NHS workers and care home staff will be legally required to have coronavirus vaccinations under plans that have the personal support of Boris Johnson.
The government will open a consultation on Thursday on making vaccinations a condition of employment for health service workers in an attempt to reduce transmission in hospitals and save lives.
Ministers will also announce that they are changing the law to make vaccines compulsory for staff employed in care homes amid concerns about take-up in some parts of the country.
According to official figures, 151,000 NHS workers, equivalent to slightly more that one in ten, are unvaccinated and 52,000 care home workers, equivalent to 16 per cent, have not been jabbed. In some regions take-up is significantly lower, and there are particular concerns about the rate of vaccination among people from ethnic minorities.
A study by The BMJ in February found that vaccine rates among ethnic minority doctors and healthcare staff were significantly lower than the rate among white staff.
All health and care workers should have been offered at least a first jab as they were in the first and second priority groups when the programme began.
A government source said that Johnson personally backs the proposals for mandatory vaccination: “It’s only that those who are caring for people who are particularly vulnerable to coronavirus should be vaccinated. This will save lives.”
The move towards mandatory vaccination is likely to prove controversial. Labour has previously said that compulsory vaccination for healthcare workers is “threatening” staff at a time when the NHS is facing a recruitment crisis.
Unions are also opposed to mandatory vaccinations. Legal experts have also suggested that the move could be challenged as a potential breach of the European Convention on Human Rights and the Equality Act.
However, ministers are supportive of the approach. Matt Hancock, the health secretary, has previously highlighted the requirement for some doctors and NHS staff to have the Hepatitis B vaccine as a potential precedent. That requirement, however, is based on guidance rather than enforced in legislation, whereas the Covid proposals would need legal changes and probably a vote in the Commons.
Although 89 per cent of NHS workers have had their first jab overall, there are significant regional disparities. In London nearly a fifth of NHS workers are unvaccinated and more than a quarter of staff have not received two doses.
Vaccine take-up is lower in care homes, where 83.7 per cent of staff have had one jab. There are significant regional disparities, with more than 25 per cent of staff unvaccinated in 18 local authority areas. The lowest take-up is in Barking and Dagenham in east London, Barnet in north London and Barnsley, where more than a third of care home staff are unvaccinated.
Jeremy Hunt, a former health secretary and chairman of the health select committee, has previously expressed his support for mandatory vaccinations. “Is there not a duty of care to patients and care home residents to protect them from asymptomatic transmission?” he asked. Of course medical exemptions should apply, but the question will be why, if the government bites the bullet for social care staff, it is not doing so for NHS staff.”
He pointed out that about 40 per cent of Covid infections during the first wave were among people who picked up the virus in hospital, suggesting that about 36,000 people caught the virus because of struggles to control transmission among patients and staff.
The Royal College of Nursing has said that it would not support staff being “coerced” into have a vaccine.
Thursday’s announcement on care homes follows a five-week consultation. The change is being made to a legal regulation in the Health and Social Care Act 2008. Doing the same for NHS workers requires a separate legal change and therefore a different consultation.
Scientific advisers have recommended that 80 per cent of staff in care homes should be vaccinated to provide the minimum level of protection. Vaccination levels are below that threshold in 65 local authority areas.
Ministers will amend regulations requiring staff to have vaccinations as a condition of employment, excluding those who can provide evidence of a medical exemption.
Care home managers will be required to check the vaccination status of staff. The government’s consultation on the issue asked whether staff who are not vaccinated should be redeployed or sacked.
A study in The BMJ found that ethnic minority doctors and staff were less likely to get vaccinated. The study, which was published in February and looked at staff at the University Hospitals of Leicester NHS trust, found that 59 per cent of South Asian staff and 37 per cent of black staff had taken up the vaccine, compared with 71 per cent of white staff.
Kamlesh Khunti, a professor of primary care diabetes at the University of Leicester and the lead author of the study, said: “There wasn’t an issue about access for doctors. But there were a lot of issues of trust.”