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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

Do you have to collectively consult for the minimum period of time before you can issue notice?

These periods are often mistakenly referred to as minimum lengths of consultation (especially by Trade Unions). That is not correct. Consultation can commence, conclude and notices of dismissal be issued within the 30 and 45 day periods. The expiry of the notice would just have to be outside of those restricted periods.

How do I go about registering a death at this time?

The Government has introduced legislation to expand the list of those who can register deaths to include Funeral Directors who are dealing with the funeral arrangements and who has been authorised by a relative of the deceased to register the death. Also, the medical cause of death certificate can be emailed to the Registrar’s office and arrangements made to have a telephone appointment to provide the Registrar with information to register the death. The requirement to attend the Registrar in person to sign the Register has been relaxed so that this is not necessary. It will however still be necessary to register the death within 5 days.

What is the Clinical Negligence Scheme for Coronavirus?

The Government has recently passed the Coronavirus Act 2020 in a response to the challenges posed by the pandemic, especially in relation to those facing the NHS during this time of crisis.  NHS Resolution worked closely with the Department for Health and Social Care to draft a clause within the Coronavirus Act providing indemnity for clinical negligence for any coronavirus related activity not currently covered by an existing arrangement.  In order to implement this clause, NHS Resolution has launched the Clinical Negligence Scheme for Coronavirus (“CNSC”).

It is intended that the CNSC will cover new contracts put in place for healthcare arrangements to respond to coronavirus, such as organisations supporting testing arrangements or Independent Contractors making agreements with NHS England and NHS Improvement to release capacity to the NHS.  Membership is not required for this scheme and the contracts entered into will automatically provide indemnity under the scheme.

The CNSC will not replace existing indemnity provisions made under the Clinical Negligence Scheme for Trusts (“CNST”) and it has been confirmed that the new Nightingale Hospitals will be covered by CNST rather than CNSC.  Similarly, NHS Resolution have confirmed that those doctors and nurses returning to practice from retirement, or those joining as students will be covered by the CNST or, where applicable the Clinical Negligence Scheme for General Practice (“CNSGP”).  The CNSC will not cover returning midwives to the profession, but the Royal College of Midwives have confirmed that they will extend all of the benefits of membership including Medical Malpractice Insurance to returning retired midwives.

For more information regarding this please click here.

Do I still need to pay instalments of Community Infrastructure Levy (CIL) while the development site is closed?

Payments of the Community Infrastructure Levy (“CIL”) are tied to commencement of development, and where an instalment policy is in place, the instalments are usually tied to periods of time following commencement rather than build out rates. Therefore where a development has commenced, payments of CIL are likely to fall due in respect of a site notwithstanding that the site may have temporarily closed or build out rates have slowed.

New regulations now in force, provide some additional relief for those developers with an annual turnover of £45 million or less. Such relief will allow the Council to defer payments, disapply late interest charges, and refund late interest charges that have already been levied since 21 March 2020.

For those developers that cannot benefit from the new provisions, unless a Council has adopted an exceptional circumstances relief policy the regulations do not provide for any relief to be provided in instances where payment of CIL will create viability issues. Most Councils have not adopted such a policy, and in those circumstances the CIL liability will remain due in accordance with the payment schedule on the demand notice.

Councils are at liberty to amend their instalment policies in accordance with their own internal procedures, and the Government is encouraging Councils to explore this option to provide some relief to developers. However this will only assist in respect of any prospective instalments where the development commences after the new instalment policy has been adopted.

For those developers whose annual turnover exceeds £45 million, the Government seems to be taking the view that such developers can afford their CIL liabilities regardless of the current climate. The only concession the Government has proposed is to encourage Councils to make use of the existing discretion they have in respect of the imposition of surcharges for late payments.

Freedom to Speak up – a reminder

Has there ever been a more important time for all staff to feel that they are able to raise concerns about their working environment?

It is a pertinent time to remind all staff that they should be able to raise concerns without the fear of repercussions. It is a good time to be reviewing and re-issuing your Freedom to Speak up/Whistleblowing policy to all. Likewise it is a good time to remind all staff that they should not treat others unfairly or detrimentally for raising health and safety concerns.

Both subjecting someone to a detriment because they have blown the whistle or raised health and safety concerns (and dismissing someone for the same) is unlawful.