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

Whilst it is acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside their usual practice. Doctors should consider the best course of action to take in these circumstances by utilising the following:

• What is within their knowledge and skills
• What support other members of the healthcare team could offer
• What will be best for the individual patient given available options
• The protection and needs of all patients they have a responsibility towards
• Minimising the risk of transmission and protecting their health.

The fundamentals of risk assessment remain the same as for any other foreseeable risk.

Focus on risk controls which reflect Government guidance; social distancing (2 metres) and avoiding contact with occupiers if possible, high-quality PPE – disposable overalls, gloves and fluid repellent surgical face masks, ready access to antibacterial wipes for surfaces, tools and equipment and plentiful hand sanitizer.

Has there ever been a more important time for all staff to feel that they are able to raise concerns about their working environment?

It is a pertinent time to remind all staff that they should be able to raise concerns without the fear of repercussions. It is a good time to be reviewing and re-issuing your Freedom to Speak up/Whistleblowing policy to all. Likewise it is a good time to remind all staff that they should not treat others unfairly or detrimentally for raising health and safety concerns.

Both subjecting someone to a detriment because they have blown the whistle or raised health and safety concerns (and dismissing someone for the same) is unlawful.

This may be a good idea – whatever name they are given, it is essential that MHFAs are empowered to take a proactive approach to organisational mental health and that they have the bandwidth to be able to discharge their responsibilities.  The name should reflect the culture of the organisation, the key aspect is awareness and accessibility – identifying a name for your company that supports this is key.

The scheme is being administered by HMRC under a new online portal that has been set up. It applies to businesses, charities, recruitment agencies, individuals who employ a nanny, administrators (where there is a reasonable likelihood of re-hiring the workers) and public authorities.

All employers with a UK payroll can apply as long as you have:

• Created and started a PAYE payroll scheme on or before 28 February 2020
• Enrolled for PAYE online (which can take up to 10 days)
• A UK bank account.

To make a claim you will need:

• The number of employees being furloughed
• The start and end date of the claim
• The name and National Insurance Numbers for each furloughed employee
• Your employer PAYE reference number
• To be registered for PAYE online
• The Self-Assessment Unique Taxpayer Reference, Corporation Tax Unique Taxpayer Reference or Company Registration Number as appropriate for your entity
• Your UK bank account details and sort code
• Your name and contact number
• Your organisation’s registered name
• Your organisation’s billing address
• The full amounts you are claiming for including:
  • Employee wages
  • Employer national insurance contributions
  • Employer minimum pension contributions

For claims for those who are flexibly furloughed you will also need:

• the number of usual hours the employee would work during the claim period
• the hours the employee has worked or will work during this period
• you will also need to keep a record of the number of furloughed hours that the employee has or will be furloughed for.

You will need the above information ready before you access the system to make a claim. You will also need to have calculated the amounts claimed in advance as the application needs to be completed in one session. You can currently save one draft of the application and it must be completed within 7 days of starting it.

The Government has issued a step-by-step guide for employers who wish to make a claim under the scheme which can be found using the link below. It contains useful information about calculating the payments claimed. You will need to register for a Government Gateway ID and password if you do not yet have one in order to access the portal.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/880099/Coronavirus_Job_Retention_Scheme_step_by_step_guide_for_employers.pdf

If you use an agent who is authorised to act for you for PAYE purposes, they will be able to make a claim on your behalf. If you use a file only agent (who files your RTI return but doesn’t act for you on any other matters) they won’t be authorised to make a claim for you and you will need to make the claim yourself. A file only agent can assist you in obtaining the information required to make a claim (listed above). If an agent makes a claim on your behalf you will need to tell them which bank account you would like the grant to be paid into.

For claims for fewer than 100 employees you will need to input the details separately for each employee. If claiming for more than 100 employees you can upload a file with the information instead. The file should include the following information for each furloughed employee: name, National Insurance number, claim period and claim amount, payroll/employee number (optional). You will also need to include details of hours normally worked, actual hours worked and hours furloughed for those who are flexibly furloughed.

The need to demonstrate the impact of coronavirus on your business is not one of the criteria listed above about who can make a claim, so the government does not appear to intend to set a specific test to determine if a business is “severely impacted by coronavirus”. You are not required to explain the impact of Coronavirus on your business when submitting your claim.

HMRC will retain the right to audit any claim retrospectively. You must keep records for 6 years including:

• the amount claimed and claim period for each employee
• the claim reference number
• you calculations for each claim
• details of hours usually worked and hours actually worked for flexibly furloughed employees.

You must tell your employees that you have made a claim under the scheme, and you must continue to pay their wages during this time.