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
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.
The Thriving at Work Report and the recent NICE Workplace Mental Health Guidelines provide a good baseline for what all organisations should be doing on workplace mental health – this includes some guidance on training. There does need to be a plan in place and we recommend taking a holistic view of the integration of mental health first aiders into a business – ie it should be one component in a strategy that also comprises training for line managers, awareness training and education for all staff, peer support, and a documented framework for support and signposting. It is also worth ensuring you have senior manager sponsorship, strong links with Occupational Health if available and also raising awareness via any works councils or employee forums helps ensure there is buy in at all levels.
If suppliers still wish to terminate the contract, they must contact the directors or the officeholder dealing with the insolvency process and obtain their approval to terminate the contract – which, of course, might not be given.
If the continued obligation under the contract to supply goods/services to the customer would place the supplier in financial hardship the supplier can apply to court for permission to terminate the contract. This will involve time and legal expense.
Hopefully, further guidance will provide additional clarification on this, but it is difficult to see how a charity whose operations have been significantly curtailed because of the Covid-19 restrictions, cannot furlough employees and access the scheme, in particular where they have several different income streams. For example if a charity’s retail or fundraising operations have been significantly curtailed due to the restrictions, then it would appear unfair for it not to able to rely on the furlough scheme to assist in the funding of the employment costs associated with this part of the charity.
However, it might be prudent, where there are services that are publicly funded and employees working within those services cannot undertake their normal work, to consider if they can do different roles to work on Covid-19 activities. If there is no such work available then the guidance does appear to allow the furloughing of employees and such organisations to access the scheme.
In our experience, the funding streams and work undertaken by the organisations that could fall into the third category identified above can be exceptionally diverse and we would strongly recommend that you take advice before making such decisions about furloughing employees.
- Before any agreed reduction in wages, actual changes to earning patterns (loss of overtime, for example) may impact the pensionable salary as defined under the scheme rules, with knock-on effects to a number of benefit calculations, such as death in service benefits.
- Contractual changes to member salaries may adversely impact accrued benefits as the final salary figure may be reduced to a greater or lesser extent depending on the duration of furlough and the severity of any reductions in wage, and hence reductions may be difficult to agree with staff.
- Reducing employer contributions will be subject to a number of the same considerations applicable to a DC scheme listed above. There will also be a need to change the rules and interact with the trustees, although it may be possible to override the rules with a direct contractual agreement with members.
- Reducing employee contributions will also depend on the scheme rules, particularly as to whether there are any discretionary powers to suspend contributions, or pensionable service.
- The rules will need to be considered for any unexpected consequences of furlough: depending on the wording of the rules, furlough may or may not be considered a leave of absence and may or may not have the effect of terminating pensionable service. This could have far-reaching consequences.
- In particular, if the workforce’s pensionable service is inadvertently terminated as opposed to suspended in accordance with any relevant rule, this could trigger a statutory employer debt on an employer participating in a multi-employer scheme, if pensionable service continues for employees of other employers. This sort of issue is unlikely to be spotted until after the event, and therefore difficult to untangle. However, an employer should be able to take advantage of the “period of grace” provisions by notifying the trustees of its intention to re-admit employees to pensionable service within the next 12 months.
- Clearly the impact of the Coronavirus Job Retention Scheme on DB schemes is complex and legal advice should be sought before any changes are considered.