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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

I am dealing with an estate where the bank has sent me an indemnity to obtain the funds. Will the bank accept my signature without it being witnessed by my solicitor?

If you have obtained a Grant of Probate or Grant of Letters of Administration there should be no need to complete an indemnity, merely an account closure form. If however you have not yet obtained a Grant but the bank is willing to release funds then they will generally require an indemnity to be executed. Several banks and building societies including Barclays, Lloyds, HSBC and Santander have signed up to the British Banking Association’s voluntary Bereavement Principles, one of which is to support the bereaved according to their personal needs and work with you to resolve everything as quickly as possible.

If the indemnity requires a solicitor to act as a witness, you should contact the bank to see what they are willing to do to get around the problem, given the current situation.

What rate of pay applies to an employee returning from statutory leave who is furloughed?

Statutory leave includes family related leave, sick leave or parental bereavement leave. Claims for furloughed individuals returning from statutory leave should be based on their salary, before tax, and not the pay they received while on statutory leave.

Similarly, claims for furloughed employees returning from a period of unpaid leave on sabbatical should be based on their pay they would have had on paid leave.

Are the Courts still open and operating?

Yes, but the Courts have been temporarily restructured into three categories:

  1. Open courts (open for business including vital in person hearings)
  2. Staffed courts (for video and telephone hearings)
  3. Suspended courts (no hearings of any kind)

These changes have been effective from Monday 30 March 2020.

The employee I need to consider suspending is a doctor – do I have to follow MHPS

Yes probably in our opinion, even if you are not considering taking any formal action against them. Ultimately if a doctor is suspended this could be considered as causing them reputational damage and it therefore is correct that they are afforded the protections (in particular in relation to keeping exclusion/suspension under review) of MHPS. Under Part V of MHPS there is provision for excluding practitioners if they are a danger to patients and they refuse to recognise it or if they refuse to co-operate. It doesn’t refer to a particular risk for the practitioner themselves, but it would appear logical that it would apply.

Other considerations – the mental health and wellbeing of BAME staff and others

Undeniably and understandably BAME staff, as well as those staff who are identified as being at a higher risk, are going to have high levels of stress and anxiety. For some, this may become of such severity that those staff should be considered to be disabled under the Equality Act 2010. The question as to whether someone is disabled is one that should be answered in conjunction with appropriate medical advice. But the question about how to support any staff suffering with stress and anxiety should not be left until that stage. Proactive steps need to be taken and expert advice obtained on what support measures should be put in place. We know that many NHS organisations are already giving the mental wellbeing of their staff the highest priority.

From our perspective, we would ask managers to be mindful that stress and anxiety is likely to feature in how an individual reacts to questions about the level of risk to their health and the impact on their duties. The conversations with some staff may not be easy to have and may be met with challenge.

For those staff who’s stress and anxiety is such that it would qualify as a disability, reasonable  adjustments will need to be considered to the processes that you are applying.

An additional point to consider – it might be worth writing to all staff, asking them to come forward if they have any health conditions that they think you ought to be aware of, assuring them that such information is being given in the strictest confidence. You want to make sure that you are taking the appropriate measures to ensure their health and safety.