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
Yes, you can ask to see any information/documentation sent to an employee informing them that they should self-isolate.
If the duties are so fundamentally different from their contracted role, then yes. For example, if you are asking a frontline clinical member of staff to undertake administrative tasks in another area, then this will be a fundamental change to their terms and conditions for which you need their consent.
If there is a minor alteration to their duties, or the clause within their contract is wide enough to cover their amended duties, then arguably to do not need their consent but best practice would be to obtain their agreement.
The guidance from the Government concerning private sector organisations is very different from the guidance for public sector and organisations that receive public funding. The guidance states:
“The government expects that the scheme will not be used by many public sector organisations, as the majority of public sector employees are continuing to provide essential public services or contribute to the response to the coronavirus outbreak.
Where employers receive public funding for staff costs, and that funding is continuing, we expect employers to use that money to continue to pay staff in the usual fashion – and correspondingly not furlough them. This also applies to non-public sector employers who receive public funding for staff costs. Organisations who are receiving public funding specifically to provide services necessary to respond to Covid-19 are not expected to furlough staff.”
This guidance isn’t particularly clear but it appears that there is a recognition that there are different types of organisations which could be caught by this:
- Organisations who will be required to provide frontline services during the Covid-19 response. It is interpreted that NHS organisations such as NHS Trusts will fall firmly into this category. Employees of such organisations are expected not to be furloughed and to continue to work and be paid their normal salary in the usual way.
- Organisations who receive public funding to provide services to respond to the Covid-19 crisis. These organisations are not expected to furlough their staff. The type of organisation that would fit into this category are those that have been commissioned to developing breathing apparatus or testing kits to meet the needs of the healthcare sector during the peak of the pandemic.
- Organisations who receive public funds for staff costs to operate services. Employers are expected to continue to pay staff if the money to pay them is publicly funded. It is strongly inferred that this is irrespective of whether such staff have any work to perform. The type of organisation that is likely to fall into this category are GP practices, charities and private sector companies that have won contracts with the public sector.
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.
Mortuaries are a sui generis use, unless ancillary to some other use of land, a hospital for example.
Sui generis uses are not within any Use Class. Consequently planning permission is required for the:
- Change in the use to a sui generis use
- Subsequently for the change in the use to an alternative use, whether that be another sui generis use or a use within a Use Class
Acknowledging the above, if the scale of the use is above de minimis, planning permission is likely to be required to change the use of a warehouse or factory unit into a temporary mortuary.
Should planning control be breached, a local planning authority must decide whether to take enforcement action or not. That enforcement is discretionary was recently reiterated in a Ministerial Statement issued on 13 March 2020 a link to which is below.
Depending on the form of the enforcement action, there could be a right of appeal.