England’s Covid vaccine mandate could mean 3,000 GP staff have to be removed from patient-facing roles, the Government has estimated.
An impact assessment document published by the Department of Health and Social Care (DHSC) calculated that 3.8% (≈3,400) of the 89,000 patient-facing GP staff will be unvaccinated when the rules come into force on 1 April.
The Government estimates that 400 of these GP staff will be exempt, meaning the number of GP staff remaining unvaccinated and not exempt will be 3,000.
This means these 3,000 GP staff may have to be dismissed, as NHS England guidance said redeployment into non-patient facing roles is ‘not guaranteed’.
However the document notes that ‘it is not possible at this point to predict how many and when staff may not be deployable’.
The 3,400 patient-facing GP staff who will be unvaccinated by 1 April represent 4.7% of the total estimate of 72,900 in-scope NHS workers who will remain unvaccinated by the end of the grace period.
The document showed that in the worst case scenario, 5% of patient-facing GP staff could remain unvaccinated when the rules are due to come into force.
This would mean that come 1 April, 4,400 GP staff would still not be fully vaccinated.
In the best case scenario or ‘high behavioural impact scenario’, which is the minimum number of staff who will remain unvaccinated when the rules come into force on 1 April, 2,400 staff will remain unvaccinated.
NHS England has encouraged GPs to have ‘one-to-one’ conversations with staff who have refused Covid jabs to identify ‘reasons for vaccine hesitancy’.
A DHSC spokesperson told Pulse: ‘Health and social care workers look after the most vulnerable people in society, who could face serious health consequences if exposed to the virus.
‘Ensuring staff are vaccinated is the right thing to do to protect patients and those in care. The vast majority of NHS staff have had the vaccine which is our best defence against Covid-19.’
The document does not provide exact figures for the number of GP staff who are in scope of the mandate but are currently unvaccinated as ‘[t]here is no single source of vaccination uptake data that aligns with the scope of the workforce affected by this policy’, it cautioned.
The document also said that more women will have to switch roles due to the vaccine mandate than men, as women represent over 80% of the general practice workforce.
It said: ‘[M]ore women will be impacted compared to men by a policy requiring Covid-19 vaccination as a condition of deployment. They may be disadvantaged by this policy if more female workers are dismissed due higher representation in the workforce.’
Ethnic minority staff and ‘adherents to certain religions and beliefs’ are also likely to be negatively affected by the policy, as ‘there appears to be more significant levels of vaccine hesitancy in these groups in, for example, surveys of the wider population conducted by the ONS.’
Dr Peter Higgins, chief executive of Lancashire and Cumbria consortium of LMCs, said losing or redeploying 3,000 GP staff would worry him.
He said: ‘General practice is on its knees already. Particularly in my part of the world, it’s difficult to recruit staff, it’s difficult to recruit GPs and nurses.
‘Quite a few reception staff have left because of the abuse that they had. So we could ill afford to lose anyone, really.’
He added that there is still time for the Government to reverse its decision: ‘Boris changes his mind every day.
‘Although the legislation is there to carry this through, we still have to be aware that at the last minute it might change.’
York GP partner Dr Abbie Brooks said that ‘at a time where GP numbers are at an all-time low, I think we should be considering things flexibly’.
She said practices should ‘have one-to-one conversations with these clinicians on the front line as to why they don’t want to be vaccinated, why they can’t be vaccinated, and can we support them, rather than necessarily separating them from the clinical team with a one-size-fits-all model’.
Dr Brooks said: ‘Ultimately, we might be shooting ourselves in the foot. I don’t think dictating from above is necessarily always helpful and we need to take it on a more local level.’
Chesterfield GP and GP trainer Dr Naren Sentil Nathan said clinicians have ‘a duty and a moral obligation to protect ourselves but also our patients, and the general public as well’.
He told Pulse: ‘In one of my roles as a training programme director for GP training in Chesterfield, we are in a situation where we have a few registrars and GP trainees who are not willing to get vaccinated.
‘So they have been fully informed that they are at risk of losing their training status, [and] employment if they don’t have vaccinations.’
He added that there will be a ‘burden’ on GP practices if they have to replace unvaccinated staff, but said it ‘depends on where they will be deployed to’ and if staff can work from home or in non-patient facing roles.
It comes as NHS England advised GPs to ‘seek their own legal advice’ on redeploying and dismissing unvaccinated staff.
About the vaccine mandate
Thursday 6 January was the start of the 12-week grace period to ensure unvaccinated individuals get their first dose by 3 February and can receive their second dose by the 1 April 2022 deadline.
Currently, two Covid jabs are considered ‘fully vaccinated’ for the mandate, but NHS England has said this is due to include the requirement of a booster jab in the future.
The mandate extends to all non-clinical workers in direct contact with patients, meaning GPs will be banned from deploying unvaccinated public-facing staff.
It will be for the CQC to ensure compliance and in the worst-case scenarios, they could withdraw registration for practices with unvaccinated staff – effectively shutting them down.
Some GP leaders have expressed concern that the mandate may hit the GP practice workforce.
There are ‘no plans’ for Scottish and Welsh Governments to introduce a Covid or flu vaccine mandate for healthcare staff.
For England, flu vaccination mandates have not been ruled out for future winters.
Northern Ireland is planning a public consultation on making Covid vaccination compulsory for ‘new recruits’, but there is still no date for the consultation.
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07 December 2023
07 December 2023
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