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).
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Whilst it is acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside their usual practice. Doctors should consider the best course of action to take in these circumstances by utilising the following:
- What is within their knowledge and skills
- What support other members of the healthcare team could offer
- What will be best for the individual patient given available options
- The protection and needs of all patients they have a responsibility towards
- Minimising the risk of transmission and protecting their health.
- Trusts should allow for telephone advice rather than face-to-face review from critical care when clinically appropriate.
- Hospitals should discuss the sharing of resources and the transfer of patients between units, including units in other hospitals, to ensure the best use of critical care within the NHS.
Please note, the above is intended to provide a summary of the key recommendations which emerge from this guidance. Access to the full guidance can be found here.
The CMA is particularly concerned about certain activities, its guidance highlights:
- Exchange of commercially sensitive information where this is not necessary in response to the crisis
- Collaboration which unfairly excludes third parties
- Abuse of a dominant position (including a dominant position held as a result of the crisis) – particularly to charge excessive prices
- Seeking to maintain prices or prevent reductions in prices
- Cooperation going beyond what is necessary to respond to the crisis in the interests of consumers
On 13 March 2020 the Secretary of State for Housing, Communities and Local Government issued a Written Statement in respect of delivery restrictions.
In this respect, many supermarkets, food retailers and distribution centres in England operate under planning restrictions (conditions and/or obligations) which limit the time and number of deliveries from lorries and other delivery vehicles which can take place particularly at night primarily to protect the residential amenity of nearby residential property.
Key points in the Statement include;
- Given the exceptional challenges facing the UK from the coronavirus, it is vital that deliveries of food, sanitary and other essential products over the coming weeks can be made as quickly and safely as possible, minimising disruption to the supply chains. The likely pressures on driver capacity mean additional flexibility is needed so that retailers can accept deliveries throughout the day and night where necessary.
- That planning enforcement is discretionary and that local planning authorities should act proportionately in responding to suspected breaches of planning control.
- That local planning authorities should not seek to undertake planning enforcement action which would result in unnecessarily restricting deliveries of food and other essential deliveries during this period having regard to their legal obligations.
The Statement acknowledges that the increased frequency of deliveries particularly at night could have a temporary impact on residents. It therefore concludes that the Government will review the need for the flexibility outlined in the Statement after the pressure from the coronavirus has reduced and that it is the intention to withdraw it once the immediate urgency has subsided.
A link to the Written Statement is below.
Failure to comply with the collective inform and consult obligations could impact on the fairness of any dismissals – see next question. In addition, a Tribunal can award a protective award of up to 90 days gross pay for each affected employee. The purpose is intended punish the employer for not complying with the obligations, not to compensate the employee for their individual financial loss.