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What happens if a patient is admitted to critical care during the pandemic?

  • On admission to critical care, the risks, benefits and likely outcomes of the different treatment options should be discussed with patients, families and carers so they can make informed decisions about their treatment wherever possible.
  • A member of the critical care team should be involved in these discussions whenever the patient or team needs advice about critical care to make decisions about treatment.

Related FAQs

I work in construction. Should construction sites continue to operate?

The formal Government position relating to construction sites is that construction work should continue on site if it can be conducted safely, and the Business Secretary, Alok Sharma, has written an open letter to the UK Construction Industry thanking it for all its help in the current crisis. The letter also confirms the Government’s current official policy of keeping construction sites open. The full text of the letter can be downloaded.

This also remains the formal position of the Construction Leadership Council (CLC) with the qualification that sites should operate in accordance with Public Health England instructions; without compromising health and safety; and in accordance with the Site Operating Procedures issued last week by the CLC.

In practice, many construction sites have been closed by national developers and house builders due to difficulties with staffing and supply chain, and practical issues with compliance with the social distancing and site operating procedures.

The Scottish Government has recently issued guidance that all non-essential construction sites, which includes housing, office, leisure, schools and retail sites, must close to reduce the risk of the spread of Covid-19.

Can I dismiss an employee who refuses to return to work?

Potentially. The first question is why the person is not able to return, as their individual circumstances will be very relevant in terms of whether they can be safely dismissed.

Employers should ask themselves 2 questions in this situation:

  1. Have I done everything I am required to do in order to make the workplace safe for the individual to return; and
  2. Is what the employee saying reasonable?

If the answer to question 1. is no then a dismissal is unlikely to be fair. However, even if the answer to question 1. is yes, then there is still question 2. to address. If the employee has reasonable grounds as to why they are unable to return to work, e.g. due to health issues, childcare responsibilities etc then the dismissal is unlikely to be fair. It is only if you can answer yes to question 1. and no to question 2. that you can have some confidence in the potential safety of the dismissal.

Dismissals based on objections to returning to work on health and safety grounds will very often be risky and are highly fact specific, therefore please contact one of the employment team for further advice prior to dismissal.

Agreeing or imposing changes

A reduction in hours or salary or changes to hours or patterns of work is a contractual change – you can’t just impose it without significant risk. The same applies for lay-off or short-time working where there is no existing contractual right to impose these.

In summary, the process that an employer should follow to implement these measures is as follows:

  1. Communicate the Company’s position clearly and the urgent need to achieve temporary cost-saving to ensure the ongoing financial viability of the organisation
  2. Explain the proposed changes in detail and seek the employee’s agreement, and
  3. Record the agreed changes in a letter which is counter-signed by the employee.

If employees will not agree then employers will be at substantial risk of claims for unlawful deduction of wages, breach of contract and/or constructive unfair dismissal if they seek to impose these changes unilaterally. Employers should be mindful that this approach is likely to cause significant employee relations issues and dissatisfaction if only some employees agree to a reduction in pay. Employers should have a clear strategy for what their approach will be if this is the case – for example, they may wish to instead explore a different measure such as redundancies. This may form part of the employer’s communication when explaining the reason for the changes and seeking the employee’s agreement.

Unions: Employers should also be aware that where there is a recognised trade union in respect of any part of the workforce which is being asked to agree to a change to terms and conditions, the recognition agreement or collective agreement will require the employer to consult and/or negotiate with the trade union in the first instance.

Collective consultation: Where 20 or more dismissals are proposed at one establishment in any 90-day period, there are stringent collective consultation rules which apply (regardless of whether the employees have two years’ service or not). All dismissals count towards this total unless the dismissal is “not related to the individual concerned” – therefore dismissals for things such as conduct or capability do not count, but most other dismissals will count. This will include where you are imposing changes to the contract such as reduced hours or pay.

The rules on collective consultation set out a prescriptive and time-consuming process which must be followed, and minimum timescales before any redundancies can take effect. The cost of any claims relating to failure to follow collective consultation requirements are substantial, and specific advice should therefore always be sought before seeking to implement collective redundancies. We will be publishing further guidance on this on the Hub shortly.

Can I dismiss an employee if they refuse to have the vaccine?

See above FAQ about whether you can demand that your employee has the vaccine.

Dismissal for failing to follow a reasonable instruction would be a possibility but it should be the last resort.

First you will need to be able to show that you have reasonable grounds for insisting that they have the vaccine. You will then need to demonstrate that you have taken into consideration the reasons why the employee has refused and why they are not considered reasonable. Before taking a decision to dismiss you should look at alternatives such as other duties/other roles.

What are the publicity requirements for Traffic Regulation Orders?

In making a Traffic Regulation Order (“TRO”) local authorities must follow the regulations, which include provisions relating to publicity requiring publishing the notice in a local newspaper, making the orders available for public inspection at a Council’s offices (which are likely to be closed to the public during this time) and where considered appropriate, posting the notices on the streets.

In recognition of the potential difficulties with complying with the publicity requirements, the Department for Transport has issued guidance as to how a Council may still publicise a TRO. The guidance recognises that not everyone may be able to access local newspapers online and suggests that people and organisations could be adequately informed by means of letter, leaflet drops, or local radio. In respect of making the relevant document available at the Council’s offices, the guidance suggests that notices could be placed online or outside offices with brief details and including a telephone number or email to use to request a hard copy of the documents.

While the guidance is helpful, it is important to note that it is guidance only and that the regulations have not been relaxed. Authorities will still need to demonstrate that they have satisfied all of the publicity arrangements in respect of the TRO.