What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?

If you are separated from your child’s other parent, government guidance about self-isolation and social distancing may have an impact on the contact arrangements that are in place and give rise to disagreements about spending time with the other parent, travelling arrangements and whether the child should continue to go to school, where one of the parents is a key worker and a school place is available.

The government has issued guidance which makes it clear that where parents do not live in the same household, children under the age of 18 can be moved between their parents’ homes.

Cafcass has also issued guidance which states that, “unless there are justified medical/self-isolation issues – or some future nationally issued guidance or expectation associated with leaving the house in your area – children should maintain their usual routine of spending time with each of their parents. If there is a Child Arrangements Order in place this should be complied with unless to do so would put your child, or others, at risk”.  The guidance from Cafcass be accessed here.  https://mcusercontent.com/2750134472ba930f1bc0fddcd/files/987e77d6-0827-470c-9447-acc61404f465/CAFCASS_Covid19_advice_for_familes_20.pdf

It remains the case that anyone who has symptoms, however mild, or is in a household where someone has symptoms, should not leave their house to go to work. Those people should self-isolate, as should those in their households.

Put simply, if it is a requirement of a particular role that PPE is worn, then this should be provided to the employee. If an employer dismissed an employee for refusal to carry out their role due to lack of PPE then this is likely to be an automatically unfair health and safety dismissal.

Furthermore, anyone who is subject to a detriment as a result of raising a health and safety concern, e.g. someone in this situation who refuses to work due to lack of PPE and is sent home without pay, will also have a potentially valid claim in the Employment Tribunal for that detriment, even if they are not dismissed.

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.

The Government will allocate £360 million to charities providing key services and supporting vulnerable people during the crisis.  £200 million of this amount will be paid to Hospices UK to be distributed to hospices to help increase capacity and give stability to the sector.  The remaining amount is to be allocated to:

• St Johns Ambulance to support the NHS
• victims charities, including domestic abuse, to help with potential increase in demand for charities providing these services
• charities supporting vulnerable children, so they can continue delivering services on behalf of local authorities;
• disabled people
• Citizens Advice Bureau to increase the number of staff providing advice during this difficult time

The Government Departments will identify priority recipients, with the aim that these charities will receive money in the form of a cash grant over the next few weeks and by the end of April to assist in paying amongst other costs April’s wage bill.