What is the NICE guidance around clinical decision-making?

The Act should make it easier for residents to obtain relevant information. It includes an obligation for the Principal Accountable Person to prepare a strategy for promoting the participation of residents, including the information to be provided to them and consultations about relevant decisions. The strategy must be provided to residents, and there will be provision for residents to be able to request information and copies of documents from the Principal Accountable Person. The type of information and the form in which it is to be provided will be set out in secondary legislation in due course, but the explanatory notes anticipate that it will include:

• Full current and historical fire risk assessments•Planned maintenance and repair schedules
• The outcome of building safety inspection checks
• Information on how assets in the building are managed
• Details of preventative measures
• Details of fire protection measures and the fire strategy for the building
• Information on the maintenance of fire safety systems
• Structural assessments
• Planned and historical changes to the building

As the project progresses, it is important to continually monitor the contractor’s performance.  Any one or more of the items below can be early warning signs that the contractor is in financial difficulty, and that further actions may be necessary:

• Decrease in labour or contractor’s personnel on site, and/or rapid turnover of contractor’s personnel
• Slowdown in progress on site
• Plant, equipment or materials suddenly disappearing from site for no apparent reason – unpaid subcontractors may unilaterally decide to remove items from site regardless of their contractual rights to do so
• An increasing number of defects and reduction in the quality of the contractor’s work
• The contractor seeking changes in the payment arrangements, and in particular early payments
• The contractor making spurious claims or contra charges
• The contractor seeking assignment of its benefit of the building contract
• Late filing of accounts by the contractor at Companies House
• Unsatisfied court judgements against the contractor
• Subcontractors and suppliers not being paid or being paid late
• Rumours in the press, in the industry, on site or elsewhere regarding the solvency of the contractor
• Unusual visits to site, for example from the contractor’s senior management or other personnel who had not previously been present or are not expected to be present
• Increasingly aggressive behaviour by the contractor
• The contractor’s parent company or another company within the contractor’s group displaying any of the above signs

The definition of a relevant establishment is a question of fact for an Employment Tribunal. Guidance from case law says that ‘establishment’ should be interpreted very broadly (so as to avoid employers escaping the need to collectively consult), and may consist of:

• A distinct entity
• With a certain degree of permanence and stability
• Which is assigned to perform one or more tasks
• Which has a workforce, technical means and a certain organisational structure to allow it to do so

However, there is no need for it to have the following:

• Legal, economic, financial, administrative or technological autonomy
• A management which can independently effect collective redundancies
• Geographical separation from the other units and facilities of the undertaking

The basics of health and safety law requires that employers take “all reasonably practicable steps” to ensure workers’ safety and that a suitable and sufficient assessment of risk is undertaken. It is the individual assessment of Covid-19 risk in each workplace that will be central. Employers will be required to conduct a robust risk assessment and then, following the hierarchy of controls, put robust processes and safeguards in place to address those risks.

UK government guidance and HSE advice is continually evolving, which in practice means that any risk assessment will need to be reviewed very regularly as that guidance develops. There is flexibility for individual businesses within the overall government framework and there will need to be a process of evaluation to ensure that the measures in place continue to meet the requirements.

The starting point of avoid, eliminate and control means looking at individuals continuing to work from home where possible (the fewer the number of people back in the workplace the lower the risk), and if not look at risk management, which leads to administrative controls – i.e. changing work practices before ending up at PPE. PPE is generally seen as control of last resort but in practice – facemasks, disposable gloves and constant prompts to wash hands for example.

In terms of changing working practices, employers should be thinking about:

• the workspace and how this is laid layout
• how do we make sure it is kept clean and hygienic
• how do we keep people apart
• how can we use toilets, canteens or other shared spaces/facilities safely
• how do we promote and enable higher levels of workplace hygiene
• if we are going to rely on PPE – can we get it, and is it suitable
• what about limiting customer interactions
• will there be enough first aiders on site
• can we manage fire safety, deliveries etc
• what about higher risk workers
• should work tools and equipment be allocated on an individual basis to employees.

These decisions need to be recorded and clearly communicated to staff members.

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.