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 Act is intended to facilitate the rescue of businesses that are in financial difficulty by preventing suppliers from invoking certain termination clauses under a supply contract, and therefore maintaining supply of goods and services to the business whilst plans to save the business can be considered.
Supply contracts often contain a clause enabling them to terminate the contract, or take other steps such as requiring payment in advance, in the event that the customer enters an insolvency procedure.
This new Act removes any such contractual right by dis-applying any clause that allows the supplier to terminate the contract, or take any other step, due to the customer entering an insolvency process.
Suppliers are also prevented from demanding payment for pre-insolvency debts owed by the customer as a condition of continued supply.
Additionally, where the supplier had a contractual right to terminate the contract due to an event occurring before the customer went into the insolvency process (whether or not linked to payment issues), the supplier loses this right for the duration of the insolvency process.
In the event that the worst happens and contractor insolvency occurs, there are a number of steps which the employer should take immediately:
- Confirm that insolvency has actually occurred and the type of insolvency (for example liquidation or adjudication) – actions taken based on rumours can have adverse consequences
- Secure the site and carry out an audit of the plant, equipment and materials present – this may extend to changing the locks on site in order to prevent overzealous contractors and sub-contractors seeking to return and take what they see as their possessions. The building contract may contain a provision that these are the employer’s property, but they can be difficult to recover if they are not within the employer’s possession – possession is 9/10ths of the law!
- Ensure that there are adequate insurance and health and safety arrangements in place for the site – these would usually be dealt with by the contractor and therefore may no longer be in place, so alternative arrangements may be required
- Ensure that any further payments to the contractor are stopped pending a more detailed review
- Consider whether any off-site materials have already been paid for and can be secured. This can however be difficult in practice where the materials are not physically within the employer’s possession
In addition, there are also a number of further actions which the employer should consider in the slightly longer term:
- Investigate the options available and ascertain the cost of completing the works to assist in deciding how best to proceed
- Consider whether termination of the contractor’s employment under the building contract is required, and if so take the necessary steps in accordance with the building contract
- Consider whether there are any bonds or guarantees in place upon which the employer can rely, and if so assess their terms as to whether and how to make a claim
- Make arrangements to complete the works – as a general rule of thumb the cost of completing the works may increase by around 30% if it is necessary to get a replacement contractor
- Consider whether direct payment to subcontractors is possible or desirable
- Although we would say this(!) we would strongly recommend taking legal advice, as insolvency and its implications are complex and it is easy to inadvertently fall foul of the various different requirements
Data on properties, and people, has never been more important.
Given that compliance is at risk here, such a decision must be made by the Board to ensure good governance. Board approval should be sought and recorded for the approach the organisation is taking.
It is essential that you continue to record your data on compliance and report to your board at all times, and that there is a clear audit trail for issues with access, and if appropriate to the Regulator. Access issues as a result of self-isolation should be readily identifiable.
Operatives need to be provided with the tools to operate in as safe a way as possible:
- Checklist of questions to ascertain occupant’s current health
- Protective equipment (masks, gloves, over clothing)
The Gas Safe website is a useful resource for updates: https://www.gassaferegister.co.uk/help-and-advice/covid-19-advice-and-guidance/
You must only make a report under RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013) when:
- An unintended incident at work has led to someone’s possible or actual exposure to coronavirus. This must be reported as a dangerous occurrence
- A worker has been diagnosed as having COVID 19 and there is reasonable evidence that it was caused by exposure at work. This must be reported as a case of disease
- A worker dies as a result of occupational exposure to coronavirus.
After 25 March 2020, and until 30 September 2020, a landlord can only start possession proceedings against a tenant if they have served 3 months’ notice upon the tenant – irrespective of any grounds relied upon.
On 27 March 2020, the Court introduced new rules to put all possession proceedings (except against trespassers) on hold until 25 June 2020 – it means that the Court cannot make an order for possession or any other order that would cause someone to be evicted during that time.
These rules do not just apply to tenants who have fallen into rent arrears.
On 5 June 2020, the Government announced that this stay would be extended further until 23 August 2020.
This means that you can issue new possession proceedings (provided you have complied with the new temporary rules in relation to notice periods, if the notice was served since 25 March 2020) and you can continue with existing possession proceedings.
However, any progress you may be able to make in dealing with those proceedings is likely to be very limited – the Court will allow you to comply with directions orders that have already been made but non-compliance will not be punished (at least for the time being).
These rules, and the latest announcements, are in keeping with the Government’s expectation that landlords show compassion towards affected tenants and that all parties will work together to establish a suitable repayment plan to allow tenants to repay the arrears at an affordable rate.