What is the NICE guidance around clinical decision-making?

In practice this means that any risk assessment will need to be reviewed constantly and adjusted as our understanding of the nature and level of the risk grows.

Some service-providers are instigating special Oversight Groups to keep this issue under review but engagement and consultation with those affected is critical and making sure they feel confident to raise concerns and refuse to work if they believe they are not safe.

If the business has areas requiring an increased workforce whilst others require a reduced workforce, staff can be retrained and redeployed across the organisation or even across a wider group of companies. This will not reduce the wage bill but will avoid the need for redundancies. Making fundamental changes to an employee’s role and duties will require their agreement following a fair selection and consultation process.

Where it is envisaged that 20 or more employees will be dismissed at a relevant establishment within a 90 day period or less, then collective consultation is required (in addition to individual consultation) and the company must inform BEIS (using form HR1).

If there are less than 20 dismissals then you are only required to carry out individual consultation.

The current position is that the PSC is responsible for assessing whether IR35 applies. This current regime has been difficult to police by HMRC and HMRC considers there is widespread flouting of the rules by contractors.

From April 2021 the responsibility for assessing whether IR35 applies will shift to the end user/client (with the exception of ‘small’ companies) which will require an assessment to be carried out on a contract by contract basis. HMRC anticipates that this will be easier to monitor and that end user businesses will be more compliant.

The reformed regime will apply to payments made on or after 6 April 2021 for services carried out on or after this date.

• Integration:
  • Is the individual held out as being employed by the business by having a company email address, uniform, how would they introduce themselves to customers?
• Exclusivity:
  • Is the contractor restricted from working for other organisations without the consent of the end user client?
• Length of engagement:
  • Is the contractor engaged to work on a specific project for a defined period? Or are they engaged for an indefinite period with no reference to a specific task or project?
• Pay:
  • Are there regular fixed payments or is payment on completion of specific task or commission based? Is the contractor entitled to benefits or bonuses?
• Facilities:
  • Does the contractor provide their own equipment and materials to provide the services?
• Financial risk:
  • Is the contractor personally responsible for any loss arising from their work in performing the services? Will they have to rectify unsatisfactory work at their own time and expense? Will they have the opportunity to profit from the success of a project?