Vaccination as a condition of deployment (VCOD) for all healthcare workers



Classification: Official

Publication approval reference: C1451


  • ICS leads
  • All Trust (acute, community, ambulance, mental health):
    • Chief Executives
    • Chief Operating Officers
    • Chief AHPs
    • Chief Nursing Officers
    • Medical Directors
    • Chief People Officers/HR Directors
    • Chief Dental Officers
    • Chief Pharmaceutical Officers
    • CCG accountable officers
    • CCG HR Directors
    • Regional Directors of Primary Care
    • Regional Directors of Public Health
    • PCN Clinical Directors and GP providers
    • All NHS Primary Care Dental Contract Holders


  • Regional Directors
  • Regional Directors of Commissioning
  • Regional Directors of Primary Care and Public Health Commissioning
  • Regional Directors of Performance and Improvement
  • Regional Chief AHPs
  • Regional Chief Nurses
  • Regional Medical Directors
  • Regional Chief People Officers
  • ICS chairs
  • Chairs of NHS Trusts and Foundation Trusts
  • CCG Chairs

10 November 2021

Dear colleague

Policy announcement by the Department of Health and Social Care

The Department of Health and Social Care (DHSC) has formally announced (9 November) that individuals undertaking CQC regulated activities in England must be fully vaccinated against COVID-19 no later than 1 April 2022 to protect patients, regardless of their employer, including secondary and primary care.

The government regulations are expected to come into effect from 1 April 2022, subject to parliamentary process. This means that unvaccinated individuals will need to have had their first dose by 3 February 2022, in order to have received their second dose by the 1 April 2022 deadline.

This government policy takes into account specific exemptions, including those who are medically exempt; under 18 years of age; do not have contact with patients; or are a participant in a clinical trial investigating COVID-19 vaccination. Further details on exemptions will be detailed within the DHSC Code of Practice which the NHS is expecting to be published imminently. The policy applies to the first and second dose of the COVID-19 vaccination, and not to boosters or the flu vaccination at this stage.

Next steps from NHS England and NHS Improvement

The NHS has always been clear that individuals should get the life-saving COVID-19 vaccination to protect themselves, their loved ones and their patients; the overwhelming majority have already done so. We will continue to support individuals who have not yet received the vaccination to encourage them to take up the offer of the 1st and 2nd doses, which will always be made available to them (the ‘evergreen’ offer).

NHS England and NHS Improvement is working with NHS Employers, DHSC and wider stakeholders to develop detailed implementation guidance, which will be issued in due course. This will give clarity and confirm specifically which individuals are in scope of this policy. We will work with you to minimise service disruption and ensure patient care and safety continues to be our core priority.

We ask local commissioners and systems to support primary care organisations, particularly where uptake is lower. NHS England and NHS Improvement will continue to work with local, regional, and national vaccination teams providing support to increase vaccination uptake. Targeted information is available to tackle misconceptions around vaccinations. For example, we are engaging with clinical, BAME networks and faith leaders through our advisory groups to ensure we provide appropriate support across the workforce; and have created videos with experts around fertility and pregnancy to reassure staff of the safety and importance of being vaccinated against COVID-19.

Next steps for the service

We know that one-to-one conversations have been the most effective way to support colleagues to make an informed choice, often leading to vaccination uptake. Therefore, we ask organisations to ask line managers to have supportive one-to-one conversations with unvaccinated staff members to identify reasons for vaccine hesitancy and provide information that will support them to make an informed decision about the vaccine. Resources to assist with this can be found here.

Other actions which have been found to be especially effective in increasing vaccination rates include:

  • Making it as simple and convenient as possible to receive the vaccine and to make the most of walk-ins, pop-ups, and other delivery models, such as hospital hubs, vaccinations centres and local vaccination services.
  • Engagement with targeted communities where uptake is the lowest, including extensive work with BAME and faith networks to encourage healthcare workers to receive the vaccine.
  • Senior leaders and clinicians to proactively encourage vaccination uptake for all individuals through concerted communication campaigns and proactive engagement with individual colleagues.
  • One-to-one follow up with unvaccinated individuals to offer structured support and access to expert clinical advice.

Please encourage individuals who have not yet been vaccinated to use the resources available and discuss with their own GP or trusted healthcare professional if they wish to have a further conversation or have any questions around vaccination.

Staff can access their COVID-19 vaccine from their place of work, from a community pharmacy, or a local vaccination centre using the National Booking Service. Frontline healthcare workers working outside of the NHS, including clinical and non-clinical staff, students, volunteers, and laboratory or mortuary staff, can use the National Booking Service to book their vaccine.

Support for staff

NHS England and Improvement has put in place a comprehensive package of wellbeing support for health and social care staff which includes:

We would like to take this opportunity to thank all those who have already been vaccinated and to emphasise how important it is that every person who is eligible to do so also takes up COVID-19 boosters and flu vaccinations in the lead up to winter.

Thank you for your continued support throughout the vaccination programme and for everything you are doing to care for patients and support your colleagues at this time.

Yours sincerely

Amanda Pritchard | NHS Chief Executive

Prerana Issar | Chief People Officer for the NHS

Professor Stephen Powis | National Medical Director

Ruth May | Chief Nursing Officer for England

Dr Nikita Kanani MBE | Medical Director for Primary Care