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
As with a Will, your solicitor can take instructions by telephone, Skype or a similar tool. Your solicitor can then post or email the documentation to you. As with Wills, your signature and those of your proposed Attorneys will need to be witnessed, but in this case only by one other person. However, there are specific requirements as to who can witness your signature. The witness must be aged 18 or older and cannot be your Attorney but they can be your Certificate Provider.
Your Certificate Provider must either be someone you have known personally for at least two years or an appropriate professional. However, they must not be your Attorney and they must not be a member of your family or the partner, boyfriend or girlfriend of a member of your family or a business partner or employee of yours.
Also, if you are living in a care home, the Certificate Provider cannot be the owner, manager, director or employee of the home you live in.
Given the current restrictions on movement, if you have regular medical checks you could ask your GP or another medical professional to witness your signature and act as your Certificate Provider when you go to see them or they come to you. Alternatively, if someone you have known for two years or more is dropping off essentials, they could act as a witness and Certificate Provider remembering to retain the necessary distance and protective measures.
Concerning your Attorney(s) you cannot act as their witness. Otherwise, anyone aged 18 or older can act as their witness, including the other Attorney. Ideally, a witness to your or your Attorney’s signatures should not be a family member for the sake of impartiality and to avoid disputes. If necessary they can be.
Employers who have apprentices on fixed-term contracts due to end during the pandemic should discuss arrangements with the apprentices including whether an extension to the contract can be offered to allow them to complete their apprenticeship.
You can claim for regular payments you are obliged to pay staff such as non-discretionary overtime, non-discretionary fees, non-discretionary commission and piece-time payments. Overtime in this context is referred to as ‘past overtime’ in the updated guidance which would suggest that you should use the variable pay calculation (see FAQ above) for those who regularly carry out overtime.
A reduction in hours or salary or changes to hours or patterns of work is a contractual change – you can’t just impose it without significant risk. The same applies for lay-off or short-time working where there is no existing contractual right to impose these.
In summary, the process that an employer should follow to implement these measures is as follows:
- Communicate the Company’s position clearly and the urgent need to achieve temporary cost-saving to ensure the ongoing financial viability of the organisation
- Explain the proposed changes in detail and seek the employee’s agreement, and
- Record the agreed changes in a letter which is counter-signed by the employee.
If employees will not agree then employers will be at substantial risk of claims for unlawful deduction of wages, breach of contract and/or constructive unfair dismissal if they seek to impose these changes unilaterally. Employers should be mindful that this approach is likely to cause significant employee relations issues and dissatisfaction if only some employees agree to a reduction in pay. Employers should have a clear strategy for what their approach will be if this is the case – for example, they may wish to instead explore a different measure such as redundancies. This may form part of the employer’s communication when explaining the reason for the changes and seeking the employee’s agreement.
Unions: Employers should also be aware that where there is a recognised trade union in respect of any part of the workforce which is being asked to agree to a change to terms and conditions, the recognition agreement or collective agreement will require the employer to consult and/or negotiate with the trade union in the first instance.
Collective consultation: Where 20 or more dismissals are proposed at one establishment in any 90-day period, there are stringent collective consultation rules which apply (regardless of whether the employees have two years’ service or not). All dismissals count towards this total unless the dismissal is “not related to the individual concerned” – therefore dismissals for things such as conduct or capability do not count, but most other dismissals will count. This will include where you are imposing changes to the contract such as reduced hours or pay.
The rules on collective consultation set out a prescriptive and time-consuming process which must be followed, and minimum timescales before any redundancies can take effect. The cost of any claims relating to failure to follow collective consultation requirements are substantial, and specific advice should therefore always be sought before seeking to implement collective redundancies. We will be publishing further guidance on this on the Hub shortly.
- The Pensions Regulator has published regularly-updated guidance for employers.
- It will take “a proportionate and risk-based approach towards enforcement decisions … with the aim of supporting both employers and savers”. In other words, the law remains the same, but the Regulator will show restraint in enforcement against breaches.