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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 processes can I adapt regarding Housing Disrepair?

As we all adjust and adapt in line with the Government’s guidance throughout this uncertain time, we must consider how we can revise current processes and implement new ones to maintain effective and compliant ways of working. We have identified several key issues that all housing providers should consider.

Protocol Compliance

Housing providers will continue to receive new disrepair claims. Throughout the disruption caused by coronavirus, landlords will still be expected to respond to these claims and comply with the Pre-Action Protocol for Housing Conditions Claims whilst doing so. We address the issue of disclosure in particular below.

Letters of claim will continue to be sent by post to your Registered Office, and the deadlines will run from the date of deemed service. Ensure you have systems to enable you to scan correspondence and forward it to the responsible officer who will handle the claim so deadlines are met.

Under the Protocol, the deadline for disclosure is 20 working days from deemed service of a letter of claim (2 working days after it is sent). So, for example, a letter dated 2 March 2020 would be deemed served on 4 March 2020 and disclosure would therefore be due by 1 April 2020. All housing providers must continue to comply with the Protocol and so landlords should begin preparing now.

Failure to meet deadlines often result in the issuing of further applications to court by tenant’s solicitors which in turn will lead to unnecessary costs orders against landlords.

Therefore, all records, particularly relating to customer contact and repair logs, should be held electronically. If required, this will allow for such documentation to be redacted for GDPR purposes remotely and disclosed to the tenant’s solicitor simply and efficiently.

Remember it is possible to request an extension to all Protocol deadlines and it is inevitable in these unusual times, this will need to be utilised, and should not be refused. Request extensions to deadlines at the earliest opportunity to enable an achievable timescale. It would be a difficult lawyer that would not agree to such a request.

Given the recent decline in financial performance, the business is now in breach of its covenants with the bank. Should we be concerned?

That will depend on the terms of your facility and the stance taken by your bank.

Banking facilities often place obligations on businesses to stick to certain financial criteria. For example, an obligation to keep turnover or profit above certain levels or a commitment to keep the bank’s exposure within an agreed percentage of the value of the company’s assets (known as loan to value ratio).

The consequences of breaching those covenants will depend on the terms of your facility, but normally this amounts to an event of default. Events of default can result in the loan (or whatever form the facility takes) becoming repayable and could give the bank certain powers to take action to recover the money that they are owed.

Whether the bank will take action during these unprecedented times is another matter, particularly given the extent of support being offered to businesses via mainstream lenders and the political desire to keep viable businesses up and running. Lenders themselves will no doubt wish to remain supportive where possible. The underlying performance of the business (and whether but for the effects of Covid-19 it would have been in a healthy financial position), the relationship you have with the bank and your history with them will no doubt be relevant to the approach taken by the bank. However, early engagement with your bank (as well as other key stakeholders in the business) will be important.

Retraining and redeploying

If the business has areas requiring an increased workforce whilst others require a reduced workforce, staff can be retrained and redeployed across the organisation or even across a wider group of companies. This will not reduce the wage bill but will avoid the need for redundancies. Making fundamental changes to an employee’s role and duties will require their agreement following a fair selection and consultation process.

Can charities furlough their employees?

Hopefully, further guidance will provide additional clarification on this, but it is difficult to see how a charity whose operations have been significantly curtailed because of the Covid-19 restrictions, cannot furlough employees and access the scheme, in particular where they have several different income streams. For example if a charity’s retail or fundraising operations have been significantly curtailed due to the restrictions, then it would appear unfair for it not to able to rely on the furlough scheme to assist in the funding of the employment costs associated with this part of the charity.

However, it might be prudent, where there are services that are publicly funded and employees working within those services cannot undertake their normal work, to consider if they can do different roles to work on Covid-19 activities. If there is no such work available then the guidance does appear to allow the furloughing of employees and such organisations to access the scheme.

In our experience, the funding streams and work undertaken by the organisations that could fall into the third category identified above can be exceptionally diverse and we would strongly recommend that you take advice before making such decisions about furloughing employees.

What happens if a patient is admitted to hospital during the pandemic?