Staff shortages

Doctors Warn Sacking the Unvaccinated Will Make NHS Staffing Crisis Worse

The Government has been warned by doctors and trade union leaders that the impending deadline for NHS staff to be vaccinated or lose their jobs will result in making the NHS staffing crisis worse. MailOnline has the story.

Trade union leaders have warned the Government that mandatory COVID-19 vaccines for NHS workers will make staff shortages worse.

Last month, MPs approved mandatory vaccinations for NHS and social care staff by April this year.

The Government decided that all NHS staff in England who have direct contact with patients must have their first dose of a Covid vaccine by February 3rd, so they can receive their second dose before the March 31st deadline. 

But the Trades Union Congress (TUC) has called for the policy to be delayed “with immediate effect” to avoid a shortage of key workers.

It comes after Steve James, a consultant anaesthetist at King’s College Hospital in London, who has worked in the ICU since early 2020 treating Covid patients, told Sajid Javid why he did not believe he should have to be vaccinated after being infected. 

Meanwhile, social care isolation rules have been relaxed following concerns over staff being off sick and problems discharging patients from hospital.

There are already fears of staff shortages as 39,142 NHS workers in hospital trusts in England were absent for COVID-19 reasons on January 2nd, NHS England data shows.

This was up a staggering 59% on the previous week and more than three times up from the start of December, when there were 12,508 workers absent. 

Hospitals in Lincolnshire declared a staffing emergency, while bosses at United Lincolnshire Hospitals warned that so many doctors and nurses were now absent from shifts that patient care was “compromised”.

It was announced earlier this week that hundreds of troops are being sent into London hospitals to fill in for NHS staff who are isolating because of Omicron.

But the TUC warned that the mandatory vaccination policy will worsen the staffing crisis, making it impossible for NHS trusts to maintain safe staffing levels in the coming weeks.

With over 90% of NHS staff double vaccinated while more than 60% have had a third dose, the mandate is unlikely to make a significant impact on transmission, particularly given how poorly the vaccines prevent infection with Omicron and how many NHS staff will already have been infected or exposed to the virus (surely all of them, exposed many times over). The rationale for such an illiberal and disruptive policy is therefore lacking. As Consultant Anaethetist Steve James told Sajid Javid yesterday: “The science isn’t strong enough.”

Sir David Nicholson, a former chief executive of NHS England who now chairs the Sandwell and West Birmingham Hospitals Trust, warned that his trust could lose hundreds of staff from the mandatory vaccination policy.

Government Suspends Access to Confirmatory PCR Tests for Asymptomatic LFT Positives, Raising Fears of False Positives Consigning Thousands to Their Homes

In what was presented as a relaxation of testing requirements, but is in fact a withdrawal of service, the UKHSA has announced that as of January 11th confirmatory PCR tests will no longer be recommended – and thus unavailable – for those who test positive on a lateral flow test (LFT) without symptoms. MailOnline has more.

Confirmatory PCR tests will no longer be needed for people testing positive for Covid on a lateral flow test, health chiefs confirmed today.

Previous guidance to back up positive rapid tests with more accurate lab results will be removed from January 11th.

The UK Health Security Agency (UKHSA) announced the move amid sky-high case numbers across England. 

The move will free up capacity in laboratories for PCR tests for those who have Covid symptoms.

People who receive a positive result on a lateral flow device (LFD) will be required to self-isolate immediately for seven days, without requiring PCR confirmation. 

UKHSA said this is a temporary measure while Covid rates remain high across the UK.

Officials said that while levels of Covid are high, the “vast majority” of people with positive LFD results can be confident they have the virus.

They estimated the number of “false positives” results, where people without the virus get a positive LFD result, are as low as three in 10,000.

However with just under 1.5 million of LFD tests being conducted across the UK every day this could lead to thousands of people who don’t have Covid having to isolate. 

People who have Covid symptoms, such as a high temperature, a new, continuous cough, or change in sense of taste and/or smell should still get a PCR test, UKHSA said. 

UKHSA has said that LFTs are 80% effective at finding people with high viral loads of Covid. However, Professor Sheila Bird, a former programme leader of the MRC Biostatistics Unit at the University of Cambridge, said the 80% figure is based on data from the Alpha and Delta waves. “For transparency, results for these Omicron-era dual-testing evaluations should be placed in the public domain at the earliest opportunity,” she said.

Anecdotally I have been told by several people that they tested positive on LFT but then subsequently tested negative on PCR. Some of them were symptomatic. They said the person on the phone at Test and Trace told them this was very common at the moment as the LFTs were cross-reacting with other viruses and producing false positives that the PCR test then overruled.

If this is the case – and I have no reason to doubt it – then despite the change being billed as a solution to the staffing crisis it will only make it worse as thousands of people have to isolate from LFT false positives for which no confirmatory PCR test is available.

