Encouragement not coercion is the way to boost vaccine take-up

Chris Hopson profile picture

12 November 2021

Chris Hopson
Chief Executive
NHS Providers


The government's decision to make COVID-19 jabs a condition of employment for those working in adult social care prompted many to ask why a similar approach wasn't being taken with the NHS workforce. Staff in both sectors look after vulnerable people who are at most risk from infection, serious illness, and death so why the difference in approach?

Despite some concerns from those representing the health and care workforce, it wasn't a huge surprise to trust leaders when the government announced a similar approach – with exemptions – for the NHS. When we asked them, most trust leaders told us they were in favour of introducing mandatory vaccinations because it would help protect both their workforce and patients against coronavirus and flu. But – and this is a huge but – they were also acutely aware that this policy isn't without risk. The main worry is that it could exacerbate staff shortages at a time when the NHS is already under severe pressure and heading towards a very difficult winter.

There is a real risk that mandatory COVID-19 vaccinations could aggravate staffing pressures.

Chris Hopson    Chief Executive

There are 93,000 vacancies across the NHS, with continuing concerns over staff exhaustion and capacity constraints, rising demand and rapidly growing waiting lists. There is a real risk that mandatory COVID-19 vaccinations could aggravate staffing pressures, with some potentially leaving their jobs in protest, affecting the morale of those that remain, while the costs of hiring short term staff cover may rise. And there are the resources needed to recruit and train new permanent staff to consider too.

There is clearly a major balance of risks here, but we are pleased that the government has listened to trust leaders and confirmed that the deadline for mandatory vaccinations for health staff will be introduced in April next year, when immediate winter pressures should have eased. Had the policy been introduced any sooner, we would have risked worsening the NHS' workforce shortages at a time when the health service is already under huge operational pressure, putting quality of care at risk.

It is now important that the government works with the NHS to reach out to those staff groups who have the lowest rates of vaccine take-up, particularly younger women of child bearing age and those from Black, Asian or ethnic minority communities. Data shows 90% of healthcare staff are vaccinated, notably higher than the population as a whole, proving that explanation and encouragement, rather than control, has been the most effective method of communication about the vaccines. Trust leaders told us that sensitive but challenging one-to-one conversations with hesitant staff have helped to change mindsets.

It is so important that the government gets the tone right, acknowledging the risks to workforce supplies, and avoid scapegoating those staff who have chosen not to get vaccinated so far.

Chris Hopson    Chief Executive

We have seen first-hand how team briefings and workshops, and the use of staff networks and vaccine champions from a range of backgrounds to spread positive messages, can – and have – made a real difference. Education and communication campaigns and onsite vaccination hubs and clinics have also played a key part in driving up vaccination rates. It is so important that the government gets the tone right, acknowledging the risks to workforce supplies, and avoid scapegoating those staff who have chosen not to get vaccinated so far. Getting it wrong could erode trust between staff and frontline leaders, aggravating existing health inequalities in wider society.

If this is done well, mandatory vaccination will help reduce the risk of infections in healthcare settings. Some groups of staff will particularly benefit from this policy. They include those at higher risk of COVID-19 or flu, such as older people, colleagues with pre-existing conditions, and those with protected characteristics, including some disabled people and ethnic minority groups. And while a number of staff may be redeployed or leave the service, there is a hope that a mandate may reduce staff sickness absences, and some colleagues may feel less anxious about contracting or spreading COVID-19 to their loved ones.

This blog was first published by The Times Red Box.

About the author

Chris Hopson profile picture

Chris Hopson
Chief Executive
@ChrisCEOHopson

Chris Hopson is the chief executive of NHS Providers. He joined in September 2012 after a career in politics, commercial television and the civil service. Read more

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