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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Whilst it is acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside their usual practice. Doctors should consider the best course of action to take in these circumstances by utilising the following:
- What is within their knowledge and skills
- What support other members of the healthcare team could offer
- What will be best for the individual patient given available options
- The protection and needs of all patients they have a responsibility towards
- Minimising the risk of transmission and protecting their health.
The guidance has confirmed that all remaining employment rights and terms continue while an employee is furloughed. Holiday will continue to accrue during furlough however you may reach agreement with employees on reducing entitlement provided that it does not fall below the statutory minimum of 5.6 weeks per year.
On 7 May the Government published guidance on how contracting parties can act responsibly in order to assist the effort to deal with Covid-19. The guidance seeks to persuade contracting parties to act reasonably and recognise the impact of Covid-19 on contractual counterparties. This will continue to be relevant as business begins to emerge from lockdown.
You should have in place a dispute resolution procedure that sets out the appeal process or contractors or the agency as appropriate. You must respond to an appeal within 45 days.
If the status determination is disputed you should consider the contractor or agency’s reasons objections. You must consider if the original determination is to be maintained and give reasons for this. Or a new determination with reasons can be provided if appropriate.
Records of disputed determinations and the outcome of any appeal should be kept.
Potentially, yes. If someone refuses to follow the health and safety measures that have been put in place to protect them, colleagues and possibly their customers, including (where appropriate) the use of PPE then this is a disciplinary issue and should be dealt with as such. Repeated failure to comply with the requirement to follow these measures, or a one off significant failure, may be sufficient to justify dismissal, depending on the circumstances.