Tomorrow is the final day for someone to have their first vaccination if they want to be fully vaccinated by 11 November. With one day to go, we finally have news about medical exemptions. It's not the news I was expecting.

DHSC have today written to care home providers indicating that employees can now self certify that they are medically exempt from vaccination. The letter provides a form that can be completed by an employee to self certify. The decision to allow self certification has clearly been taken in a rush and the communications contradict earlier messages from DHSC. The letter gives a non-exhaustive list of potential grounds for exemptions and also provide that "A time-limited exemption is also available for pregnant women should they choose to take it."

The self certification form requires an individual to confirm that they meet the medical criteria "in this guidance". However, the attempt to include a hyperlink within the form, to more information has failed, so what they mean by "this guidance" isn't entirely clear. The form just includes examples of exemptions. For something so serious, this is very disappointing and creates further uncertainty.  

The form makes clear that "providing false information may result in disciplinary action". However, the form itself doesn't require someone to state on what the medical criteria they are relying on is.  

We consider providers accepting self certification should be seeking information as to the medical exemption being relied on, so they can be satisfied that the self certification is appropriate.  

The reason would need to be checked back against the content of the Green Book and/or the special warnings and precautions for use for each of the approved vaccines. The government obviously has better things to do than create a clear list and thinks the social care workforce should work it out for themselves!  

The form says it will be valid for 12 weeks after a clinical review process goes live however, there is no confirmation as to when the clinical review process may go live.

This latest development just shows how rushed and ill thought through many aspects of the mandatory vaccination rules are. With a judicial review having been formally issued on 9 September, care providers have further uncertainty ahead.

There is also a form that can be used by people vaccinated abroad which is a more welcome development.