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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

What is the NICE guidance around clinical decision-making?
  • Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
  • Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.
Can I demand that my employees have the vaccine?

In most circumstances the answer will be no. It would be an infringement of their human rights. It could also be a criminal assault.

However where there is a high risk to employees of exposure to COVID-19, such as care homes and healthcare environments, you might be able to make it a requirement of their role to have the vaccine.

First, consider whether you need to have a blanket requirement covering all employees or whether only certain groups who work in the most high risk areas require the vaccine.

You will need to do a thorough risk assessment balancing the amount that the risk of exposure would be reduced against the interference with the employee’s human rights. Consideration will need to be given as to whether insisting on the vaccine is proportionate to the risk and whether other less invasive steps could be taken instead, such as maintaining social distancing, wearing a mask, washing hands.

Any requirement for employees to be vaccinated should be communicated clearly to employees and trade unions together with a clear explanation for why it is necessary.

What actions and measures should be avoided?

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
If an employee works with vulnerable people who are at high risk of catching coronavirus, can the employer require them to limit their activities outside of work?

It is unlikely that an employer can place such a requirement on staff without infringing the employee’s privacy. If the employee is acting in accordance with the rules, limiting their activity would likely be considered unreasonable.

How do you ensure clinical governance around MHFAs?

MHFAs are not qualified mental health medical professionals and they should not be diagnosing or giving medical advice, however, their training will equip them to provide initial support to those experiencing symptoms of mental ill health, and to signpost to further professional help when needed. The MHFA training makes the boundaries of the MHFA role very clear and there should be clearly defined role specifications, procedures and support pathways in place to ensure that individuals are referred on appropriately. There should be peer support in place for MHFAs and a system in place to ensure no individual or individuals are overloaded.