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).
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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.
Head of Commercial, Colin Hewitt, speaks with the team at NewcastleGateshead Initiative about the complexities of event cancellations and the associated legal implications.
Click here to listen to the full podcast.
On 13 March 2020 the Secretary of State for Housing, Communities and Local Government issued a Written Statement in respect of delivery restrictions.
In this respect, many supermarkets, food retailers and distribution centres in England operate under planning restrictions (conditions and/or obligations) which limit the time and number of deliveries from lorries and other delivery vehicles which can take place particularly at night primarily to protect the residential amenity of nearby residential property.
Key points in the Statement include;
- Given the exceptional challenges facing the UK from the coronavirus, it is vital that deliveries of food, sanitary and other essential products over the coming weeks can be made as quickly and safely as possible, minimising disruption to the supply chains. The likely pressures on driver capacity mean additional flexibility is needed so that retailers can accept deliveries throughout the day and night where necessary.
- That planning enforcement is discretionary and that local planning authorities should act proportionately in responding to suspected breaches of planning control.
- That local planning authorities should not seek to undertake planning enforcement action which would result in unnecessarily restricting deliveries of food and other essential deliveries during this period having regard to their legal obligations.
The Statement acknowledges that the increased frequency of deliveries particularly at night could have a temporary impact on residents. It therefore concludes that the Government will review the need for the flexibility outlined in the Statement after the pressure from the coronavirus has reduced and that it is the intention to withdraw it once the immediate urgency has subsided.
A link to the Written Statement is below.
As the pandemic progresses, more and more people will be forced to self-isolate and, inevitably, both tenants and staff will be affected. Put plans in place to mitigate the impact that this may have, particularly regarding staff shortages. The most important focus here should be communication.
The Covid-19 outbreak will affect the pace of everyday life and delays will be expected. Rather than allowing the pandemic to take over completely, it is important to maintain open communication with tenants as much as possible and inform them of any front-facing challenges that you may face.
The Protocol does envisage that delays may occur and allows for some degree of flexibility. Whilst all efforts should be made to conduct inspections where practical and possible, it should be expected by all parties that timescales will be extended during this crisis. It is fundamental, however, that all changes made to standard practice are communicated and explained to tenants to manage expectations.
Similar flexibility should be afforded to tenants. As households are required to isolate it will not always be possible to gain access to properties as would usually be expected and required. Likewise, vulnerable people will wish to protect themselves and their families and may refuse access on this basis. During this period, a degree of understanding must be exercised and concessions made.
Inspections may be delayed if anyone in the household has symptoms. A questionnaire should be prepared for those visiting properties to assess so far as possible the risk; Personal Protective Equipment should be issued to those visiting, and government guidelines followed.
The Competition and Markets Authority (CMA) has issued a number of guidance documents about the application of competition law rules during the coronavirus outbreak. In general, the competition law rules are being relaxed in very specific circumstances.