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.
Related FAQs
Although these measures fall short of the level of assurance given to employees both in terms of eligibility for an immediacy of access to payments, they are a vast improvement on the support for self-employed workers that has been put in place until now. Current support includes:
- Access to business interruption loans
- Self-assessment tax payments that were due in July 2020 have been deferred until January 2021
- VAT is deferred until the next quarter
- The introduction of Time to Pay arrangements under which deferrals for HMRC payments can be agreed
- The minimum income floor for universal credit has been suspended which will allow self-employed workers to access the equivalent of Statutory Sick Pay (SSP)
- Universal credit and tax credit payments to increase by £1000 per year
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
The MHFA training makes this clear, it should be made clear in the MHFA role specification and procedures and discussed during regular MHFA peer support and MHFA surgery sessions. It is important to ensure that where an Employee Assistance Programme is in place, all MHFAs have details of that scheme available so they are able to instantly share details of the scheme with those who require support. If in doubt due to serious concerns then using 999 or Samaritans is an option.
A claim for indirect discrimination is the most likely risk here. The first point to make is that the decision to review duties is being made based on the growing amount of medical evidence that the BAME community is being disproportionately adversely affected by the COVID 19 pandemic compared to other ethnic groups. The key is to ensure that blanket policy decisions are not taken, nor should assumptions be made about the risk to each individual concerned. Decisions should only be made on an individual basis with an open dialogue with the individual concerned. You as their employer, need to ensure that the individual feels listened to and heard; that this is not just a tick box exercise.
Consider having a working group which has an overview of the policy decisions being made. That working group should contain representatives from across the staff groups including staff side, but importantly, representatives from different ethnic backgrounds to ensure the important voices are heard. Accountability should be built into that group. This group should also be a safe environment for staff to raise concerns about their health and safety and safe systems at work.
Homeworking can cause work-related stress and affect people’s mental health and being away from managers and colleagues could make it difficult to get proper supervision and support.
Encourage your employees to keep in touch. Put procedures in place so you can keep in direct contact with home workers and can recognise signs of stress as early as possible. Use group chat and video chat tools imaginatively.
Have an emergency point of contact and share this so people know how to get help if they need it.
People are much more anxious than usual and may be less productive as a result – recognise this and try to be patient.