How do you ensure clinical governance around MHFAs?
MHFAs are not qualified mental health medical professionals and they should not be diagnosing or giving medical advice, however, their training will equip them to provide initial support to those experiencing symptoms of mental ill health, and to signpost to further professional help when needed. The MHFA training makes the boundaries of the MHFA role very clear and there should be clearly defined role specifications, procedures and support pathways in place to ensure that individuals are referred on appropriately. There should be peer support in place for MHFAs and a system in place to ensure no individual or individuals are overloaded.
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Employees on any type of employment contract including full-time, part-time, agency, flexible or zero hours and foreign nationals who are eligible to work in the UK on any visa can be furloughed subject to the following excluded categories:
- Anyone who was not employed prior to 30 October 2020
- Anyone for whom you haven’t made a PAYE Real Time Information submission to HMRC between 20 March 2020 and 30 October 2020.
- Employees who are working but on reduced hours or for reduced pay
- Employees currently receiving SSP (see FAQ on SSP and self-isolation below)
- Public sector employees
- Employees of businesses or organisations in receipt of public funding for staff costs (except for those who are not primarily funded by the government and whose staff cannot be redeployed to assist with the Covid-19 response)
Schools should be considering both Youth MHFA training and Adults MHFA training so that there are people within every school who have the skills and knowledge to support the mental health needs of students and teaching staff.
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.
The immediate impact is accounting for payroll purposes for the additional cost of 13.8% employers NIC’s and 0.5% apprenticeship levy on top of the payment to the contactor’s PSC.
Secondary NIC’s cannot be recovered from payments due to employees and the same applies under the new IR35 regime. However, new terms can be agreed with reduced level of fees to reflect this additional cost.
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.