What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?
- Start critical care treatment with a clear plan of how the treatment will address the diagnosis and lead to agreed outcomes.
- Review critical care treatment regularly and when the patient’s clinical condition changes.
- Stop critical care treatment when it is no longer considered able to achieve the desired outcomes. Record the decision and the discussion with family, carers and the patient (if possible).
Related FAQs
Lay off is a temporary measure where an employee is required not to do any work by their employer in any given week and does not receive any salary for that period. This is sometimes used interchangeably to refer to redundancies; however, this is not correct and lay-off is different to redundancy.
Lay-off may be very useful to achieve short or medium-term cost savings in response to a temporary reduction in demand for products or services. Whether the employer has the right to implement lay-offs and how swiftly they can expect to be able to do so will depend on whether the relevant contracts of employment have specific provisions which deal with lay-off.
Short time working is where an employer temporarily reduces an employee’s working hours, with a corresponding reduction in their pay to less than 50% of their usual salary. This could be through reducing the number of working days, reducing the length of working days or a combination of both.
Short time working provides the employer with the ability to reduce staffing costs whilst providing flexibility in deciding the form of working pattern. As with lay-off, whether the employer has the right to unilaterally impose short-time working and how swiftly they can expect to practically implement this will depend on whether the relevant contracts of employment contain a short time working clause.
Where there is a contractual right to lay off or impose short time working: There is no strict process which has to be followed. We would advise transparent communication and confirmation in writing.
Where there is no contractual right: Imposing these options without a contractual right to do so will be a fundamental breach of the employee’s contract of employment. In these circumstances the employee’s options are: accept the situation and keep working; claim for lost pay; resign and claim constructive dismissal. The best approach for employers in these circumstances is to instead seek to agree lay-off or short-time working arrangements with employees.
Selecting employees for lay-off or short time working: There is no prescribed method for selecting which employees are to be laid-off or placed on short-time working, provided that the employee cannot argue that the method of selection is discriminatory in some way. We would advise selection based on objective business reasons.
Entitlement to pay during lay-off or short time working: Employees must be paid for the time they work. Additionally, while on lay off or short time working, an employee is entitled to receive statutory guarantee pay for the first 5 workless days in any 3-month period. The maximum statutory guarantee pay in any 3-month period is £150 (i.e. £30 for each workless day up to a maximum of 5).
Entitlement to statutory redundancy pay: Once employees have been on lay-off or on short-time working for 4 consecutive weeks or for a combined total of 6 weeks during any 13-week period, they may seek to claim a statutory redundancy payment (provided that they have two years’ service). There is a prescriptive process for this – please seek advice.
Employees are generally permitted to take holidays during furlough. However, Government guidance has been updated to state that “Employees should not be placed on furlough for a period simply because they are on holiday for that period.” If a period of furlough happens to coincide with an employee’s holiday then you should ensure that there are business grounds to support furlough being used in that instance so that it isn’t just being used as a means to fund holiday utilisation.
You can rotate staff on furlough or flexible furlough.
One option is to make it clear in the letter agreeing to being furloughed that there is an open ended right to rotate and to be able to take them off furlough and bring them back and put them back on.
So the employer reserves the ability to rotate by building into the agreement, but only exercises it if it is permissible.
Rotation is quite key for employers who need to make a temporary reduction to their overheads but want to retain the skills base to call back when work picks up. Having furloughed staff return on a part-time basis may reduce the need to rotate.
It also helps in the employer being able to show that they are treating the workforce as fairly as possible and everyone is taking a reduction. Get in touch if you need help preparing the documentation for furlough that will permit rotation or flexible furlough.
Read more about flexible furlough and how this can be used as part of the CJRS.
Almost two thirds of hearings conducted in the Civil Court will occur in person over the next few months as the Civil Court sees an influx in cases.
The Courts
In the Business & Property Courts, cases have been dealt with consistently since the start of the pandemic, except for trials that run for longer than 10 days in the Commercial & Admiralty Court. The Queen’s Bench Division and Administrative Court are also running as normal. If your case is listed for one of these courts, you do not need to be concerned that your case may take longer than anticipated, with conclusions still being reach at the normal rate.
Hearings
Since the start of the pandemic, most hearings have been conducted online through various platforms such as Skype for Business and Cloud Video Platform. The courts are of the view that remote hearings tend to take longer than those that are held in person. As a result, if your case is due to be held in person, the case may be heard in less time. HM Courts and Tribunals Service stated that:
“Wherever possible we will look to facilitate face-to-face hearings, but our expectation is that remote hearings will continue to play an important role for the foreseeable future, given that social distancing will continue to limit courtroom capacity compared to pre-Covid levels.”
More courtrooms have become available since the start of the pandemic, resulting in more facilities for cases to be heard in person, which will have the aim of helping to rid of the backlog of cases, along with remote hearings being conducted too, which is a welcome step forward.
Approximately 300 additional support staff will be employed for remote hearings before the end of 2020, enabling better service with remote hearings. The Government has decided that some civil judges will have the option to extend operating hours for cases to be held in the evenings and on weekends too, which may be most suitable for small and fast-track claims, resulting in a potentially faster outcome. The efficiency of all the new measures are being monitored and changes are being implemented, such as increasing the capacity of the Small Claims Mediation Service.
Small Claims Mediation Service
With claims of a lower value, a high proportion of cases successfully settle outside of court, therefore, if you have a small claim, the mediation service may be suitable for your case. Mediation involves a trained impartial third party, with the parties to the case discuss the dispute with the assistance of the third party, aiming to reach a settlement. Now with the increased capacity, it may make the mediation service more accessible, meaning that an agreement can be reached more swiftly rather than waiting for the matter proceed to a hearing.
The courts have stated that:
“We aim to increase capacity to accommodate 90% of parties who want mediation, rather than the current 40%. We are recruiting additional mediators and restructuring ways of working to achieve this.”
This is a positive shift for those with small and fast-track claims where legal costs ought to be kept to a minimum. Settling by mediation removes the need for trial costs, amongst other costs, and has additional benefits such as the matter being dealt with more amicably.
The General Medical Council (GMC) have published guidance online for doctors during this time of uncertainty.
Alongside this, their website displays guidance for temporary registration to approximately 15,000 doctors, who left the register or gave up their licence to practise in the last three years.
These clinicians have been contacted to assist with the growing pandemic, outlining the process they would follow and informing them of their right to opt-out. The Secretary of State for Health can ask the GMC to grant such registration under Section 18a of the Medical Act 1983, in an emergency.