Since mass testing of the healthy has clearly failed to contain the virus – with new figures from the ONS today showing that an estimated 6% of the country was infected at the end of December – and with so many protected via natural immunity and vaccination, and with Omicron so mild, the Government needs to end all mass testing without delay and limit testing to contexts, such as hospitals and care homes, where it is needed to diagnose illness and protect the vulnerable.

Stop Press: The Mail is reporting that the Government is set to scrap all pre-departure Covid traveller tests today in a boost for the tourism industry, while the airline industry is demanding the Government goes a step further and axes all travel tests. Good news – but is it not time to accept that mass testing no longer serves any useful purpose (if it ever did) and we need to end this expensive drag on our economy and lives?

Australian Care Home Residents May Have Died From Neglect After Staff Were Furloughed

St. Basil’s Home for the Age in Melbourne has faced an inquiry to answer why 50 residents of the care home died between July and August 2020. It has been uncovered that the existing staff were furloughed, meaning that the facility could not provide enough personnel to adequately look after the residents, leading to severe cases of neglect, with one resident left unable to speak due to dehydration. The Australian Associated Press has the story.

In an opening statement counsel assisting Peter Rozen QC said staff at the home were deemed ‘close contacts’ and furloughed on July 22nd, with the Commonwealth taking over the home despite multiple warnings that regular staff should not be replaced.

He said one doctor involved in the response, Dr. Rabin Sinnappu, warned that furloughing St. Basil’s staff would result in disaster, while another doctor described it as a “shocking” idea.

Rozen said a lack of care for residents had become apparent by the end of the first day of the takeover, after the Federal Health Department could not find enough new staff.

“There were far too few of these workers at St. Basil’s for them to have provided care at the level the residents deserved and the law required,” he said.

The court heard that by July 23rd, pathology staff visiting to test residents found the conditions “shocking to say the least”.

The Medical Director of Melbourne Pathology, Dr. Ellen Maxwell, alerted the Victorian Health Department in an email that Covid-positive residents were mixing freely with others, bins were overflowing, PPE had not been cleared and medication was on the floor.

She said one staff member was in tears, appalled that a patient who had died was wheeled out of the home with no attempt to clear the corridor of people.

The first witness at the inquest was Christine Golding whose mother Efraxia, 84, caught the virus at the home.

She testified that St. Basil’s had provided good, culturally appropriate care for her mother, but during the outbreak her mother’s treatment was inhumane and degrading.

Although Efraxia could not feed herself, several trays of food were found left in her room, and at one point she was no longer able to talk due to dehydration and lack of food, Golding said.

She recalled the facility manager warning that if staff were furloughed, people would die from neglect rather than Covid.

“That sent a shiver up my spine,” she told the hearing.

During the outbreak a group of residents’ families met outside the home, and when staff would not tell them who was in charge, they began banging on the windows until the police were called, she said.

“It was a state of chaos and desperation… the anger was driven by fear,” she said.

“Australians deserve to know why our aged care Covid preparedness was so poor, why it spectacularly failed my mother and contributed to her premature death.”

Rozen said the inquest would not lay blame on the workers brought in to care for St. Basil’s residents, saying the evidence would show a number of them went “above and beyond”, but the circumstances were impossible.

He also explained that an expert report would show the delay between the notification of the first Covid case at the home on July 9th, and test results becoming available on July 17th, was a root cause of the failure to contain the outbreak, as was a lack of co-ordination between state and federal health departments.

45 residents died from Covid, but the inquest is also covering five other deaths at the home during the same period.

Worth reading in full.

Care Sector Could Lose up to 60,000 Staff Under New Mandatory Vaccination Measures

Starting from today, all care workers that have not been double vaccinated will be sacked. It is estimated that roughly 60,000 will lose their jobs as a result, with 20,000 having already resigned or been fired by their employer before the new law was applied. The Telegraph has more.

Industry leaders have repeatedly urged the Government to consider an “11th-hour reprieve” amid fears that the sector could lose up to 60,000 staff as a direct result of mandatory jabs.

However, a leading membership body has indicated that tens of thousands of staff may have already quit or been sacked as a result of the “chaotic” new rules, as the sector awaits the impact of the Department for Health and Social Care’s (DHSC) ‘no jab, no job’ policy on the final number of carers.

The National Care Forum (NCF), representing over 150 leading not-for-profit social care providers, surveyed its members and found that thousands of carers had already quit, and raised fears of the “human costs, financial costs and the loss in trust and goodwill amongst care staff and their employers as a direct result of this policy”.

The response from the member organisations, which support over 11,000 people, operate around 300 services and employ approximately 14,000 staff, found that 3.5% of carers had already left as a result of resignation or dismissal.

The survey, which covers the period between November 2nd to 8th, found that a further 4.4% might yet leave (including those who have self-certified for exemption or are currently seeking medical certification).

