Around a fifth of home care staff could leave if the coronavirus vaccine becomes mandatory for remaining social care staff, the sector fears.
The Government has launched a six-week consultation on making vaccination a condition of deployment for frontline workers in health and more social care settings.
Staff at registered care homes have already been told they will need to be double jabbed as a condition of deployment in England’s care homes by November 11, unless they are exempt.
The UK Home Care Association said it believes that persuasion will be more effective than compulsion for increasing uptake “without losing vital workforce capacity”.
Some 81.7% of home care workers have had their first dose, and 69.4% are fully vaccinated, according to the NHS data platform capacity tracker.
The organisation said: “Our concern is that vaccination as a condition of deployment will likely result in a substantial loss of the workforce, potentially at least 20 per cent.
“Right now, we are experiencing the most extreme challenges in recruitment and retention in history, at a time of rising demand for home care.
“We feel it’s very important to balance the mitigated risk of infection with the risk of unavailability of care at home for highly dependent older and disabled people.”
Vaccination is just one of multiple measures to protect vulnerable care recipients including use of PPE, regular testing, ventilation and cleaning, it added.
Latest figures from NHS England suggest that 234,873 social care staff, outside of those working in older age care homes, are yet to be vaccinated.
Some 90,109 (17.6%) staff working in care homes for younger adults, or in domiciliary care, have not yet had a first jab or their first jab has not yet been reported.
Three in 10 (152,400 staff) are not doubly vaccinated, the data suggests.
And 144,764 staff (25.1%) working in other settings, such as non-registered providers and those employed by local authorities, have not yet had a first dose or this has not yet been reported.
Just 32.4% in these settings are recorded as having had both vaccine doses, suggesting 389,875 are not yet fully vaccinated.
Updated NHS England data will be published later on Thursday.
UKHCA chief executive Jane Townson said the consultation only applies to registered providers, so could lead to a loss of staff “into the grey economy”.
Areas such as Lewisham, in south-east London, face losing up to 40% of their staff based on current vaccination rates, she said.
She told the PA news agency: “Vaccination is such a good thing because it protects the care workers as well, so we’re doing our absolute best to make sure as many get vaccinated as possible.
“All we’re trying to say is that forcing people isn’t going to achieve the end that we need, because they’ll just leave, and then we’ve got an even bigger problem.
“Already, the hospitals can’t discharge people back to the community, and some hospitals have 100,130 people medically fit to discharge – they can’t get out.
“So how are they going to get through their elective backlog, if I’ve got no spare beds?”
Jane Brightman, co-founder of the Outstanding Manager group and director of social care at the Institute of Health and Social Care Management, said she is very worried about the consultation, which members are seeing as “another nail in the coffin”.
She told the PA: “I think that certainly our members, and the group members, feel that’s a done deal.
“They feel like, if you go off the last consultation, it’s a consultation in name only and it’s a done deal, it will definitely go ahead.
“So they’re just bracing themselves for it, they’re just thinking ‘right that’s the next thing that’s coming’.”
The membership body Care England said the delay in publishing the consultation “has heavily impacted recruitment and retention in care homes”.
Chief executive Professor Martin Green said he hopes this will be a “small step towards creating level playing field between NHS and social care” and alleviate some of the workforce pressures due to residential care being “singled out” initially.
He added that there are still unanswered questions about booster jabs and the sector is still waiting for guidance around exemptions, with just a week until care home staff must have had their first dose.