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
The Chief Coroner supports the position, communicated by NHS England and the Chief Medical Officer that Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death (MCCD) and is considered a naturally occurring disease. This cause of death alone is not a reason to refer a death to a coroner under CJA 2009.
If the cause of death is believed to be due to confirmed Covid-19 infection, there is unlikely to be any need for a post mortem to be conducted and the MCCD should be issued, and guidance is given on how this is delivered to the Registrar in the event of the next of kin/informant being in self-isolation.
In a hospital setting the MCCD process should be straightforward because of diagnosis and treatment in life. This may be more complex in a community setting. The Coronavirus Act 2020 however expanded the window for last medical review from 14 to 28 days. Outside of this, the death will need to be reported to the coroner.
Although Covid-19 is a naturally occurring disease, there may be additional factors around the death which mean it should be reported to the coroner; for example, the cause of death is unclear, or where there are other relevant factors. Guidance is given to coroners on how to manage such reported deaths, particularly where post mortem examinations may not be readily availability.
No, where employees cannot work from home, and it is safe for them to return to work, they should do so.
The National Police Chiefs Council (NPCC) issued guidance mid-April confirming that you can move to a friend’s address for several days to “cool off” following an argument at home. You should strongly consider either yourself or your spouse moving elsewhere where children are involved as it prevents the children from witnessing conflict within the home, at what is already an emotionally charged time for them. Nevertheless, you should also consider and take legal advice on the financial implications of either of you or your partner moving out and how contact with the children is going to be promoted with both parents, if suitable. The Government Guidance has confirmed that children can be moved between households if they have separated parents.
It is still possible to issue Divorce proceedings and much of the process has now been taken online. The main divorce suit is dealt with separately to the separation of financial assets and children arrangements, which can often take much longer to review and discuss. While staff shortages may mean slower turn-around times there is no reason to suspect that a divorce will not otherwise go ahead as anticipated. Once coronavirus has passed, it is likely that divorce rates will spike and there will be an increased demand on the Court system, so your divorce process may take longer if you delay filing your divorce.
It is also still possible to issue Court Applications regarding any financial settlements or children arrangements, however, the Court system was already under significant pressure before coronavirus, so the pandemic will only add to that and we expect Court processes to significantly be slower in those areas.
Court Applications should in any event be used as a last resort and there are alternative dispute resolution processes available which you should consider, including Arbitration and Mediation. Family lawyers are continuing to advise and assist individuals, manage their separations and can provide information about the options available, using alternative methods of communication such as Teams, Skype or Zoom for clients. Understandably, speaking aloud may be difficult in circumstances where you are not able to get any private time away from your spouse due to you being in lockdown and so email correspondence may be the most appropriate method of communication.
The Flexible Furlough Scheme, ‘FFS’ an unfortunate acronym, allows employees to work for some of the week and be furloughed for the rest.
On 7 May the Government published guidance on how contracting parties can act responsibly in order to assist the effort to deal with Covid-19. The guidance seeks to persuade contracting parties to act reasonably and recognise the impact of Covid-19 on contractual counterparties. This will continue to be relevant as business begins to emerge from lockdown.