Frontline social care worker definition: COVID-19 vaccination

We want to ensure that that we reduce mortality from COVID-19 as much as possible. The Joint Committee on Vaccination and Immunisation (JCVI) have considered how to achieve this by vaccinating the most vulnerable groups first. They have drawn up a list of vaccination priority groups. This guidance looks at the definition of social care worker in priority group 2.

Who do we regard as frontline social care workers for the purposes of identifying who should be in priority group 2 for COVID-19 vaccination?

Joint Committee on Vaccination and Immunisation (JCVI) definition

The JCVI states the following with regard to the prioritisation of frontline health and social care workers:

The committee considers frontline health and social care workers who provide care to vulnerable people a high priority for vaccination.

Frontline health and social care workers at high risk of acquiring infection, at high individual risk of developing serious disease, or at risk of transmitting infection to multiple vulnerable persons or other staff in a healthcare environment, are considered of higher priority for vaccination than those at lower risk. This prioritisation should be taken into account during vaccine deployment.

Green book description of social care staff

The Green Book Chapter 14a describes frontline social care staff as those:

• Working in long-stay residential and nursing care homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality
• Social care staff directly involved in the care of their patients or clients
• Others involved directly in delivering social care such that they and vulnerable patients/ clients are at increased risk of exposure

Welsh Government COVID-19 vaccination board guidance

This guidance is to provide clarity and consistency and ensure we vaccinate those social care workers that will have the greatest impact on mortality as quickly as possible. An element of professional judgement will be necessary, but this should be within the parameters set out in this guidance.

Eligibility for frontline social care workers should be based on the following factors:

The vulnerability of the person in receipt of care or support:

• Those aged 65 and over (group 5)
• Those deemed extremely clinically vulnerable (group 4)
• Those with underlying health conditions (group 6)
• Children under 16 with complex medical needs/ serious neuro-disabilities

Nature of the care or support provided:

• Personal care as defined in Regulation and Inspection of Social Care Act 2016 and further clarified by Care Inspectorate Wales in their guidance note (Annex One). Domiciliary care services and care homes are registered with CIW to deliver personal care and we would therefore expect employees of these services who are delivering personal care to be included. Personal Assistants should be included where their duties include personal care.
• The care for children under 16 years of age with serious neuro-disabilities would be expected to be beyond usual daily support and child care tasks that care givers would provide for a child. It should be frequent and may include tasks such as, for example, tracheostomy tube care, airway suction, repositioning to manage pressure areas, and care interventions such as respiratory physiotherapy.
• Close regular and prolonged contact with people in the risk categories defined above in order to provide support functions where maintaining social distancing and/or the wearing of face masks is not possible. This could include, for example, those working in the supported housing sector, provided this satisfies the criteria outlined above in respect to type of contact and vulnerability of the person in receipt of care and support. Examples of this may be:
  • intervening in challenging behaviour
  • intervening in self-harm or risky behaviour
  • day to day support of person with severe learning disability who cannot adhere to social distancing
  • prolonged and close contact due to teaching life skills in confined conditions

Eligibility is not based on:

• Location of where care or support is delivered. This could be the person’s own home, care home, supported living, supported housing, day centre.
• Employment. This could be local authority, independent sector, self-employed, agency staff.

Health boards working with their respective Directors of Social Services have ultimate responsibility for identifying eligible social care workers, underlined by the principal aim of achieving high rates of vaccination amongst frontline social care workers, recognising that vaccine supply is constrained and must be used for those at highest risk of severe morbidity and death. They should ensure that identification of eligibility is consistently applied across the system.

The local authority and NHS vaccination services will work in partnership to reach all eligible frontline social care workers irrespective of the sector in which they work.

Vaccination does not remove the requirement to have mitigation measures of social distancing, hand hygiene, environmental cleaning and good levels of ventilation in place. Strict infection prevention and control measures appropriate to the setting and the care being provided remain essential.