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
Some employers falling into the third group of organisations described above could understandably feel aggrieved that on the first reading of the guidance they are not able to furlough employees and rely on the Government scheme. Many publicly funded organisations that are not public sector employers, receive a package of public funding with little expectation on how that funding is used or applied, other than broadly for it to be used in providing the services it is contracted to deliver. Also, several publicly funded organisations have many different income streams and the element of funding that is received from the public purse can be only an element of their operating costs.
Unfortunately there is still no clear guidance on when employers falling into the third category identified above can use the scheme. The only reference in the guidance on this states that where organisations are not “primarily funded” from the public purse and whose staff cannot be redeployed to assist with the coronavirus response, the scheme might be appropriate to be used for some staff. This seems to suggest that where an employing organisation is not wholly or mainly funded by public funding and staff cannot be redeployed to work in areas in the effort to combat coronavirus, then it would be appropriate for the employer to access the scheme.
If considering applying for grants under the scheme a sensible approach would be to look at the combined total of your public funding and payments under the scheme and make sure it will not represent more than 100% of the level of total income you would have expected to receive during this period in a non-Covid scenario.
Local Authorities are expected to maintain support to suppliers and this should be considered:
Data on properties, and people, has never been more important.
Given that compliance is at risk here, such a decision must be made by the Board to ensure good governance. Board approval should be sought and recorded for the approach the organisation is taking.
It is essential that you continue to record your data on compliance and report to your board at all times, and that there is a clear audit trail for issues with access, and if appropriate to the Regulator. Access issues as a result of self-isolation should be readily identifiable.
Operatives need to be provided with the tools to operate in as safe a way as possible:
- Checklist of questions to ascertain occupant’s current health
- Protective equipment (masks, gloves, over clothing)
The Gas Safe website is a useful resource for updates: https://www.gassaferegister.co.uk/help-and-advice/covid-19-advice-and-guidance/
With the exception of the Covid-19 Corporate Financing Facility (see below), there was initially little dedicated financial assistance for medium-sized and larger businesses affected by the coronavirus outbreak (the so-called “stranded middle”); however, from 20 April 2020 such businesses (with a turnover above £45 million) have been able to access finance via the Coronavirus Large Business Interruption Loan Scheme (“CLBILS“).
CLBILS operates in a similar manner to CBILS except that a lender can provide:
- up to £25 million to businesses with turnover from £45 million up to £250 million; and
- up to £50 million to businesses for those with a turnover of over £250 million.
Finance is available in the form of:
- term loans
- revolving credit facilities (including overdrafts)
- invoice finance and
- asset finance,
in each case available on repayment terms of up to three years.
Several changes to CLBILS took effect from 26 May 2020. The maximum amount available through CLBILS to a borrower and its group increased from £50m to £200m. Term loans and revolving credit facilities over £50m will be offered by CLBILS lenders which have secured additional accreditation. The maximum size for invoice finance and asset finance facilities remains at £50m. Companies borrowing more than £50m through CLBILS will be subject to further restrictions on dividend payments, senior pay and share buy-backs during the period of the loan. Further information on the most recent changes, including new provisions on seniority of CLBILS facilities, can be found on the CLBILS page on the British Business Bank website. There is also an in-depth FAQs section for businesses, which has the full details of the changes to the scheme.
Unlike CBILS, the UK government will not make payments to cover the interest and any lender-levied fees in the first 12 months of any facility so these larger businesses will not benefit from the no upfront costs and lower initial repayments that smaller businesses eligible for CBILS benefit from. The other key provisions of CLBILS, such as the eligibility criteria, the 80% government-backed guarantee and security, are similar to those of CBILS.
Eligibility is similar to CBILS and businesses must:
- Be UK-based in its business activity
- Have an annual turnover of more than £45 million
- Have a borrowing proposal which the lender would consider viable, were it not for the current pandemic, and for which the lender believes the provision of finance will enable the business to trade out of any short-term to medium-term difficulty
- Self-certify that it has been adversely impacted by the coronavirus (COVID-19)
- Not have received a facility under the Bank of England’s Covid Corporate Financing Facility.
Businesses from any sector can apply, except the following:
- Credit institutions (falling within the remit of the Bank Recovery and Resolution Directive), insurers and reinsurers (but not insurance brokers)
- Building Societies
- Public-sector bodies
- Further-education establishments, if they are grant-funded
- State-funded primary and secondary schools
All lending decisions remain fully delegated to the accredited lenders.
An obvious cost cutting measure is to reduce salaries, either temporarily or permanently. If you are to seek a reduction in salaries, this should be done fairly – either across the board or by selecting teams/individuals based on objective business reasons.
Note that this cannot be imposed without significant risk. Without agreement, this would need fair selection and consultation.
Privacy policy – You must make sure the relevant privacy policies deal with how you will process Covid-19 data. You should have an employee privacy policy and this may already deal with health data (if it doesn’t, it should). You might also need to look at privacy policies for customers, visitors and suppliers. This ensures that processing is lawful, fair and transparent.
Lawful processing conditions – You will need to consider which processing conditions you are relying on (remembering that you need both an Article 6 condition and an Article 9 condition – this is the part of the GDPR which deals with special category data). As a lot of the data you collect will be about employees, you can’t use consent so you will have to find another lawful reason under GDPR which allows you to process the data.
Appropriate policy document – When you are considering your Article 9 processing conditions, remember you must also have an “appropriate policy document” in place.
Processing record – Finally make sure your processing record is up to date with information on what data you collect and use.