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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

What are the negatives associated with having MHFAs in the workplace and what is the best way to manage this without removing MHFAs from the company?

The only potential negatives are the potential for MHFAs to become overloaded, or for MHFAs to overstep the boundaries of their role. Both would be avoided if a suitable framework is in place around them, and if adequate ongoing support and training is provided.

Given the recent decline in financial performance, the business is now in breach of its covenants with the bank. Should we be concerned?

That will depend on the terms of your facility and the stance taken by your bank.

Banking facilities often place obligations on businesses to stick to certain financial criteria. For example, an obligation to keep turnover or profit above certain levels or a commitment to keep the bank’s exposure within an agreed percentage of the value of the company’s assets (known as loan to value ratio).

The consequences of breaching those covenants will depend on the terms of your facility, but normally this amounts to an event of default. Events of default can result in the loan (or whatever form the facility takes) becoming repayable and could give the bank certain powers to take action to recover the money that they are owed.

Whether the bank will take action during these unprecedented times is another matter, particularly given the extent of support being offered to businesses via mainstream lenders and the political desire to keep viable businesses up and running. Lenders themselves will no doubt wish to remain supportive where possible. The underlying performance of the business (and whether but for the effects of Covid-19 it would have been in a healthy financial position), the relationship you have with the bank and your history with them will no doubt be relevant to the approach taken by the bank. However, early engagement with your bank (as well as other key stakeholders in the business) will be important.

Is the current pandemic an event which will allow me to argue that the lease has been ‘frustrated’?

This is unlikely. Frustration is a doctrine rarely used as a way of getting out of leases. It operates to bring a lease to an early end because of the effect of a supervening event. It is then not a concept readily applicable to a situation where one party is looking to get out of a lease. To be able to argue the doctrine of frustration, you must be able to demonstrate that something unforeseeable has happened that makes it impossible to fulfil the lease and unjust to hold a party to its obligations.

This is not something that can be demonstrated easily.

There was a case in the High Court last year when the doctrine of frustration was looked at in a case involving the European Medical Agency.

The court found that Brexit did not frustrate EMA’s lease. EMA was granted leave to appeal that decision to the Court of Appeal, but unfortunately, the parties settled out of court so the arguments were not tested in the higher court.

Another reason why frustration is likely to fail is an argument that, whilst the current lockdown may force closures to businesses and whilst such closures maybe for a lengthy period, such closures will only be temporary.

How can RPs carry out Person Centred FRAs/PEEPs on tenants within directly managed supported living units where the RP is not providing support and any floating support provider doesn't see it as part of their responsibility?

There is no simple answer.

The NFCC guidance states:

“The person-centred fire risk assessment is intended only as a simple means for non-specialists who have suitable understanding of relevant fire risks to determine whether additional fire precautions might be needed. The person who carries out the person-centred fire risk assessment will depend on the circumstances of the housing and support provision. It can be carried out by those who regularly engage with the resident, with input from specialists where necessary. Assessments will normally be undertaken with residents themselves.

In sheltered housing with scheme managers, the scheme managers normally engage with residents on a routine basis, enabling residents who need a person-centred fire risk assessment to be identified. Many vulnerable residents will be in receipt of care, so enabling the care provider to identify residents in need of a person-centred fire risk assessment. Providers of regulated care are required to take into account risks to people from their wider environment, to take steps to help people ensure that they are dealt with by appropriate agencies, or to raise safeguarding alerts when this is appropriate. Where a ‘stay put’ strategy is adopted, there will be a need to identify residents who need assistance from the fire and rescue service to evacuate the building.

In supported housing, the number of residents in each property is usually quite small. This, and the nature of the care service normally provided, enables person-centred fire risk assessments to be carried out asa matter of course, when a resident first moves into the property.

Where additional fire precautions cannot be provided in the short term, the risk should be reduced as far as reasonably practicable and an adult at risk referral should be made to Adult Social Care.”

Ideally then the RP will need to engage with any care providers in order to conduct the PCRA and identify risk mitigation measures. If they are reluctant to do so, the RP should engage with the individual in any event in undertaking the assessment.

What is the government guidance on making places of work as safe as possible to return to?

The government has produced a series of industry specific “Covid-19 Secure” guidelines, which employers should follow. These guidelines are designed to keep the risk of infection as low as possible, while allowing as many people as possible to resume their livelihoods.