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
The Chief Coroner adopts the approach taken by the Lord Chief Justice in that no physical hearing should take place unless it is urgent and essential business, and it is safe for all involved. If a hearing is to take place, social distancing must be maintained. All hearings that can take place remotely should do so, if it is not possible for social distancing requirements to be met. The expectation is that some hearings will go ahead, most notably Rule 23 hearings. Coroners are reminded that they must however conduct any remote hearings from a court. Decisions as to the most appropriate approach will be left to the senior coroner in that jurisdiction.
As we have already seen, some inquests will be adjourned, most notably those with multiple witnesses and/or a jury.
The guidance stresses the need, when dealing with medical professionals, for coroners to recognise their primary clinical commitments, particularly in these high-pressured times. This could mean avoiding or deferring requests for lengthy reports/ statements and accommodating clinical commitments if clinicians are called as witnesses.
The guidance encourages proactive reviews of outstanding responses to Prevention of Future Death reports and extending timescales for Trusts to respond.
The golden thread requirements will be retrospective, so will apply to existing buildings as well as new build. This is part of the reason for the Building Safety Regulator’s ‘get to know your building’ guidance referred to in the talk, with the link in the Powerpoint presentation. While the details of the golden thread requirement are still to be confirmed, now is a good time to start to gather as much information as can be obtained about existing buildings as possible in preparation. The Government guidance anticipates that the Principal Accountable Person will be responsible for developing and coordinating the golden thread for existing buildings.
As we move to look at re-opening businesses and getting people back into the workplace there is work to be done by employers, firstly in planning how they are going to do this, and secondly, communicating those plans to staff. The only way in which businesses are going to be able to manage the transition back to some form of normality is by speaking to their staff and re-assuring them about the measures that will be put in place to safeguard their health and safety in order to enable them to return. Any successful return to work will need to based on carefully thought out plans and providing re-assurances to employees that necessary action is being taken.
Employers will be focusing on:
- How do I get my workforce back safely, and
- How do I give my workforce the confidence to return.
Hopefully, further guidance will provide additional clarification on this, but it is difficult to see how a charity whose operations have been significantly curtailed because of the Covid-19 restrictions, cannot furlough employees and access the scheme, in particular where they have several different income streams. For example if a charity’s retail or fundraising operations have been significantly curtailed due to the restrictions, then it would appear unfair for it not to able to rely on the furlough scheme to assist in the funding of the employment costs associated with this part of the charity.
However, it might be prudent, where there are services that are publicly funded and employees working within those services cannot undertake their normal work, to consider if they can do different roles to work on Covid-19 activities. If there is no such work available then the guidance does appear to allow the furloughing of employees and such organisations to access the scheme.
In our experience, the funding streams and work undertaken by the organisations that could fall into the third category identified above can be exceptionally diverse and we would strongly recommend that you take advice before making such decisions about furloughing employees.
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.