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I’m a doctor. Should I work outside my field of practice during the pandemic?

Whilst it is acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside their usual practice. Doctors should consider the best course of action to take in these circumstances by utilising the following:

  • What is within their knowledge and skills
  • What support other members of the healthcare team could offer
  • What will be best for the individual patient given available options
  • The protection and needs of all patients they have a responsibility towards
  • Minimising the risk of transmission and protecting their health.

Related FAQs

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.

I would like to make a Lasting Power of Attorney. How do I and my Attorney(s) get our signatures witnessed and who can be my Certificate Provider?

As with a Will, your solicitor can take instructions by telephone, Skype or a similar tool. Your solicitor can then post or email the documentation to you. As with Wills, your signature and those of your proposed Attorneys will need to be witnessed, but in this case only by one other person. However, there are specific requirements as to who can witness your signature. The witness must be aged 18 or older and cannot be your Attorney but they can be your Certificate Provider.

Your Certificate Provider must either be someone you have known personally for at least two years or an appropriate professional. However, they must not be your Attorney and they must not be a member of your family or the partner, boyfriend or girlfriend of a member of your family or a business partner or employee of yours.

Also, if you are living in a care home, the Certificate Provider cannot be the owner, manager, director or employee of the home you live in.

Given the current restrictions on movement, if you have regular medical checks you could ask your GP or another medical professional to witness your signature and act as your Certificate Provider when you go to see them or they come to you. Alternatively, if someone you have known for two years or more is dropping off essentials, they could act as a witness and Certificate Provider remembering to retain the necessary distance and protective measures.

Concerning your Attorney(s) you cannot act as their witness. Otherwise, anyone aged 18 or older can act as their witness, including the other Attorney. Ideally, a witness to your or your Attorney’s signatures should not be a family member for the sake of impartiality and to avoid disputes. If necessary they can be.

What are the existing legal obligations to conduct a suitable and sufficient assessment of risk for a workforce, and where particular characteristics require it, for individuals?

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.

Is the Land Registry functioning?

Yes. The Land Registry published a new service update on 14 May, here:

https://www.gov.uk/guidance/coronavirus-covid-19-impact-on-hm-land-registrys-service

Importantly, the Land Registry will process registrations where documents have been executed using the Mercury signing approach:

For land registration purposes, a signature page will need to be signed in pen and witnessed in person (not by a video call). The signature will then need to be captured, with a scanner or a camera, to produce a PDF, JPEG or other suitable copy of the signed signature page. Each party sends a single email to their conveyancer to which is attached the final agreed copy of the document and the copy of the signed signature page.

To summarise some further points:

  • Most information enquiries are experiencing minimal delays
  • Registrations of new titles, such as on sales of part or new leases, and applications to update existing titles, are experiencing more significant delays but can be expedited via the expedite service
  • Cancellation dates for replying to requisitions are extended until further notice
  • Access to free documents on the land registry portal has been extended to 90 days from completion of the transaction
  • Identity requirements have been relaxed. The Land Registry will now raise a requisition for identity documents, and not cancel applications
  • Requests for extensions to a notice or objection period will be granted if lawfully possible
  • Land charges searches can be submitted electronically with PDF documents
Can I rotate staff who are furloughed? Can I put someone on furlough, bring them back when I need to, and then put them back on furlough, as demand requires? And practically how can we deal with this for those who want to rotate?

You can rotate staff on furlough or flexible furlough.

One option is to make it clear in the letter agreeing to being furloughed that there is an open ended right to rotate and to be able to take them off furlough and bring them back and put them back on.

So the employer reserves the ability to rotate by building into the agreement, but only exercises it if it is permissible.

Rotation is quite key for employers who need to make a temporary reduction to their overheads but want to retain the skills base to call back when work picks up. Having furloughed staff return on a part-time basis may reduce the need to rotate.

It also helps in the employer being able to show that they are treating the workforce as fairly as possible and everyone is taking a reduction. Get in touch if you need help preparing the documentation for furlough that will permit rotation or flexible furlough.

Read more about flexible furlough and how this can be used as part of the CJRS.