The COVID-19 vaccination programme is progressing at pace across the UK. But, as with all types of vaccination, there will always be individuals who refuse to take part, for a variety of reasons including their own personal beliefs.
If a member of your staff – whether a GP, reception staff or a nurse – refuses the COVID-19 vaccine, what are your obligations towards patients or other staff who have been not been vaccinated? Or indeed to any other people the staff member who refuses the vaccine may come into contact with outside the practice?
Is there anything you need to specifically do in response? And does this make you more vulnerable to medicolegal complaints?
Speaking to staff
While the COVID-19 vaccination is highly recommended, ultimately it is not mandatory and practice staff cannot be forced to have it. Healthcare employers, including GP practices, should have a discussion with these staff members to try to understand why they are reluctant to have the vaccine.
Practice managers may wish to encourage staff to have a vaccination through discussing their increased risk of repeated exposure to the virus as healthcare workers, the benefits of having the vaccination to themselves, their colleagues, patients and family, and the wider benefits of reducing the transmission of COVID-19.
The GMC’s Good medical practice states: 'Doctors should be immunised against common serious communicable diseases, unless this is contraindicated'.
Although there are no contractual obligations, as an NHS employer there is the potential concern for the health and safety of patients with life threatening diseases. For this reason, any medical staff who refuse the vaccine should have appropriate reasons for refusal.
There are nine protected characteristics under the Equality Act 2010. If the reluctance to have the vaccine is related to a particular health concern, forcing the employee to receive the vaccine could be seen as unlawful discrimination.
Alternatively, if the refusal is due to religious beliefs (for example, some vaccines contain pork galantine), the employee’s belief or condition should be respected under employment laws while taking steps to ensure patient safety.
This could include a risk assessment involving the staff member who is unwilling or unable to have a COVID-19 vaccination.
It may also be worthwhile considering if there would be an alternative, non-patient facing role within the practice the relevant staff member could carry out, or whether they could work remotely. This would help to demonstrate that the appropriate steps have been taken to reduce risks and prioritise patient safety.
Anyone who has attended the practice and believes they have developed COVID-19 as a result of acquiring it on the practice premises, could make a complaint.
It is possible that complaints may also arise from employees who allege that they have contracted COVID-19 during their employment. However, it would be quite difficult to establish that a patient or member of staff became infected from a non-vaccinated member of staff. Nevertheless, this may not stop complaints.
What if a complaint does arise?
If a complaint does arise due to the failure to maintain and operate safe premises, and which alleges that the health and safety of employees was compromised, the GMC’s Good Medical Practice says: 'You must respond promptly, fully and honestly to complaints and apologise when appropriate. You must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange'
It is vital to maintain a professional, empathetic manner and deal with the complaint in an honest manner. It may be helpful to discuss the prevention controls in place, which are used to maintain and operate safety on the premises.
Where allegations against a health care professional relate directly to the provision of the patient’s clinical treatment, members can request assistance from Medical Protection in the usual way.
Key factors to consider when responding to a complaint include:
- Notifying patients of the complaint’s procedure, timeframes and informing them of any likely delays.
- Identifying concerns raised and responding to the complaint. If concerns relate to the safety of the premises due to a practice staff not being vaccinated it may be helpful to set out the steps taken to ensure patient safety. For example, if the employee has been provided with a non-patient facing role, and the infection control measures in place within the healthcare setting.
- It is important to maintain the employee’s privacy if the refusal to have the vaccine is related to a health or religious reason.
- Taking time to provide a considerate response, avoiding jargon and including information on what to do if the patient is not satisfied with response.
Medical Protection has further guidance on responding to a complaint here. If GPs require further advice, you should contact your medical defence organisation.
- Dr Peter Mackenzie is quality assurance lead at Medical Protection. Ceylan Simsek is case management assistant at Medical Protection