Maternity wards are particularly vulnerable to closure due to a national shortage of midwives. Photograph: Peter Byrne/PA
By Denis Campbell Health policy editor
Entire hospital units could be forced to shut because of staff quitting in protest at the government’s order that they must all be vaccinated against Covid-19, a senior NHS leader has warned.
Chris Hopson, the chief executive of NHS Providers, said that at one hospital trust in England, 40 midwives were refusing to get jabbed, raising fears that the maternity unit may have to close.
“Trust leaders are acutely aware that, from April onwards, when Covid vaccinations will become mandatory, decisions by staff to remain unvaccinated could – in extreme circumstances – lead to patient services being put at risk,” said Hopson.
“If sufficient numbers of unvaccinated staff in a particular service in a particular location choose not to get vaccinated, the viability and/or safety of that service could be at risk.”
Hopson did not name the trust. But he cautioned that its maternity unit is “one representative example” of potential closures on grounds of patient safety that the government’s decision to compel NHS staff in England to be vaccinated or risk losing their job could lead to.
Hopson said: “I was talking to a [trust] chief executive who said that 40 of the midwives on their midwifery service … were saying they were not prepared to be vaccinated. Those staff, given their skills and their expertise, are not easily redeployed but they’re also extremely difficult to replace.
The trust’s chief executive “is seriously concerned about the safety of the service” because of the potential exodus of midwives.
Maternity staff quitting over compulsory jabs posed a particular challenge because of the NHS-wide shortage of midwives, Hopson said. NHS England estimates that maternity services need 2,000 more whole-time equivalent midwives, while the Royal College of Midwives (RCM) puts the figure at 2,500.
The health secretary, Sajid Javid, and NHS England need to “be clear well in advance how we will resolve the hopefully small number of instances where service viability and safety could be at risk” because of frontline personnel leaving rather than getting immunised, said Hopson. The new rule applies to any staff who have face-to-face contact with patients but also non-clinical staff including hospital porters.
Javid told the Commons last Tuesday that “despite the incredible effort to boost uptake across the country, there are still approximately 94,000 NHS staff who are unvaccinated. It’s critical to patient safety that health and care staff get the jab.” However, the number of NHS workers who have had a first dose since the government first announced in September that it was adopting a policy of compulsory has risen since by 55,000, he added.
The Department of Health and Social Care (DHSC) impact assessment of its policy found that as many as 126,000 unvaccinated staff could lose their job when the rule comes into force on 1 April.
The House of Lords has raised concerns about the policy. Its secondary legislation scrutiny committee has warned that the DHSC’s definition of “face-to-face” is too vague, that it had no obvious contingency plans to “cope with expected staff losses” and that the potential loss of unvaccinated staff was “likely to be particularly acute” in London.
The RCM said: “We don’t yet have a number for midwives who have yet to be vaccinated. However, to meet the statutory requirement they will need to have their first vaccination by 3 February. The RCM will represent members. But there are very limited options.
“We are concerned that this will inevitably deepen maternity staff shortages and severely impact those midwives and maternity support workers left behind in services already struggling with acute staffing shortages.”
The DHSC did not respond directly to Hopson’s comments. A spokesperson said: “We are grateful to all our NHS staff who work incredibly hard.
“Vaccinations remain our best defence against Covid-19. This is about patient safety and it’s our duty to ensure that they are as safe as can be.
“Working with organisations in the health and care sector, we will continue to support those who have not yet received the vaccination to take up the offer to protect themselves, their loved ones and their patients.”