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Covid-19: Halt mandatory vaccination to keep England’s maternity services safe, pleads royal college

BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o249 (Published 28 January 2022) Cite this as: BMJ 2022;376:o249
  1. Zosia Kmietowicz
  1. The BMJ

The Royal College of Obstetricians and Gynaecologists (RCOG) has become the latest organisation to ask the government to reconsider mandatory vaccination for NHS staff in England because of the potential effects on delivering safe care, this time in maternity services.

Previously, the Royal College of General Practitioners, the Royal College of Midwives, and the Royal College of Nursing had all called for the new rules to be deferred, and the BMA has warned that the NHS must not lose any more staff because of the rules.

The mandate requires all patient facing staff to be fully vaccinated by 1 April 2022 and to have had a first dose by 3 February or risk losing their job. As of 16 January, however, 80 092 staff remained unvaccinated (5.4% of the total).1

The RCOG said that even before the pandemic the maternity workforce was extremely fragile with an estimated shortfall of around 500 doctors and 2000 midwives. As understaffing in maternity care poses an extremely high risk, the college believes that services cannot afford to lose more staff because of the vaccination mandate. A parliamentary report published last July recommended urgent action to tackle staffing shortfalls in maternity services.2

Greater risk

Edward Morris, RCOG president, backed vaccination as the best way for staff to protect themselves and their patients from covid-19 infection and to reduce staff absence, but he said that the risk of the vaccination mandate on safe staffing of maternity services was too high.

“Maternity services require specialist staff whose skill cannot be replicated elsewhere in the NHS,” he said. “The risk of doctors, midwives, or maternity support workers being dismissed from frontline roles in maternity because they are unvaccinated creates a far greater risk to maternity services’ ability to deliver safe, high quality care for women.

“We ask that the government reconsiders introducing this policy at this time because of the impact on the safe delivery of maternity services. A delay would allow more time to help maternity staff with concerns or hesitancies feel more confident about having the vaccine.”

Earlier this month Gill Walton, chief executive of the Royal College of Midwives, said that while she supported vaccination she did not believe that making it compulsory was the right approach.

“Levels of vaccination in the NHS are high and rising, and we should be using discussion and education to increase vaccination among NHS staff, not the hammer blow of mandating it,” she said. “Moving forward with mandatory vaccination could only see staffing levels fall further. The government has opened a Pandora’s box of unforeseen consequences—but there is an opportunity now to close it. We are urging Sajid Javid to do just that.”

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