An extrapolation of the NCF figures suggests that if 3.5% of the current 550,000 carer workforce have already quit or been sacked, it means that as many as 19,250 may have already quit across the entire sector.

The NCF is not the only group concerned that thousands have already quit. Another leading industry body, which did not want to be identified, said the figure could be “even higher” than 20,000.

The NCF described the national rollout of the mandatory vaccine policy as “chaotic”.

Worth reading in full.

Stop Press: Read a heartbreaking story in MailOnline about a care home boss who broke down after having to fire six members of staff today.

Mandatory Vaccination Will Only Persuade 20,000 Out of 70,000 Unvaccinated NHS Staff to Get Jabbed, According to Government Predictions

From April 1st, all NHS staff will need to be fully vaccinated or risk being sacked when the Government’s ‘no jab, no job’ policy for the health sector becomes enforced. However, official predictions reveal that only 20,000 out of 70,000 unvaccinated workers will come forward for the jab, sparking fears of chronic staffing shortages, but the Health Secretary, Sajid Javid, supports mandatory vaccination for NHS employees, declaring that it is their “duty” to receive the Covid vaccine. The MailOnline has more.

Unions have warned the controversial policy threatens to do more harm than good by exacerbating crippling staff shortages across England’s health service, which already has in the region of 100,000 vacancies. 

But the Health Secretary stuck by the move, saying it was the “duty” of NHS workers to get the jab in order to protect patients, and insisted that he does “not want to see anyone have to walk away from their job”.

“This is all about patient safety, we know vaccines work, we know that they reduce the risk of you being infected, so it reduces the spread of an infection”, he told BBC Radio 4’s Today programme. 

“People whether they are in care homes or a hospital bed, they are particularly vulnerable to this virus, it could be fatal. It is our duty to do everything we can to protect them”.

Javid said the public would have questioned why they did not introduce the policy, when other countries around the world have. “I think you’d have me on the show saying ‘why didn’t you do anything about it’?”, he said.

Meanwhile, No10 was today urged to delay the same controversial ‘no jab, no job’ policy for carers until the spring to match the same timeline set for NHS workers, over fears the plans could backfire and kill elderly residents.

From tomorrow, all care home employees must have had two Covid vaccines to keep their jobs. Estimates suggest up to 60,000 workers will be made redundant. Unions have already claimed hundreds of homes may be forced to close their doors for good from tomorrow because of staffing shortages. The sector was already short of 100,000 workers before the pandemic struck. 

Defending the vaccine mandate, Javid told Sky News: “I don’t want to see anyone lose their job, I don’t want to see anyone have to walk away from their job.

“I just do think it is important to be doing everything we can, because also what I don’t want to see, most of all what I don’t want to see, is someone… that’s vulnerable being exposed to Covid when it could have been prevented, and perhaps they might even die from that, and I think that would be totally unacceptable.”

He added: “I’m not pretending, nobody is saying that you could have a 100% method of protecting them.

“But what you can do is reduce the chances of them becoming infected, and I think it is perfectly reasonable to say to everyone that works in health and care, please take this vaccine.

“Some 93% have had at least one shot and that’s fantastic to see. There’s still around 100,000 we estimate in the NHS that have not.”

Speaking to LBC, he added: “The vast majority of NHS workers are already vaccinated and I want to, of course, thank them for that.

“They’ve done that not only to protect themselves or their colleagues, most of all I think they’ve done it to protect their patients.

“We know that people in hospital, they’re already very vulnerable, and the last thing they want is to be exposed to Covid when it could have been prevented, and that can be fatal for them in that condition.

“I think, ultimately, this is the right call, that it is the duty of the NHS and the Government to do everything that we can to protect vulnerable people.”

Worth reading in full.

Mandatory Vaccination Will Cause One in 10 Care Workers to Lose Their Jobs

The Government is set to introduce a mandatory vaccination requirement for all care home staff this Thursday, with one in 10 employees facing the sack because they haven’t received both doses of a Covid vaccine. In addition, the General Secretary of Unison, a trade union which represents public sector workers, has called on the Government to scrap the vaccine mandate as it will “cause more harm than good”. The Times has the story.

The Government’s policy requiring all care home staff to have had two doses of the vaccine comes into force on Thursday, and the Care Quality Commission said it would take action if necessary to ensure people’s safety.

Social care experts warned that the measure was likely to exacerbate existing staff shortages, leaving people without the care they needed, and one of the biggest trade unions urged the Government to reconsider its position.

In 76 out of 151 upper-tier local authorities in England, more than 10% of staff in care homes for older adults were not fully vaccinated, according to NHS England statistics up to the end of last month.

Nationally, 89.4% of the almost 462,000 staff working in older adult care homes were double-jabbed.

