Government announces temporary scheme for self-certification of medical exemption from mandatory vaccination

On Wednesday 15 September, the eve of the last day that care home workers must have their first COVID jab in order to comply with the 11 November compulsory vaccination deadline, and with no sign of the promised medical exemption certification scheme in sight, the government announced a temporary scheme, which will potentially make the situation even more complex for care service owners.

Our HR & Employment Law experts summarise the temporary scheme, and its potential impact on care services, below.

What is the temporary scheme?

On a temporary basis, from Wednesday 15 September, people working or volunteering in care homes “who have a medical reason why they are unable to have a COVID-19 vaccine“ will be able to self-certify that they meet the medical exemption criteria, using the form attached in a letter announcing the scheme, which has been issued to all care home providers and managers.

The announcement says, “this temporary self-certification process has been introduced for a short period prior to the launch of the new NHS COVID Pass system which will go live imminently”.

What do employees need to do?

Care home workers “who are exempt” should sign the self-certification form and give this to their employer as proof of their “temporary exemption status”. Once the NHS COVID Pass system is launched, employees will have to apply for a formal medical exemption through that process.

How long will the temporary exemption last?

The temporary self-certification will expire 12 weeks after the NHS COVID Pass system is launched.

Who is exempt?

The announcement is unclear on this critically important point. It says,

“While this list is not exhaustive, examples of medical exemptions from COVID-19 vaccination could include individuals:

  • receiving end of life care where vaccination is not in the individual’s interests
  • with learning disabilities or autistic individuals, or with a combination of impairments which result in the same distress, who find vaccination and testing distressing because of their condition and cannot be achieved through reasonable adjustments such as provision of an accessible environment
  • with medical contraindications to the vaccines such as severe allergy to all COVID-19 vaccines or their constituents
  • who have had adverse reactions to the first dose (for example, myocarditis)”

It adds that exemptions for conditions listed in section 4.4 (special warnings and precautions for use) in the Summary of Product Characteristics for each of the approved COVID-19 vaccines may also be considered.

From a practical perspective, there is clearly enormous scope for employees who were previously thought to fall outside the scope of medical exemption, to argue that, as this list just contains examples, they are entitled to self-declare medical exemption even if they subsequently fall out of scope of the permanent scheme. The self-certification form carries a warning that providing false information on the form may result in disciplinary action, but this may not seem like a huge deterrent to employees who are already facing dismissal.

Short-term exemption

The temporary scheme also provides for time-limited exemptions for those with short-term medical conditions (the examples given in the letter are people receiving hospital care or receiving medication that may interact with the vaccination).


The time-limited exemption is available to pregnant workers should they choose to take it. This will be welcomed by employers who were struggling with issues involving employees who are happy to be vaccinated but wish to delay this until after their pregnancy.

Vaccinations abroad

The government has been considering how to deal with those who’ve received vaccinations abroad. The announcement states that in these cases those individuals can also self-certify as medically exempt, as it would not be clinically appropriate for them to be vaccinated again in the UK if they have already received a “partial or full course” of vaccination overseas.

The temporary scheme of self-certification introduces scope for many employees to self-declare exemption in circumstances where they will not qualify under the permanent exemption process, meaning that their self-declared exemption period will take them beyond the 11 November deadline, but may still leave them unable to work after this point if they are not fully vaccinated and are refused exemption certification under the full scheme. Employers will have to carefully manage the dismissal process in such circumstances.

Vaccination policy

Citation has updated our vaccination policy template in line with the new scheme and this can be found on Atlas, here.

And remember, if you need help understand how this new update may affect your care service, you can call our 24/7 advice line on 0345 844 4848.

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