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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 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

How do you prevent MHFA from handling situations that are for qualified individuals such as their GP or EAP?

The MHFA training makes this clear, it should be made clear in the MHFA role specification and procedures and discussed during regular MHFA peer support and MHFA surgery sessions. It is important to ensure that where an Employee Assistance Programme is in place, all MHFAs have details of that scheme available so they are able to instantly share details of the scheme with those who require support. If in doubt due to serious concerns then using 999 or Samaritans is an option.

Last updated on 8th April, 2022

Is there a matched funding scheme for the National Emergencies Trust?

The government has also confirmed it will match donations to the National Emergencies Trust as part of the BBC’s Big Night In fundraiser on 23 April – pledging a minimum of £20 million.

Last updated on 9th April, 2020

Employer furlough schemes

Furlough means temporary leave of absence. There is nothing to stop an employer seeking to agree a temporary leave of absence – with or without pay – with its workforce.

This could not be forced on an employee without significant risk. Without agreement, this would need fair selection and consultation – more on that later.

Last updated on 6th May, 2020

BSA 2022 states that RP’s will have greater powers (to encourage residents to provide access and to fulfill their duties). What are these powers and when are they expected?

Residents will be obliged to:

  • Not act in a way that creates a significant risk of a building safety risk materialising
  • Not interfere with building safety equipment in the common parts
  • Comply with an Accountable Person’s request for information in relation to the assessment and management of building safety risks.

The Accountable Person then has powers in relation to these duties, including:

  • Issuing a contravention notice, requiring a resident to pay for replacement or repair of safety equipment which they have interfered with
  • Applying for court orders in certain situations
  • Requesting access at a reasonable time (in writing with at least 48 hours’ notice) to a resident’s property for the purposes of assessing or managing building safety risks, or checking compliance with the resident’s duties as above.

Secondary legislation is still awaited to bring these provisions into force, so the timing is unknown, but it will likely be within the next 12 months in line with the anticipated timetable for the remainder of the Act.

Last updated on 13th October, 2022