The lowest rates were in Thurrock, Essex, and Manchester, where only 79.1% and 79.4% of staff were double-jabbed. The highest rates were in York, where 94.8% of staff were double-vaccinated, and Rutland, where the figure was 95.6%.

Some of those who are unvaccinated will have medical exemptions, whereas others may not have recorded their vaccination properly.

Simon Bottery, the Senior Fellow in Social Care at the King’s Fund think tank, said the sector would lose workers, with the only question being how many. The Government’s own estimate is that about 40,000 staff could leave as a result of the policy.

Bottery said: “In the last full year for which we’ve got statistics, there were over 100,000 vacancies at any one time. We also know that although the vacancies fell in the initial stages of the pandemic, they’ve since been increasing, and they’re now almost certainly higher than they were before the pandemic started.

“There’s a chronic problem with recruiting into adult social care, and that problem is becoming really acute. And the moment the sector loses a significant number of staff on top of the existing problem, then it creates really significant serious problems for the providers but also crucially for people who rely on adult social care services.”

Mike Padgham, Chairman of the Independent Care Group, who has worked in the sector for 30 years, said at the weekend that the deadline could mean up to 500 homes across England having to close their doors.

Worth reading in full.

Mandatory Vaccination For NHS Workers Would Lead to A Winter Staffing Crisis, Warns NHS Providers Chief

Chris Hopson, the Chief Executive of NHS Providers has sent a warning that the NHS could suffer severe staff shortages this winter if mandatory vaccination for NHS staff comes into effect. Approximately 10% of all NHS workers haven’t received two doses of a Covid vaccine, which encompasses roughly 120,000 members of staff, with Hopson saying that any vaccine mandate should be delayed until April to avoid any serious problems over the next few months. The Telegraph has the story.

Latest NHS figures show that 90% of staff have been double-jabbed. However, about 120,000 workers are not – and at some trusts, including major hospitals in London and Birmingham, uptake is as low as 80%.

Barts Health NHS Trust, Birmingham and Solihull Mental Health Foundation Trust, North Middlesex University Hospital NHS Trust, Barnet, Enfield and Haringey Mental Health NHS Trust and Sandwell and West Birmingham Hospitals NHS Trust all have an uptake of 80% or less, according to NHS figures for the week ending October 14th. 

Sajid Javid, the Health Secretary, last week said he is “leaning towards” making jabs compulsory for frontline health workers.

But on Monday Chris Hopson, Chief Executive of NHS Providers, which represents hospitals, said that if the Government was to press ahead, it should delay until April to ensure the NHS can get through the “very, very difficult winter”…

Hopson said around two thirds of NHS leaders backed mandatory jabs, but one third objected. 

He told BBC Breakfast: “If we lose very large numbers of unvaccinated staff, particularly over the winter period, then that also constitutes a risk to patient safety and quality of care.

“We know – and the Chief Medical Officer has said this really clearly – that we’ve got a very, very difficult winter coming up and we know the NHS is going to be absolutely at full stretch.

“So it makes sense to set the deadline once that winter period has passed”.

Worth reading in full.

A Surgeon Writes…

An NHS surgeon who’s contributed to the Daily Sceptic before has sent us an email offering us his perspective on the current NHS ‘crisis’. It’s a reminder that even though the current pressure on the NHS cannot realistically be attributed to Covid hospital admissions – which remain at around 5% of the total – that doesn’t mean that the NHS isn’t under strain.

There are various debates about whether or not the NHS is under pressure with pundits rightly pointing out that the NHS is not under pressure due to Covid-related disease. I think at this stage this is an unhelpful diversion. The fact is there is a big problem and trying to disprove it by just looking at Covid is missing the bigger picture.

The NHS is under a lot of pressure due to processes unrelated to Covid workload. While hospitals are not yet full to the brim, the overall activity levels are higher than usual for certain regions (whether this is due to the catch-up effect, neglect, the iatrogenic effect of recent non-pharmaceutical or other interventions/measures, etc.). The main crisis is related to staffing. This labour shortage has been noted in many sectors of the economy, but the staffing crisis (mainly non-doctoral) in the NHS has been chronic and worsening for years. This year tipped the balance (psychological exhaustion, physical exhaustion, sickness absence, track and trace, etc.). In our region hospitals are routinely cancelling (relatively non-essential) surgery due to lack of staff required to either run operating theatres or wards/ancillary services. Hospitals are routinely running extra activity on Saturdays to try and catch up on cancer work. This is a weekly occurrence not limited to the place I work. Factor in the very long (self-created) waiting lists and the winter (which has not even started), and the crisis could become unmanageable.

I am pessimistic. Regardless of the Covid workload, the Government may use a real crisis in the NHS to justify more pointless non-pharmaceutical interventions and vaccine passports (complete nonsense from a medical, ethical and social perspective) out of desperation, misconception, or both.