What is the NICE guidance around clinical decision-making?

There has been a significant amount of press coverage talking about institutional racism within the NHS not only in terms of the treatment of patients but also in terms of the low representation of ethnic minority staff in management positions. Whilst tackling that issue is beyond the brief here, it is important to recognise that sub conscious bias can, regrettably, play a part in decision making processes. An Employment Tribunal will explore a alleged discriminator’s conscious and sub conscious decision making and working in an environment which has not set out sufficient controls to avoid such sub conscious stereotyping places someone at a greater risk of being discriminated against.

In the context of the issues we are addressing here, i.e. risk assessments around BAME staff, as we have stated above, it is essential that BAME staff are represented at all levels in the discussion. Trusts need to be mindful that BAME are underrepresented in management positions.

BAME staff need to be included in the dialogue and need to have a safe place where they can challenge decisions that are being made in relation to them. There needs to be accountability in the processes applied. Meaningful conversations need to happen and concerns should not be dismissed.

If such testing is regarded as a “reasonably practicable step” which has been identified as an appropriate control following a risk assessment then it is something you can do.

Although you can’t physically force someone to have something intrusive done, this is very likely to be a reasonable management instruction and therefore if someone refuses to have this done as a condition of entry into the work place then disciplinary action may follow.

Where this is something that is required of employees, employers should be letting their staff know that this is one of a number of measures that are being introduced into the workplace for their own safety. If the employer can explain, in advance of the return, why temperature checks need to be taken, what the consequences of the results will be- i.e. will they be sent home if over a certain temperature, whether this data will be stored (and if the sole purpose is to determine whether or not they are fit to attend work on a particular day then why are they being stored), and the fact that temperature checks are a requirement of entry to company premises for everyone, then there shouldn’t be significant resistance to this measure.

Large scale temperature checks have in some businesses become part of the “new normal” working environment.

Where a development is considered to be “EIA development” (being development where an Environmental Impact Assessment or Environmental Statement is required to be submitted) there are additional statutory publicity and notice requirements over and above the requirements for a standard planning application. Regulations usually require that the environmental statement is to be made available for inspection by the public at all reasonable hours at an address in the locality for a period of at least 30 days. Copies of the environmental statement are also to be made available for people to take away from that address. This clearly requires physical copies to be available at a specified location for a prolonged period of time, which may prove problematic during the current health crisis.

New regulations came into effect on 14 May 2020 which will temporarily suspend the above requirements and will instead require the Environmental Statement to be available for inspection online. The applicant must however provide a certificate to the Local Planning Authority stating what steps have been undertaken to bring the application (and the Environmental Statement) to the attention of people who are likely to have an interest and why it considers that such steps were reasonable.

The Charity commission has issued the following guidance

https://www.gov.uk/guidance/coronavirus-covid-19-guidance-for-the-charity-sector

Borrowers will not have to pay a guarantee fee. Lenders will pay a fee to access the scheme. The Government will make a Business Interruption Payment to cover the first 12 months of interest payments and any lender-levied fees, allowing smaller businesses to benefit from no upfront cost.

British Business Bank has indicated that following earlier discussions with the banking industry, some lenders indicated that they would not charge arrangement fees or early repayment charges to SMEs borrowing under the scheme. Each business should check the terms of the loans being made to ensure this is the case and what the interest rate and prepayment fees will be following the period in which the Government makes payment of these amounts.