uniquely possible for Britain’s NHS) is as important as Levelling Up – and keeping the public happy with the care they receive from the NHS and its delivery partners has to be attractive to any government.

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