What is the NICE guidance around Service organisation?
- Trusts should allow for telephone advice rather than face-to-face review from critical care when clinically appropriate.
- Hospitals should discuss the sharing of resources and the transfer of patients between units, including units in other hospitals, to ensure the best use of critical care within the NHS.
Please note, the above is intended to provide a summary of the key recommendations which emerge from this guidance. Access to the full guidance can be found here.
Related FAQs
The guidance gives numerous examples of the types of performance adjustment which parties should consider. For example this includes:
- Varying deadlines (e.g. for performance or payment)
- Varying compensation (e.g. to recognise increased costs)
- Varying the nature of performance (e.g. allowing substitute goods, allowing pert delivery of services)
The guidance also encourages a reasonable approach to enforcement, which might encourage delaying issuing formal proceedings, increased use of mediation or providing more information to the other party than would be volunteered under normal circumstances.
Every company has to file accounts at Companies House every year. If they are filed late, a fine is automatically levied. If there is a long delay in filing them, the directors are at risk of prosecution and the Registrar of Companies might start a process which could ultimately lead to the company being struck from the register.
However, Companies House has recognised that businesses might currently face exceptional problems in preparing and filing their accounts on time and so have posted a notice on their website which says that if immediately before the filing deadline, it becomes apparent that accounts will not be filed on time due to coronavirus, you can make an application to extend the period allowed for filing.
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
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.
It is the individual assessment by an organisation of its Covid-19 risk in its workplace that will be central. There may be common features across sites or areas of a site but every workplace will have a different risk profile depending on the service it offers and the workers who deliver those services. No one size fits all.
The context of managing Covid-19 risk is the need to tie in with UK government guidance and HSE advice – which despite being a lot more comprehensive than it was, is not a panacea and will continue to evolve. The difficulty we have with this in the context of the known increased risk to BAME employees from Covid-19 is that our understanding of the risk is, we would suggest, at a pretty early stage which makes it more difficult to address. However we know the increased risk exists and we owe our BAME workers a duty to manage that risk and keep them safe.
We also have a duty to consult employees. This is critical in managing this risk – ensuring BAME workers have a loud voice in the assessment process will be very important.
Where an individual has a particular characteristic, for instance they’re pregnant, they have physical or mental disabilities etc, the law requires us to look at that individual or, where it is a group, that group of individuals and assess the risk to them and take any reasonably practicable steps to control the risk to them.
Risk control hierarchy is key. In “normal” businesses we reduce our Covid-19 risk by keeping people away from the workplace – “avoid, eliminate and substitute” then changing work practices (e.g. social distancing measures) before we arrive at PPE. In a healthcare context, we arrive at PPE a lot more quickly.
We need to ensure our people are given sufficient information, instruction and training so they can do their jobs safely and we must consult workers and involve them in workplace safety – this is going to be critical in the context of Covid-19.