What is the NICE guidance around clinical decision-making?

During the Covid 19 crisis lawyers and the courts have had to adapt with hearings being heard remotely and with more electronic communication. It is clear that going forward, some of these changes will become more permanent.

The Lord Chancellor, Robert Buckland QC MP, has spoken last week regarding changes to the justice system following the COVID-19 pandemic and we know that there is a significant backlog of work that needs to be processed.

Firstly, 10 sites have been identified for ‘Nightingale courts’ which will allow for better social distancing. The authorities have suggested that it is a possibility that courts will need to stay open for a longer time or at weekends, to increase the number of cases that can be heard safely on any given day. This will enable more cases to be heard in a day and therefore a swifter outcome for your case. The standard of video technology will also continue to improve, with plans for new technology being rolled out across all courts form July onwards. The enhanced use of technology may result in matters being heard more efficiently, decreasing the time spent during each hearing.

HMCTS is working to expand access to audio and video technology to support more and new types of hearings. There has been an increase in the use of new and varying equipment over the lock-down period. With the appropriate systems in place, many more hearings could take place on platforms such as the Cloud Video Platform (CVP). Throughout July, the CVP will be more readily available to Country courts. There will be further hardware rolled out to improve the quality of video hearings, and there will be more efficient methods used to organise video lists.

The increased use and training of CVP means that witnesses and advocates may not need to attend court and could attend the hearing remotely. This will give you increased flexibility, enabling you to attend from your office or home. The CVP is efficient and simple to use, with no complex functions; making it user-friendly. This should make litigation more time and cost effective (albeit that there will be the cultural challenge of having less contact with your legal team or the court experience).

In the unfortunate event that there will be a significant number of deaths, planning will fall to the local resilience forum; which includes all relevant local organisations and statutory bodies, who will have prior experience in working in excessive death scenarios.

It is for the coroners to ensure that they are familiar with the local resilience forum plans and discussions required. This will include issues regarding storage capacity and post-mortem examination capacity.

It really depends on what your measure of success is! We would suggest regular wellbeing surveys – if the results of wellbeing surveys suggest that the culture is becoming more open, more psychologically safe, if people are asking for help or referring colleagues to MHFAs as a safe and effective pair of hands – these would be strong indicators of success.

The now defunct Guidance for the Tier system suggested that the clinically extremely vulnerable would be treated in the same way as those who were shielding in Lockdown 1. This means that anyone who is clinically extremely vulnerable and cannot work remotely, will be entitled to SSP. These employees should receive a letter confirming that they are deemed to be clinically extremely vulnerable/shielding and you should ask for a copy of it as evidence to support a claim for SSP. It is likely that the Lockdown 3 Guidance will be the same.

You could also furlough an employee in the clinically extremely vulnerable category. Again we do not anticipate this changing.

As the project progresses, it is important to continually monitor the contractor’s performance.  Any one or more of the items below can be early warning signs that the contractor is in financial difficulty, and that further actions may be necessary:

• Decrease in labour or contractor’s personnel on site, and/or rapid turnover of contractor’s personnel
• Slowdown in progress on site
• Plant, equipment or materials suddenly disappearing from site for no apparent reason – unpaid subcontractors may unilaterally decide to remove items from site regardless of their contractual rights to do so
• An increasing number of defects and reduction in the quality of the contractor’s work
• The contractor seeking changes in the payment arrangements, and in particular early payments
• The contractor making spurious claims or contra charges
• The contractor seeking assignment of its benefit of the building contract
• Late filing of accounts by the contractor at Companies House
• Unsatisfied court judgements against the contractor
• Subcontractors and suppliers not being paid or being paid late
• Rumours in the press, in the industry, on site or elsewhere regarding the solvency of the contractor
• Unusual visits to site, for example from the contractor’s senior management or other personnel who had not previously been present or are not expected to be present
• Increasingly aggressive behaviour by the contractor
• The contractor’s parent company or another company within the contractor’s group displaying any of the above signs