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What is the NICE guidance around clinical decision-making?

  • Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
  • Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.

Related FAQs

Can I apply a Force Majeure clause?

If a contract contains a force majeure clause this may become operative due to the coronavirus pandemic and related emergency legislation. Such clauses exist to ensure that if some unforeseen event prevents a party from being able to perform their obligations under a contract, either on time or at all, they will be excused from their obligations and not be held liable for non-performance.

The clause must actually be written into the contract to have effect – a force majeure clause cannot be implied into a contract. Whether it can be relied on by a party will depend on the wording of the clause itself as it may only be applicable in certain limited circumstances.

You should seek legal advice at an early stage if you think that force majeure is relevant, because a number of potentially complex issues must be addressed, many of which will turn upon the exact wording of the force majeure clause in the contract in question:

  • Has a force majeure event actually arisen?
  • What notification process do you have to follow to rely on the provision?
  • What mitigation steps do you have to take?
  • What is the effect of the force majeure event – is the contract suspended, or can it be terminated (which might not be what you want)?
What steps can we take to avoid sub conscious bias being a factor in our decision making?

There has been a significant amount of press coverage talking about institutional racism within the NHS not only in terms of the treatment of patients but also in terms of the low representation of ethnic minority staff in management positions. Whilst tackling that issue is beyond the brief here, it is important to recognise that sub conscious bias can, regrettably, play a part in decision making processes. An Employment Tribunal will explore a alleged discriminator’s conscious and sub conscious decision making and working in an environment which has not set out sufficient controls to avoid such sub conscious stereotyping places someone at a greater risk of being discriminated against.

In the context of the issues we are addressing here, i.e. risk assessments around BAME staff, as we have stated above, it is essential that BAME staff are represented at all levels in the discussion. Trusts need to be mindful that BAME are underrepresented in management positions.

BAME staff need to be included in the dialogue and need to have a safe place where they can challenge decisions that are being made in relation to them. There needs to be accountability in the processes applied. Meaningful conversations need to happen and concerns should not be dismissed.

What amounts to a dismissal?

For the purposes of collective consultation, making someone redundant and/or changing terms and conditions of employment, by termination and re-engagement, is also classed as a dismissal by reason of redundancy and so has the exact same consultation requirements.

I’m in the process of litigation. What happens during the coronavirus outbreak?

The best advice is that parties should proceed as they would have done before the crisis began.

Can an employee in a public facing role refuse to interact with a customer who is not wearing a face mask?

In some circumstances, visitors and customers are required to wear face coverings, such as those travelling on public transport, shoppers and museum visitors. The government guidance states that:

  • businesses must remind people to wear face coverings where mandated; and
  • premises where face coverings are required should take reasonable steps to promote compliance with the law.

As part of their duty of care to employees and to uphold a relationship of mutual trust and confidence, employers should consider how employees can ensure that visitors and customers comply with the rules and provide their staff with guidance. They must also seek ways to protect their employees both from the risks of those customers not wearing face masks and potential abuse from customers or visitors who decline to wear a face covering. This may include having signs in place requiring customers and visitors to wear a mask and allowing staff to refuse to serve customers if they do not follow the rules.

However, it is ultimately the responsibility of the police, security and public transport officials to remove customers from premises where they are not complying with the rules on face coverings.

The police and Transport for London have been given greater powers by the government to take measures if the public do not comply with the law relating to face coverings without a valid exemption, such as refusing to wear a face covering. This includes issuing fines which have now been increased to £200 for the first offence (and £100 if paid within 14 days). Transport operators can also deny access to their public transport services if a passenger is not wearing a face covering, or direct them to wear one or leave a service.