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
Yes. The Land Registry published a new service update on 14 May, here:
https://www.gov.uk/guidance/coronavirus-covid-19-impact-on-hm-land-registrys-service
Importantly, the Land Registry will process registrations where documents have been executed using the Mercury signing approach:
For land registration purposes, a signature page will need to be signed in pen and witnessed in person (not by a video call). The signature will then need to be captured, with a scanner or a camera, to produce a PDF, JPEG or other suitable copy of the signed signature page. Each party sends a single email to their conveyancer to which is attached the final agreed copy of the document and the copy of the signed signature page.
To summarise some further points:
- Most information enquiries are experiencing minimal delays
- Registrations of new titles, such as on sales of part or new leases, and applications to update existing titles, are experiencing more significant delays but can be expedited via the expedite service
- Cancellation dates for replying to requisitions are extended until further notice
- Access to free documents on the land registry portal has been extended to 90 days from completion of the transaction
- Identity requirements have been relaxed. The Land Registry will now raise a requisition for identity documents, and not cancel applications
- Requests for extensions to a notice or objection period will be granted if lawfully possible
- Land charges searches can be submitted electronically with PDF documents
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?
In practice this means that any risk assessment will need to be reviewed constantly and adjusted as our understanding of the nature and level of the risk grows.
Some service-providers are instigating special Oversight Groups to keep this issue under review but engagement and consultation with those affected is critical and making sure they feel confident to raise concerns and refuse to work if they believe they are not safe.
Yes, but the Courts have been temporarily restructured into three categories:
- Open courts (open for business including vital in person hearings)
- Staffed courts (for video and telephone hearings)
- Suspended courts (no hearings of any kind)
These changes have been effective from Monday 30 March 2020.
If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.
If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.