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What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?

  • 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).

Related FAQs

What are the new Procurement Policy Notes (PPN)?

The Government has produced and published three new Procurement Policy Notes as a direct result of the ever changing Covid-19 environment.

PPN 01/20: Responding to COVID-19

The purpose of PPN 01/20 is to ensure that contracting authorities are able to procure goods, services and works with extreme urgency, to allow them to respond to the pandemic efficiently.

This PPN provides guidance for the following circumstances:

  • Direct award due to extreme urgency (regulations 32(2)(c)) (click here to read our article regarding regulation 32)
  • Direct award due to an absence of competition or protection of exclusive rights
  • Call off from an existing framework agreement or dynamic purchasing system
  • Call for competition using a standard procedure with accelerated timescales
  • Extending or modifying a contract during its term

PPN 02/20: Supplier relief due to COVID-19

PPN 02/20 focuses predominantly on the supplier to assist in keeping supply chains open and ensuring that suppliers are kept financially sound during these unpredictable times.

This PPN provides guidance for the following circumstances:

  • Urgent reviews of contract portfolios and to update suppliers if they believe they are at risk
  • Put in place appropriate payment measure to support supplier cash flow
  • Where contract payments are based on ‘payment by results’ make payments based on previous invoices
  • Ask suppliers to act on a ‘open book’ basis and make cost data available to the contracting authority during this period
  • Ensure invoices submitted by suppliers are paid immediately on receipt

PPN 03/20: Use of Procurement Cards

The third guidance note PPN 03/20 relates to the use of procurement cards to increase efficiency and accelerate payment to suppliers.

This PPN provides the following advice and urges organisations to arrange with their procurement card provider to:

  • Increase a single transaction limit to £20,000 for key card holders
  • Raise monthly limits on spending with procurement cards to £100,000 for key card holders
  • Spend on procurement cards each month in excess of £100,000 should be permissible to meet business needs

Although the above advice has been provided, should these limits not be necessary, organisations should seek an appropriate transaction limit or monthly limit.

The PPN also advises that by 30 April 2020, in scope organisations should:

  • Ensure that a number of appropriate staff have the authority to use these cards
  • Open all relevant categories of spend to enable these cards to be used more widely
Flexible working

Many employees require flexible working now more than ever. That could be reduced hours, working from home, reduced days, etc. Be careful to act fairly when considering these requests as they can be a discrimination claim in the waiting.

A flexible working request is a request for a permanent change to the contract of employment however to encourage a greater take up during this difficult time, you can agree this on a temporary basis.

What further proposals has the Government made in relation to Public Companies?

It has also been proposed in the Corporate Insolvency and Governance Bill that public companies who were due to file their accounts in the period from 26 March 2020 to 30 September 2020 will have until the earlier of the 30 September 2020 and the date which is 12 months after the end of their relevant accounting period to do this.

This is separate from the pre-existing scheme, announced on 25 March 2020, whereby companies can apply to Companies House for a 3 month extension for filing their accounts.

How can workers get to work safely?

The Government’s guidance says walk, cycle or drive to work and avoid public transport if you can. Businesses will need to support workers in adopting alternative travel methods to reduce exposure to the virus. You could consider staggering start and finish times for shifts to reduce commuting during peak hours, or support cycling with secure storage facilities and a drying room.

What should I do if the contractor is in suspected financial difficulty?

In the event that the contractor is displaying one or more of the above signs, then it is worth considering the following actions to protect the employer’s position as far as possible:

  • Closely monitor the financial and on-site performance of the contractor in order to assess the likelihood and timing of potential insolvency
  • Ensure all bonds, guarantees and collateral warranties have been obtained under the building contract, and if not take steps to obtain them immediately
  • Consider the terms of any guarantees to ensure that the guarantor’s obligations are not inadvertently discharged
  • Bonds may require adjudication to have been commenced (or even completed) prior to insolvency so as not to be stayed pursuant to insolvency laws
  • Carry out an audit of the on-site plant, equipment and materials, and evidence this (for example with photographs and written records)
  • Ensure that copies of all relevant documentation have been obtained, for example drawings, specifications and anything required to comply with CDM requirements. If not, take steps to obtain these
  • Review the payment position under the building contract, including whether any over payments have been made to the contractor which should be reclaimed, what retention is held or has been released, whether any payment notices may be necessary, and whether there are rights of set-off which should be exercised
  • Check whether the involvement of any third party is required, for example funders, landlords, tenants or purchasers who may have rights in relation to the building contract and how it is administered
  • Review the terms of the building contract relating to contractor insolvency – hopefully the parties will be fully aware of the building contract terms and have been administering it correctly to date, but if it has been hiding in a draw then now would be a good time to dust it off and ensure familiarity with the relevant provisions!

In general. there is often a stick or twist decision.  If the employer chooses to financially support the contractor (for example by agreeing different payment arrangements), this may help to keep the contractor solvent and more likely to complete the project, but it also exposes the employer to greater risk if the approach is not successful.  Conversely, withholding payments  from the contractor may make insolvency a self-fulfilling prophecy.  The precise advantages and disadvantages of the approach will be dependent on the specific circumstances of each case.