In the UK, the first health sector to have compulsory vaccinations comes into affect today and impacts staff working in registered care homes in England. If they do not have both jabs by that date, they will no longer have their jobs. For many, this exflow of employees puts a strain on a system which is already struggling with recruitment.

Speaking to the BBC, Mountbatten Care Home director Richard Brice said: "As of today, we have lost three members of staff. Valuable members of staff who don't want to have the jab.

"We don't have enough staff. We have to employ agency staff which comes at a cost."

He said he agreed with the mandatory jab policy because "you've got to protect yourself and you've got to protect all the residents".

Neil Russell, the chairman of PJ Care, which provides neurological care for adults, said he was losing 14 staff across three sites and potentially another dozen by 24 December unless they could persuade doctors they were medically exempt. Carers are allowed to self-certify a medical exemption until Christmas, but must leave after then if it is not confirmed.

The policy, which will be enforced by the Care Quality Commission, came into force as a National Care Forum survey revealed that its care home members feared losing 8% of staff as a result, of whom around half have already left. That translates into 50,000. The government has estimated that 7% of staff may leave the care home sector due to the policy, which while lower, is still a loss of 38,000 workers at an approximate recruitment cost to providers of £94m ($126m USD).

For managers already dealing with staff shortages caused by exhaustion, pay that averages barely £9 an hour, and the flow of foreign carers being choked off by Brexit, the rule is only made more difficult by the fact that NHS workers won’t have to get vaccinated until April 2022. Many care staff reluctant to have the vaccine have as a result already moved to the NHS, and this outflow will likely continue as the NHS pays a higher hourly wage.

Other Care Sectors at Risk

At the same time, the Homecare Association - which advocates for workers who deliver service to people in their homes - is warning of massive staff losses as their own mandate time nears. Warning of losses of up up to 25% of the regulated homecare workforce, between 120,000 and 140,000 careworkers as a result of the policy. This could result in over 120,000 older and disabled people losing access to homecare. Unmet need is already high, and rising, at the same time that recruitment and retention of the homecare workforce has never been more difficult.

Skills for Care, the UK's leading source of adult social care workforce intelligence, is showing a steeply increasing percentage of unfilled jobs since March 2021

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The organizations annual annual report on the state of the adult social care workforce, points out the sectors growing recruitment issues. Among the drivers are:

• The lack of pay progression, with care workers with more than five years’ experience being paid just 6p more an hour than those with less than a year in the role in 2020-21
• A doubling in sickness absence rates during 2020-21, reflecting the impact of Covid-19
• A fall in the number of overseas staff starting to work in the sector from 2019-21, on the back of the end of free movement of people from Europe
• The impact of mandatory vaccination on the care home sector

Skills for Care chief executive officer Oonagh Smyth said the report was “a stark reminder that our recruitment challenges continue, and to help tackle that we need to properly reward and value care workers for their high skill levels and dedication”.