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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.

Related FAQs

What steps can we take to avoid sub conscious bias being a factor in our decision making?

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.

Should you rely upon Statutory Demands issued after 1 March to present a Winding Up petition?

No. No action need be taken in relation to the demand but we would advise against presentation of a petition based upon any Statutory Demand issued between 1 March 2020 and the end of the restrictions. As you may be aware, with Winding Up there is no requirement to issue a Statutory Demand notice before proceeding so this is unlikely to create too many issues – click here to see whether you should issue petitions on other grounds.

There is nothing to prevent statutory demands being served at this time. However, there may be limited benefit as it cannot form the basis of a future winding up petition.

What are the changes to the law?

On 25th June 2020, the Corporate Insolvency and Governance Act, among other things, introduced new restrictions on suppliers of goods and services to terminate the contract in the event that the customer enters an insolvency process.  This has very important consequences for many businesses as it could expose them to greater financial risks.

What rate of pay applies to an employee returning from statutory leave who is furloughed?

Statutory leave includes family related leave, sick leave or parental bereavement leave. Claims for furloughed individuals returning from statutory leave should be based on their salary, before tax, and not the pay they received while on statutory leave.

Similarly, claims for furloughed employees returning from a period of unpaid leave on sabbatical should be based on their pay they would have had on paid leave.

What is the current guidance relating to Private Finance Initiatives and PF2 Projects in light of coronavirus?

On 2 April 2020, the Government issued guidance relating to Private Finance Initiatives and PF2 Projects. The guidance, which is to be enforced with immediate effect (currently due to stay in place until 30 June 2020), is one of several guidance notes issued to date.

A link to the guidance is set out below:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877804/2020_04_01_PFI_and_COVID19_final.docx.pdf

Key messages to contracting authorities

  • PFI contractors should very much consider themselves as being part of the public sector response to the current pandemic
  • Covid-19 is not regarded as, and is not to be classified as a force majeure event
  • PFI contractors must ensure that contingency plans are up to date and have been reviewed and discussed with contracting authorities to enable the continuity of full services to respond to the pandemic and maintain vital public services
  • Contracting authorities should work closely with PFI contractors to use all available options to maintain public services during the emergency period
  • Local arrangements should be made where PFI contractors can’t deliver the agreed requirements and performance standards
  • “Best efforts” should be made by all parties for the continuation of service provision