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We have a number of clients in the primary and social care sectors. The managers in those areas are highly regulated and are regularly inspected by the Care Quality Commission or the Care Inspectorate Wales. We currently don’t have any clients in Scotland but they have their own inspection division which I suspect will behave in much the same fashion. In addition, they have a number of other bodies that are constantly overseeing their activities whether it be local authorities, social services departments, health commissioning groups or central government through the NHS. All of these bodies put constraints on managers that we support which only allows them to work in particular ways. 

One thing that has become clear through all of this is that these regulatory bodies seem to spend most of their time telling our managers what they can’t do, never helping to empower managers to take decisions so that they can do the best for their patients or residents. I have to say, I find this somewhat depressing. For the most part, managers in these sectors want to do the best for the people that they serve. It’s just that many of them seem to have been ground down by the endless bureaucracy and negativity of the bodies that regulate their work.

I witnessed this at its most perplexing during the recent pandemic. In the social care sector, a number of care assistants had concerns about being vaccinated and were expressing those concerns to their managers. The advice from many HR consultants was that there was nothing they could do about it and this was a matter of the human rights of the care assistants involved. Because this advice matched the sort of “what you can’t do” approach that their regulatory bodies took, this was broadly accepted by care home managers.  

In fact, if you took the view of many lawyers, they were quite clear that provided you followed an appropriate process, that it was possible to ensure that all of the residents were being treated or cared for by people who had had the vaccination. This was not just a matter of health and safety (i.e. would somebody with a vaccine be more or less likely to transmit the infection to others) it was also a matter of commercial reality. Many relatives of residents in care homes would be astonished to hear that care assistants had who had not been vaccinated were still being allowed to carry out personal care for their loved ones. One of our care home clients took a quite different approach and said that they were duty bound to residents to:

  1. ensure that all people providing them with care had taken all appropriate steps to ensure that they didn’t pass on the infection to their residents  
  1. or increase the levels of fear amongst the resident’s family that their loved ones may be at risk of infection

This care home has remained Covid free and I’m sure this is down to the strength of purpose of the manager of that care home. However, she faced a lot of criticism both from staff who disagreed with her and more surprisingly from other managers for taking a firm line in regard to her staff and vaccinations.  

Now I don’t claim to be expert enough to give a view as to whether the vaccinations will reduce the transmission of Covid 19 or not. It is a long time since I studied science of any kind, and my honours degree in agricultural botany hardly qualifies me for making a scientific assessment of human vaccines. I would add that I probably have a better understanding than many of the people who post on Facebook groups. However, I do accept that people have a right to refuse vaccines if they are concerned about the effect that vaccine might have on them. What they must also accept in exercising that right, is that there are consequences of this. The consequence could well be that their employer may not find it possible to give them shifts because of their duty to their residents and families.

At its root, I think the reason managers find it difficult to deal with these issues lies with the amount of negative pressure that is placed on them. They’re constantly being told what they can’t do rather than being asked what they want to do and then given the tools to achieve it.