DHSC consultation on making COVID and flu vaccinations mandatory

In September the Government launched a consultation on proposals for mandating COVID-19 and flu vaccinations for frontline health and social care workers in England.

The proposal covers health and care staff in England who work for organisations that are regulated by the Care Quality Commission. Among optometrists, it only covers those working in hospitals at this time, (people going into care homes, such as domiciliary optometrists are already covered by a separate mandation) but the consultation includes a question about extending the requirement to other patient-facing healthcare workers, and therefore potentially those providing face-to-face eyecare in the community.

We asked members in England for their views on the proposal via a survey to provide evidence for our response.

Q: Which of the following best describes your opinion of the requirement: Those deployed to undertake direct treatment or personal care as part of a CQC regulated activity in a healthcare or social care setting (including in someone’s home) must have a COVID-19 and flu vaccination?

A: Slightly supportive

The Association of Optometrists supports and represents around 82% of the optometric workforce across the UK. We provide insurance and representation for our members in relation to clinical negligence, professional regulation, and employment matters.

The AOP surveyed its members on this issue. 1,090 responded, which is enough to give 99% confidence that the figures are representative of all our members’ views, within a 5% error margin either way.

618 (56.7%) were in favour of mandatory vaccination, with 402 (36.88%) against, and 70 (6.42%) unsure.

Therefore we are able to say with confidence that the majority of our members are in favour of mandatory vaccination.

Q: Must have a COVID-19/flu vaccination in social care

A: Slightly supportive

Some of the AOP's members provide domiciliary eye care (sight tests and eye examinations) to people unable to leave their homes. Many of those eligible for domiciliary eye care live in care homes. Domiciliary optometrists are covered by the requirement to be vaccinated in order to provide care in these settings. We support this, particularly given the vulnerability of this client group.

Q: Do you think there are people deployed in or visiting a healthcare or social care setting (including someone’s home) who do not undertake direct treatment or personal care as part of a CQC regulated activity but should also be included within the scope of a requirement to have a COVID-19 and flu vaccine?

A: Yes

Community optometrists who provide eyecare under the GOS contract

Q: For COVID-19 and flu vaccination are there people deployed to undertake direct treatment or personal care as part of a CQC regulated activity that should not be in scope of the policy?

A: No

Q: Are there any other health and social care settings where an approach similar to adult care homes should be taken? (that is, all those working or volunteering in the care home must have a COVID-19 vaccination or have an exemption)

A: Yes

Q: You said there are other health and social care settings where an approach similar to adult care homes should be taken (that is, all those working or volunteering in the care home must have a COVID-19 vaccination or have an exemption)

A: Optometric practices in the community

Of the 57% or our survey respondents who supported mandatory vaccination as a condition of deployment to patient-facing work, 96% felt that this should be extended to optometrists working in the community, who would not be covered by the current proposals.

Q: Do you agree or disagree that exemption from COVID-19 vaccination and flu vaccination should only be based on medical grounds?

A: Somewhat agree

Q: Are there particular groups of people, such as those with protected characteristics, who would particularly benefit from COVID-19 vaccination and flu vaccination being a condition of deployment in healthcare and social care? *

A: Yes

Q: Which particular groups might be positively impacted and why?

A: Take-up of vaccination has been different in different groups. The reasons are regrettably understandable: the history of different and worse treatment, particularly of people of colour. However everyone is safeguarded by high levels of vaccination uptake and this measure should encourage it for all, thereby saving lives.

Q: Are there particular groups of people, such as those with protected characteristics, who would be particularly negatively affected by COVID-19 and flu vaccination being a condition of deployment in healthcare and social care?

A: No

Q: We welcome any further comments you may have relating to this consultation

A: The minority of our members who do not support mandatory vaccination cite a number of reasons including individual rights over their own health decisions. However the majority view of our members is represented in the following comments:

"We need to protect the elderly and vulnerable. It is about protecting people who trust in us"

"There are two main factors to consider. The first is the nature of our work which necessitates close contact with our patients, many of whom will be vulnerable or exempt from wearing masks (paediatric patients especially). We have a duty of care to protect ourselves and our patients by having the vaccine which is shown to limit the severity of COVID. Secondly, as healthcare professionals we should be leading by example in our uptake of the vaccine when it is offered."

"This is a standard policy for those working in risky environments already. I needed to have vaccinations including my BCG before working in the Hospital Eye Service. Vaccination is to protect the person vaccinated which in turn protected the employer from staff absences and tribunal claims from staff saying they were not adequately protected by their employed. It also protects the vulnerable patients that we look after. For years I have had the Flu vaccination, to protect my patients. This is even more important. I am firm on the matter and I find it bordering on negligence to be unvaccinated unless you are medically exempt. If we transmitted an infection to a patient due to poor hygiene (not washing hands or cleaning a tonometer probe) we would be responsible. What is the difference if we are the vector for that transmission because we didn’t want to be vaccinated?"