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
This is something which is certainly on the Government’s radar as there is currently a Bill being heard in Parliament about making MHFAs a legal requirement for workplaces. It is still in the very early stages and therefore it is not clear at this stage what the outcome will be. What is clear is that this is an area which is being taken very seriously and it would not be surprising if measures were put in place regarding MHFAs in the workplace.
You must exercise reasonable care in assessing status and making a status determination, considering what the position would be if the contractor was engaged directly by the end user client instead of via a PSC.
Status is usually determined by looking a number of factors and how they apply to the contractor’s working arrangements. This is a difficult exercise that is usually carried out by employment and tax lawyers and it is full of grey areas. We have a toolkit that can help you navigate this process which Paul will tell you more about at the end of the session.
The key factors used to determine status are:
- Control:
- How much control does the end user client have over the contractor in terms of working arrangements (hours, place of work) and how the work is carried out? Or is the individual contractor able to determine how and when they work and without direct supervision of the end user client?
- Personal service:
- Is the contractor required to perform the services personally without the right to send a substitute? If there is a right to appoint a substitute is this subject to end user client approval?
- Mutuality of obligation:
- Is the end user client obliged to provide the contractor work with a mutual obligation on the contractor to accept that work?
The guidance is helpful and is likely to be useful to businesses as they seek to respond to the crisis and to restart their business activities as lockdown is eased. However, there remain outstanding questions. For example, can collaboration to prevent widespread insolvencies be viewed as in the interest of consumers? Businesses need to remain aware of the extremely high stakes involved in relation to competition law. Businesses contemplating collaboration with competitors should take legal advice before doing so.
Employees who are unable to work because they are shielding in line with public health guidance (or need to stay home with someone who is shielding) can be furloughed after 1 July 2020, as long as you have previously submitted a claim for them in relation to a furlough period of at least 3 consecutive weeks taking place any time between 1 March 2020 and 30 June.
In the event that the worst happens and contractor insolvency occurs, there are a number of steps which the employer should take immediately:
- Confirm that insolvency has actually occurred and the type of insolvency (for example liquidation or adjudication) – actions taken based on rumours can have adverse consequences
- Secure the site and carry out an audit of the plant, equipment and materials present – this may extend to changing the locks on site in order to prevent overzealous contractors and sub-contractors seeking to return and take what they see as their possessions. The building contract may contain a provision that these are the employer’s property, but they can be difficult to recover if they are not within the employer’s possession – possession is 9/10ths of the law!
- Ensure that there are adequate insurance and health and safety arrangements in place for the site – these would usually be dealt with by the contractor and therefore may no longer be in place, so alternative arrangements may be required
- Ensure that any further payments to the contractor are stopped pending a more detailed review
- Consider whether any off-site materials have already been paid for and can be secured. This can however be difficult in practice where the materials are not physically within the employer’s possession
In addition, there are also a number of further actions which the employer should consider in the slightly longer term:
- Investigate the options available and ascertain the cost of completing the works to assist in deciding how best to proceed
- Consider whether termination of the contractor’s employment under the building contract is required, and if so take the necessary steps in accordance with the building contract
- Consider whether there are any bonds or guarantees in place upon which the employer can rely, and if so assess their terms as to whether and how to make a claim
- Make arrangements to complete the works – as a general rule of thumb the cost of completing the works may increase by around 30% if it is necessary to get a replacement contractor
- Consider whether direct payment to subcontractors is possible or desirable
- Although we would say this(!) we would strongly recommend taking legal advice, as insolvency and its implications are complex and it is easy to inadvertently fall foul of the various different requirements