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

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.

Parties still need to comply with the various Protocols that apply and will be expected to exchange information in the usual way. Court proceedings can be issued electronically.

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 Government has produced workplace guidance for employers, setting out 2 key messages for employers:

• Continue to make workplaces as safe as possible; and
• Encourage workers to heed any notifications to self-isolate and to support them while they are require to isolate

Government guidance can be accessed here: How it works (an overview) and Workplace guidance for employers.

• Start critical care treatment with a clear plan of how the treatment will address the diagnosis and lead to agreed outcomes.
• Review critical care treatment regularly and when the patient’s clinical condition changes.
• Stop critical care treatment when it is no longer considered able to achieve the desired outcomes. Record the decision and the discussion with family, carers and the patient (if possible).