What happens if a patient is admitted to critical care during the pandemic?
- On admission to critical care, the risks, benefits and likely outcomes of the different treatment options should be discussed with patients, families and carers so they can make informed decisions about their treatment wherever possible.
- A member of the critical care team should be involved in these discussions whenever the patient or team needs advice about critical care to make decisions about treatment.
Related FAQs
This guidance from the Chief Coroner applies to reports of death and coroner investigations in England and Wales. It is to assist coroners in continuing to exercise their judicial decisions independently, in accordance with the law, and during the extraordinarily pressured events being faced at present.
The Chief Coroner supports the position, communicated by NHS England and the Chief Medical Officer that Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death (MCCD) and is considered a naturally occurring disease. This cause of death alone is not a reason to refer a death to a coroner under CJA 2009.
If the cause of death is believed to be due to confirmed Covid-19 infection, there is unlikely to be any need for a post mortem to be conducted and the MCCD should be issued, and guidance is given on how this is delivered to the Registrar in the event of the next of kin/informant being in self-isolation.
In a hospital setting the MCCD process should be straightforward because of diagnosis and treatment in life. This may be more complex in a community setting. The Coronavirus Act 2020 however expanded the window for last medical review from 14 to 28 days. Outside of this, the death will need to be reported to the coroner.
Although Covid-19 is a naturally occurring disease, there may be additional factors around the death which mean it should be reported to the coroner; for example, the cause of death is unclear, or where there are other relevant factors. Guidance is given to coroners on how to manage such reported deaths, particularly where post mortem examinations may not be readily availability.
This would depend on the reason as to why the employee is refusing to come into work. An unauthorised absence is where an employee fails to attend work and they do not have a statutory or contractual right, or their employer’s permission, to do so. An employer will not be obliged to pay employees their normal pay for periods of unauthorised absence.
There are some absences which may be viewed as authorised which would entitle the employee to their full pay. For instance, employees who believe that they are in serious and imminent danger by coming to work would be entitled to stay at home and receive pay if their belief is deemed reasonable.
An employer should always try to discuss any unauthorised absences with an employee. They may then consider whether to take disciplinary action against the employee.
CBILS is made available through the British Business Bank’s 40+ accredited lenders and partners, which are listed on their website (https://www.british-business-bank.co.uk/ourpartners/coronavirus-business-interruption-loan-scheme-cbils/accredited-lenders/).
Businesses should initially approach their own lender and only consider other lenders if they are unable to access the finance they need. Note, not every accredited lender can provide every type of finance listed.
Some banks/lenders are not included in the list of accredited lenders which appears to mean that they cannot provide support through the Scheme. We understand from the British Business Bank that further lenders are applying to be accredited but that this may take a little time to process. If the provider of your senior debt is not on the accredited list you should consider approaching the bank which provides your day to day account banking services.
If you wish or need to access the Scheme via an alternative funder the process may take longer as usual on-boarding and KYC processes will need to be undertaken.
If you don’t want to make redundancies, or if you can’t reduce employee resource, either in a particular department or across the workforce as a whole, then you need to think about alternatives to redundancy.
Equally, you may want to flex the resource you have available to you – without making drastic changes. For example you may want to consider:
- unpaid leave and sabbaticals
- retraining and redeploying
- forcing annual leave
- flexible working
- capability issues
- lay off
- short time working
- reductions in salary
- reductions in working hours
- changing to shift working