My Lords, more than ever, the social care workforce demonstrates unwavering compassion and dedication for our elderly and most vulnerable. We are proud of and immensely grateful to them. I pay huge tribute to their tireless work during this pandemic to protect people who are most vulnerable to Covid-19, including their incredible efforts to support the vaccination rollout across the sector, to bring in infection controls and to provide pastoral care during this most heartbreakingly lonely episode.
To date, 1.2 million social care workers in England have been vaccinated. This is an incredible achievement and an important step for staff to protect themselves, their loved ones and the people they care for from becoming seriously ill or potentially dying from Covid-19. However, there is a tipping point here. It is a tipping point of safety when it comes to care homes, where many of our most vulnerable priority-list loved ones live. We are not quite there yet.
SAGE recommends that 80% of staff and 90% of residents should have received their first dose of the vaccine to provide a minimum level of protection against coronavirus outbreaks. We have all been witness to the incredible pace at which vaccination programmes have been rolled out. I am delighted to report to the House that 96% of those living in older-age care homes have received their first dose and 93% their second dose. Meanwhile, 93% of those living in younger-age care homes have received their first dose and 88% their second dose.
In many places, take-up among care home staff is also impressive. Some 87% of those working in older-age care homes have had their first dose and 76% their second dose. This compares with 83% and 73% respectively for staff working in younger-age care homes. However, there is also significant variation at a regional and a local level. Only 65% of older care homes in England are meeting SAGE’s stipulated safety tipping point in the latest published data. This drops to an even more worrying 44% in the London area.
As a result, despite very high levels of vaccination, testing, PPE and other infection control measures, we are still seeing outbreaks in care homes, where residents are incredibly vulnerable to the serious effects of this terrible disease. Since January this year, care homes have tested staff more than 21 million times and made proper use of 1.2 billion items of PPE. Yet nearly 14,000 care home residents have died because of the virus this year alone.
This winter will be challenging and, in the face of rising case rates across the country, we need to make sure that we have done everything we can to prepare and to minimise the risks for residents in care homes and the incredible staff who care for them.
This is the context. It makes this legislation critical. By November this year—and subject to the usual parliamentary approval and, we hope, a helpful and practical 16-week grace period—anyone entering a CQC-registered care home in England must be vaccinated, unless a valid exemption applies. This will apply to all care home workers, agency staff and volunteers. Visiting healthcare workers, tradespeople, hairdressers and CQC inspectors will also be obliged to follow the new requirement.
We have considered this policy incredibly carefully, consulting thoroughly and extensively to get this right both for residents who are so vulnerable to Covid and the staff who go above and beyond in caring for them every day. The policy will therefore apply to all people over 18 who work inside a care home unless they have a medical reason not to be vaccinated.
Further limited exceptions have been made to ensure that this works on the ground. Emergency services, people providing emergency assistance and those undertaking urgent maintenance work can all enter a care home without needing to show that they are vaccinated. Visiting family and friends are also exempt, given the significant well-being benefits such contact provides. While we would always encourage all these people to take up an offer of a vaccine, we have acted on the advice from SAGE that a balance must be struck.
Before I turn to our assessment of the impact this may have on the workforce, I acknowledge the vital role the Secondary Legislation Scrutiny Committee has played in its calls for further details outlining the Government’s current analysis of the expected impact of the draft regulations. Following its eighth report, we made an impact statement available to this effect, and we note the further points raised in its 10th report yesterday. I can also confirm to the House that we will be publishing a full impact assessment as soon as possible.
After everything care home staff have done in the pandemic, we owe them the greatest consideration and respect. We understand that providers and their staff need time to prepare for these changes, which is why the 16-week grace period immediately following the enactment of regulations will allow staff who have not been vaccinated to make arrangements to have both doses. Unfortunately, we recognise that there will be some staff who will choose to leave rather than be vaccinated. Our central analysis estimates that around 7% of current staff may not meet the requirement by the end of the 16-week grace period. This equates to 40,000, out of a workforce of 570,000, who may need recruiting to replace staff who do not meet the requirement.
However, this estimate is very uncertain. We just do not know yet exactly how staff will respond to the requirement, not least because staff turnover in this sector is around a third each year. I am grateful to Professor Martin Green of Care England for talking me through these concerns. Of course, we do not want to lose valuable care home staff who have made an enormous sacrifice over the last year and a half, and we will continue our efforts to drive uptake across the sector. We owe it to ourselves and to their commitment to try our hardest. However, our overriding priority has to be the safety and well-being of the people they care for.
Before closing, I pay a final tribute to all care home staff, past, present and future, who have played a vital role in our nation’s recovery from the pandemic. We did not take lightly the decision to introduce this legislation. However, the risks that this winter will undoubtedly pose to the most vulnerable in our society make clear the choice that we must make: to do everything in our power to protect them. With that sentiment in mind, I commend these regulations to the House. I beg to move.
Amendment to the Motion