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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 should I do if I have a hearing scheduled in the COP?

Parties are encouraged to review upcoming matters to assess the viability for there to be any agreement which can be reached in relation to the issues in dispute or to consider whether the case needs to proceed to a remote hearing. If directions or issues can be agreed between the parties, reducing the need for remote hearings, then that is the preferred option.

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
What are the additional costs for the end user if the contractor is deemed employed?

The immediate impact is accounting for payroll purposes for the additional cost of 13.8% employers NIC’s and 0.5% apprenticeship levy on top of the payment to the contactor’s PSC.

Secondary NIC’s cannot be recovered from payments due to employees and the same applies under the new IR35 regime. However, new terms can be agreed with reduced level of fees to reflect this additional cost.

What should I do if contractor insolvency occurs?

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
What other financial support is available for self-employed individuals?

Although these measures fall short of the level of assurance given to employees both in terms of eligibility for an immediacy of access to payments, they are a vast improvement on the support for self-employed workers that has been put in place until now. Current support includes:

  • Access to business interruption loans
  • Self-assessment tax payments that were due in July 2020 have been deferred until January 2021
  • VAT is deferred until the next quarter
  • The introduction of Time to Pay arrangements under which deferrals for HMRC payments can be agreed
  • The minimum income floor for universal credit has been suspended which will allow self-employed workers to access the equivalent of Statutory Sick Pay (SSP)
  • Universal credit and tax credit payments to increase by £1000 per year