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
If you are separated from your child’s other parent, government guidance about self-isolation and social distancing may have an impact on the contact arrangements that are in place and give rise to disagreements about spending time with the other parent, travelling arrangements and whether the child should continue to go to school, where one of the parents is a key worker and a school place is available.
The government has issued guidance which makes it clear that where parents do not live in the same household, children under the age of 18 can be moved between their parents’ homes.
Cafcass has also issued guidance which states that, “unless there are justified medical/self-isolation issues – or some future nationally issued guidance or expectation associated with leaving the house in your area – children should maintain their usual routine of spending time with each of their parents. If there is a Child Arrangements Order in place this should be complied with unless to do so would put your child, or others, at risk”. The guidance from Cafcass be accessed here. https://mcusercontent.com/2750134472ba930f1bc0fddcd/files/987e77d6-0827-470c-9447-acc61404f465/CAFCASS_Covid19_advice_for_familes_20.pdf
Hopefully, further guidance will provide additional clarification on this, but it is difficult to see how a charity whose operations have been significantly curtailed because of the Covid-19 restrictions, cannot furlough employees and access the scheme, in particular where they have several different income streams. For example if a charity’s retail or fundraising operations have been significantly curtailed due to the restrictions, then it would appear unfair for it not to able to rely on the furlough scheme to assist in the funding of the employment costs associated with this part of the charity.
However, it might be prudent, where there are services that are publicly funded and employees working within those services cannot undertake their normal work, to consider if they can do different roles to work on Covid-19 activities. If there is no such work available then the guidance does appear to allow the furloughing of employees and such organisations to access the scheme.
In our experience, the funding streams and work undertaken by the organisations that could fall into the third category identified above can be exceptionally diverse and we would strongly recommend that you take advice before making such decisions about furloughing employees.
It would be prudent to take legal advice early in relation to any issue you foresee in performing a contract. This will allow you to:
- Ensure that initial contact with your counterparty is framed in the correct way
- Ensure that any variations are fully documented so that both parties are fully protected
The guidance gives numerous examples of the types of performance adjustment which parties should consider. For example this includes:
- Varying deadlines (e.g. for performance or payment)
- Varying compensation (e.g. to recognise increased costs)
- Varying the nature of performance (e.g. allowing substitute goods, allowing pert delivery of services)
The guidance also encourages a reasonable approach to enforcement, which might encourage delaying issuing formal proceedings, increased use of mediation or providing more information to the other party than would be volunteered under normal circumstances.
The guidance asks parties to act responsibly and fairly in performing and enforcing contracts. They are encouraged to act in a spirit of cooperation to achieve practical, just and equitable outcomes. In essence, rather than sticking strictly to the contract as agreed, they are encouraged to give each other leeway to deliver performance differently than they are required to do under the contract.