Care homes will be forced to choose between dismissing unvaccinated staff and risking unsafe services, or breaking the law by keeping employees on, sector leaders have said, on the deadline for staff getting their first doses.

Providers and unions have warned of an exodus of staff due to the Government’s requirement for them to be fully vaccinated against coronavirus by November 11, meaning Thursday is their last opportunity for a first dose unless they are medically exempt.

With less than 24 hours before the deadline, the Government announced a temporary self-certification process for medical exemptions, which has been described as “hastily thought-out” and a “loophole”.

It will allow staff and volunteers to self-certify that they meet the medical exemption criteria before the new NHS Covid pass system is introduced, with these exemptions expiring 12 weeks after its launch.

Those covered include people with a severe allergy to the vaccines, those who had adverse reactions to their first dose, people who are receiving end-of-life care and people with learning disabilities, autism or with a combination of impairments who find vaccination distressing because of their condition.

Pregnant care home workers and people with short-term medical conditions will also be able to apply for a “time-limited exemption”.

Providers said it could be misused by employees who are not prepared to get jabbed and wish to stay in work for longer, and that it pushes the issue of staff dismissals 12 weeks down the line.

The GMB union said the Government had “fudged it” at the eleventh hour.

Figures released on Thursday by NHS England show that 92.7% of staff at care homes for older adults have had a first dose as of September 12, while 84.8% have been fully jabbed.

There was a 0.8 percentage point rise in first dose uptake over the seven days to September 12 – the largest weekly rise for two months – suggesting the deadline has had some impact.

If uptake has stayed at the same rate this week, the proportion of care staff having had a first dose will have passed 93% by the deadline, according to PA news agency analysis.

Professor Martin Green, chief executive of Care England, told BBC Radio 4’s Today programme that care homes may have to close as a result of mandatory vaccination.

He said: “We all accept we want as many people as possible to be vaccinated. But I do feel the Government has gone forward with the social care compulsion without understanding the implications, without having a thought-out plan on how they are going to deal with staff shortages.

“Care homes are now in a difficult position, facing the reality of do they have enough staff to maintain safety and quality of care?

“They are in the position of either having to transgress the law or expose people they support to levels of staffing that are not going to deliver the safety you’re required to.

“There’s the inevitability that in some areas, if you can’t get the staff, then there will be care homes that close.”

Mike Padgham, who runs Saint Cecilia’s Care Group in Scarborough, said four of his 164 care staff do not want to get vaccinated, one of whom is medically exempt.

He is calling for the Government to postpone the mandatory vaccination deadline or rethink it entirely, allowing carers to work wearing enhanced PPE and after taking daily tests.

In a letter to be sent to Health Secretary Sajid Javid he wrote: “I cannot redeploy them, as I have nowhere to redeploy them to.

“Even if I did, I would find it extremely hard to find four care workers to replace them in the teeth of the worst staffing crisis in the history of social care provision.

“Am I to sack them or send them home and leave myself four team members down? If I do sack them, do I leave myself open to four industrial tribunals?

“Whatever I do, I run the risk of contravening Care Quality Commission (CQC) regulations and being prevented from operating as a provider.”

A Department of Health and Social Care spokesman said: “Temporarily, those who meet the criteria for a medical exemption will be able to self-certify until we introduce a new system.

“This will ensure those with medical exemptions can continue working in care homes.

“Our message is clear: vaccines save lives and it is our responsibility to do everything we can to reduce the risk for vulnerable people in care homes.”