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Should Covid-19 be recorded as a cause of death?

The Chief Coroner supports the position, communicated by NHS England and the Chief Medical Officer that Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death (MCCD) and is considered a naturally occurring disease. This cause of death alone is not a reason to refer a death to a coroner under CJA 2009.

If the cause of death is believed to be due to confirmed Covid-19 infection, there is unlikely to be any need for a post mortem to be conducted and the MCCD should be issued, and guidance is given on how this is delivered to the Registrar in the event of the next of kin/informant being in self-isolation. 

In a hospital setting the MCCD process should be straightforward because of diagnosis and treatment in life. This may be more complex in a community setting. The Coronavirus Act 2020 however expanded the window for last medical review from 14 to 28 days. Outside of this, the death will need to be reported to the coroner.

Although Covid-19 is a naturally occurring disease, there may be additional factors around the death which mean it should be reported to the coroner; for example, the cause of death is unclear, or where there are other relevant factors. Guidance is given to coroners on how to manage such reported deaths, particularly where post mortem examinations may not be readily availability.

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Should volunteers be DBS checked?

There is not currently a requirement for MHFAs to be DBS checked.

Can I demand that my employees have the vaccine?

In most circumstances the answer will be no. It would be an infringement of their human rights. It could also be a criminal assault.

However where there is a high risk to employees of exposure to COVID-19, such as care homes and healthcare environments, you might be able to make it a requirement of their role to have the vaccine.

First, consider whether you need to have a blanket requirement covering all employees or whether only certain groups who work in the most high risk areas require the vaccine.

You will need to do a thorough risk assessment balancing the amount that the risk of exposure would be reduced against the interference with the employee’s human rights. Consideration will need to be given as to whether insisting on the vaccine is proportionate to the risk and whether other less invasive steps could be taken instead, such as maintaining social distancing, wearing a mask, washing hands.

Any requirement for employees to be vaccinated should be communicated clearly to employees and trade unions together with a clear explanation for why it is necessary.

How much data can I gather?

You also need to consider other aspects of data protection.

Be proportionate – only gather and use Covid-19 data where you need to.

Keep data to a minimum – you shouldn’t gather more data than you need. You need to know someone has Covid-19 but you don’t need to know all their symptoms. Data minimisation also applies to who gets access to the data. It’s unlikely that a spreadsheet, accessible to everyone updating them on the health status of all employees, would be appropriate. Data should be shared on a need to know basis. You need to balance the privacy of individuals against your duty of care to be responsible with regards to the data of your employees, visitors, customers and suppliers.

Keep it up to date – make sure you update data. People’s health status will change and if you keep a record of this, you need to  make sure it is accurate and up to date (although this doesn’t mean you should batter individuals with constant requests for updates on health status. Again, be proportionate).

Identify individuals only when you need to – although you will need to know who has Covid-19, that doesn’t mean you need to tell everyone in the organisation. As soon as you can, you should remove personal data from any information you gather. For example, you might want to update employees on the health status of their fellow employees but you probably don’t need to name individuals and even if you feel it is necessary, you should keep the information you provide to a minimum. Removing personal identifiers in a document is also a good data security technique.

Keep the Covid-19 health data secure – Covid-19 data will be special category data and deemed high risk. This means that if you have a breach of this data you will need to notify it to the ICO. A breach could happen by someone losing a print-out of the names of Covid-19 employees, customers or visitors. It could also happen if you set access rights to lists of Covid-19 sufferers open to more people than need to know the information. The risk of ICO enforcement action increases with the potential harm the disclosure could cause. Although the ICO has indicated that it will be understanding about the impact of Covid-19 on normal operations, this doesn’t mean that they will not prosecute you if the breach is sufficiently serious.

Destroy the data once you don’t need it – Finally, of course, make sure that you delete data at the end of your needs. This might last longer than the pandemic, for example if you have an insurance claim or ongoing litigation. If you do need to keep it, consider whether or not you can delete some of the data to minimise what you hold.

Changing to shift working

Changing to shift working may give employers the opportunity to change hours / pay whilst also focusing work when it is needed. Like the other provisions, this should be done fairly, either across the board or by selecting teams/individuals based on objective business reasons. Imposing without agreement would create significant risk, therefore would require fair selection and consultation.