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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

What support is available for Start-ups?

According to the guidelines laid down by the Treasury, many Start-up businesses will not be considered “viable” as they are at an early stage in the investment cycle (i.e. delivering negative returns but with strong growth prospects). This means they are unlikely to qualify for CBILS although for primarily UK based Start-ups it is still worth making enquiries as policies are rapidly evolving.

For early-stage businesses in their first two years of trading, the British Business Bank’s Start-Up Loans programme (loans £500 to £25,000 at 6% p.a. interest) may be more suitable. Visit www.startuploans.co.uk for more information.

For start-up businesses that are unable to access CBILS, the Government launched The Future Fund in May 2020 via the British Business Bank, which provides convertible loans to UK-based innovative companies ranging from £125,000 to £5 million, subject to at least equal match funding from private investors. This scheme is available until 30 September 2020 initially.

Your business is eligible if:

  • it is UK-incorporated – if your business is part of a corporate group, only the parent company is eligible
  • it has raised at least £250,000 in equity investment from third-party investors in the last five years
  • none of its shares are traded on a regulated market, multilateral trading facility or other listing venue
  • it was incorporated on or before 31 December 2019, and
  • at least one of the following is true: (i) half or more employees are UK-based; and/or (ii) half or more revenues are from UK sales.

Further information is available on the Government website, www.gov.uk/guidance/future-fund

The Government is also offering additional support for small and medium size firms that are primarily focused on research and development. This targeted support is available through a continuity grant and loan scheme. The grant scheme is only available until 29 May 2020 while the loan scheme is open for applications until all the money is allocated or 31 December 2020 (whichever is earlier). This scheme is administered by Innovate UK, the national innovation agency, and this support will mostly only be available to existing Innovate UK customers.
Further information is available on the on the Government website, www.gov.uk/government/publications/access-coronovirus-business-innovation-support-package

What happens if that means a particular service might need to close?

Ultimately closing a service will be a decision that is taken at the highest level and that decision will depend on risk appetite.  Often these types of higher risk are mitigated by way of insurance but that still depends on an insurer being willing to accept that risk. This decision will depend on accepting a known risk and its consequences.

What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

VIDEO: Redundancy exercises in the new normal – what should we do differently?

Following our webinars on all aspects of furlough and alternatives to redundancy, it is an unfortunate fact that a number of organisations are likely, sooner or later, to be forced to make some employees redundant.

Our employment experts Jamie Gamble and Roisin Patton take you through the key aspects of conducting cost reduction redundancies, but with a focus on aspects that make this exercise different this time. For instance:

  • How are you going to conduct sensitive meetings remotely?
  • How are you going to ensure that dismissing any furloughed staff will be fair? You may have furloughed at speed, but redundancy selection criteria cannot be defined by such factors.
  • Will you use this time to review your selection criteria if you already have some in place?
  • How will you deal with individuals who are shielding, have child care issues or are pregnant?
  • How do you ensure this is all done sensitively and fairly for those roles that are being made redundant, but also for those who continue to work for you but are still isolated on furlough or working from home?
  • And what are the risks for making redundancies in this “new normal”?

Although you may be perfectly familiar with redundancy exercises these are far from normal times and it is therefore worth pausing to think about the impact that Covid-19 might have and what else you need to think about or plan for.

The webinar was recorded on Thursday 2nd July.

 

What is a small company?

The changes will not apply to end users who are a small company. If you meet two out the following 3 conditions, you will meet the small company definition and are therefore exempt from the changes to IR35:

  1. Annual turnover is no more than £10.2 million
  2. Balance sheet total is no more than £5.1 million
  3. No more than 50 employees

Companies will always be classified as small in their first financial year. Public companies will always be considered to be medium or large businesses and cannot fall under this exemption.

For a group company to be a small company its parent company must also meet the small company definition.