New national guidance, issued over the weekend, has sought to help clinicians facing difficult decisions on admitting Covid-19 patients to critical care facilities.
Medical benefit is the key factor but doctors should take into account the likelihood of a patient recovering to an outcome acceptable to them – and within a period of time "consistent with the diagnosis," according to the guidance rushed out by the National Institute for Health and Care Excellence.
Doctors should ensure they discussed the risks, benefits and likely outcomes of care with patients, carers or families, ensuring that, where possible, they can make informed decisions, NICE says.
Hospitals should also ensure that all patients admitted to hospital are assessed for frailty using a recognised frailty score.
There are also guidelines on cancer care and dialysis.
Doctors treating cancer patients will need to take into account the risks of immunosuppressive treatments and balance the risks, NICE says.
Where changes need to be made to care, "consideration should be given to delivering treatment in different and less immunosuppressive regimens, different locations or via another route of administration."
NICE says that doctors should consider whether dialysis can be delayed when a patient is feared to have Covid-19 infection. Hospitals should also ensure that patient transport services are able to continue to operate for these patients, it says.
The regulator says it is working on further guidance on symptom management, radiotherapy and rheumatoid arthritis.
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