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Home › FAQs › What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?

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

How can the State aid rules be applied in light of the coronavirus outbreak?

The coronavirus outbreak has seen State support being given to businesses on an unprecedented scale.

This issue is likely to be increasingly relevant as Governments seek to protect and stimulate their economies as they emerge from lockdown.

How have the rules been relaxed in the context of the crisis and what facets of the existing law can be used for the State to provide support to undertakings?

Last updated on 31st March, 2020

What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

Last updated on 14th April, 2020

What should I do if I have a hearing scheduled in the COP?

Parties are encouraged to review upcoming matters to assess the viability for there to be any agreement which can be reached in relation to the issues in dispute or to consider whether the case needs to proceed to a remote hearing. If directions or issues can be agreed between the parties, reducing the need for remote hearings, then that is the preferred option.

Last updated on 29th May, 2020

Can I progress an application for EIA development?

Where a development is considered to be “EIA development” (being development where an Environmental Impact Assessment or Environmental Statement is required to be submitted) there are additional statutory publicity and notice requirements over and above the requirements for a standard planning application. Regulations usually require that the environmental statement is to be made available for inspection by the public at all reasonable hours at an address in the locality for a period of at least 30 days. Copies of the environmental statement are also to be made available for people to take away from that address. This clearly requires physical copies to be available at a specified location for a prolonged period of time, which may prove problematic during the current health crisis.

New regulations came into effect on 14 May 2020 which will temporarily suspend the above requirements and will instead require the Environmental Statement to be available for inspection online. The applicant must however provide a certificate to the Local Planning Authority stating what steps have been undertaken to bring the application (and the Environmental Statement) to the attention of people who are likely to have an interest and why it considers that such steps were reasonable.

Last updated on 19th May, 2020

Can I require employees to take holiday during furlough?

Yes. Government guidance now confirms that employers can be required to take holiday during a period of furlough, so long as they are given minimum notice to do so. The notice required is double the length of the holiday.

Employers are also able to cancel employees’ holidays (or require them not to take holiday) if they are on furlough, for example if they are not in a position to pay the additional 20% top up to their normal wages (or more where they earn in excess of the £2,500 monthly cap on furlough payments). Again, employers are required to provide a minimum period of notice of cancellation, which in this case, is the length of the planned holiday.

Employers can ask employees to take or cancel holiday with less notice but they would need to get their agreement to do so.

Government guidance has been updated to state that “Employees should not be placed on furlough for a period simply because they are on holiday for that period.” If a period of furlough happens to coincide with an employee’s holiday then you should ensure that there are business grounds to support furlough being used in that instance so that it isn’t just being used as a means to fund holiday utilisation.

Last updated on 15th May, 2020