Skip to content
Menu

Home › FAQs › What is the NICE guidance around clinical decision-making?

What is the NICE guidance around clinical decision-making?

  • Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
  • Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.

Related FAQs

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.

Last updated on 14th April, 2020

Can I ask my employees to travel for work during the national lockdown?

As above, people must not leave their home unless they have a ‘reasonable excuse’ and travelling should be limited to their local area. Employees may leave their home and local area to travel for work if they cannot reasonably work from home. You should attempt to reduce the number of journeys they make.

Last updated on 5th January, 2021

Can I continue to operate from my commercial premises during the crisis?

The Government guidance does not require any business to close except some non-essential shops and public venues, so in theory, all businesses can continue to occupy and operate from their existing premises. However, government guidance strongly encourages businesses to arrange for everybody able to work from home to do so. The majority of office sector business will fall into this category.

In the industrial sector, the majority of businesses will not be able to operate via home working and will, therefore, need to retain employees on site though in some cases this may be able to be scaled back.

Any tenants continuing to operate from their premises should consider whether or not they need to make any alterations to the premises to facilitate social distancing of employees and whether or not such works would require a consent from the Landlord under the terms of the lease.

Last updated on 2nd April, 2020

Can we apply for a loan under the CBILS?

If you are running a business, yes you can.  Please see our Funding and Finance FAQ’s.

We are hearing that Banks are more likely to advance monies on the basis of known income, so for example notified legacies, where there may be a time lag in them being received or against investments where, if they were realised now, would crystallise a loss.  Asking for a loan which will need to repaid from future services or trading income should be carefully considered in particular where the charity does not operate to create a surplus which would allow this.

Last updated on 9th April, 2020

What about employees who say they cannot return to work due to childcare issues?

Employers will need to be flexible with employees who are unable to return to work at present due to childcare difficulties. While schools have reopened, a period of isolation may result in employees having to keep children off school/nursery and therefore have childcare issues. Some employees will be able to manage this with their partner and extended family, whereas others will not. Where an employee simply cannot make any other arrangements to care for their children in the short term then they will be unable to return to work until that situation changes. Any dismissals on the basis that someone is unable to return to work as a result of lack of childcare are likely to be unfair, at least in the short term where such employees may well be able to demonstrate that they had no options available to them.

Last updated on 6th May, 2020