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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

Do the usual publicity requirements for planning applications still apply?

The Government has introduced new regulations, which took effect on 14 May 2020, to relax the publicity requirements in respect of planning applications.

Planning applications are usually required to be publicised by way of site notices and local newspaper notices and applications are to be made available for public inspection. The Government has recognised that these actions may not always be possible in accordance with social distancing guidelines and in order that Councils do not delay applications as a result of an inability to comply with the publicity requirements, the Government has relaxed the requirements.

A Local Planning Authority is now required to “take reasonable steps” to publicise a planning application, which may be through use of online newspapers, social media, or other electronic measures. What is considered reasonable will depend upon the circumstances of an individual application and will be proportionate to the scale and impact of the development. A large development that has previously generated significant interest will require more steps to bring the application to the attention of all of those with an interest than a householder application. The guidance emphasises the role of the publicity requirements, namely to enable those with an interest to make representations and to effectively participate in the decision making process and therefore community engagement remains key. It is recommended that the officer’s report refers to the steps taken where a Council has relied upon the temporary publicity arrangements.

The requirement to make planning applications available for public inspection has also been temporarily suspended providing that the applications are available for online inspection. In reality most LPAs already provide such an online facility. Where individuals are unable to access an application online LPAs should make alternative arrangements, for example providing information over the phone or providing a hard copy set of documents by post.

The regulations however only amend the statutory publicity requirements. In addition to these, all LPAs are required to have a Statement of Community Involvement which may provide for additional publicity requirements and the LPA will be bound by these regardless of the temporary relaxation of any statutory requirements. Where a Statement of Community Involvement does go beyond the statutory requirements, the Government guidance suggests that LPAs update these to ensure that local communities can continue to be consulted in the current climate.

The regulations are currently due to expire on 31 December 2020.

Are the Courts still open and operating?

Yes, but the Courts have been temporarily restructured into three categories:

  1. Open courts (open for business including vital in person hearings)
  2. Staffed courts (for video and telephone hearings)
  3. Suspended courts (no hearings of any kind)

These changes have been effective from Monday 30 March 2020.

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 are the early warning signs that a contractor may be in financial difficulty?

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
What first steps would you recommend to creating a strategy to integrate pro-active mental health first aid across the workforce?

The Thriving at Work Report and the recent NICE Workplace Mental Health Guidelines provide a good baseline for what all organisations should be doing on workplace mental health – this includes some guidance on training. There does need to be a plan in place and we recommend taking a holistic view of the integration of mental health first aiders into a business – ie it should be one component in a strategy that also comprises training for line managers, awareness training and education for all staff, peer support, and a documented framework for support and signposting.  It is also worth ensuring you have senior manager sponsorship, strong links with Occupational Health if available and also raising awareness via any works councils or employee forums helps ensure there is buy in at all levels.