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What is happening with public transport?

Government guidance is that public transport should be avoided wherever possible. Transport providers will be expected to follow government guidance to make their services more COVID-19 secure.

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What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

What if the contractor is supplied by an agency?

As mentioned earlier, if an agency is involved you must send them a copy of the status determination statement for each contractor, and they will also have the right to dispute the outcome.

If the agency pays the contractor, they will be responsible for the operation of PAYE and NIC’s deductions and any apprenticeship levy. The agency may try to recover these costs from the end user client.

If workers are supplied by an agency or umbrella company and are already treated as employees by the agency, they will remain unaffected by IR35.

Should we stop employees working from home?

No, government advice remains that if employees can work from home, they should continue to do so in order to minimise social contact across the country in order to keep infection rates down.

Can charities furlough their employees?

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.

What is the guidance for doctors working during the pandemic?

The General Medical Council (GMC) have published guidance online for doctors during this time of uncertainty.

 

Alongside this, their website displays guidance for temporary registration to approximately 15,000 doctors, who left the register or gave up their licence to practise in the last three years.

 

These clinicians have been contacted to assist with the growing pandemic, outlining the process they would follow and informing them of their right to opt-out. The Secretary of State for Health can ask the GMC to grant such registration under Section 18a of the Medical Act 1983, in an emergency.