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
The European Commission has reintroduced its “comfort letter” system for cooperation in relation to shortage of supply. This allows cooperating businesses to check what the Commission’s view of their proposals are before implementing them.
In the UK context the SMA has introduced an exemption for suppliers of healthcare services to the NHS. This allows:
- Sharing information about capacity
- Coordination of staff deployment
- Joint purchasing of goods, services and facilities
- Sharing or lending of facilities
- Division of activities, including agreeing whether to expand or reduce the volume or type of services provided by suppliers
In relation to whether the CMA will investigate cooperation, it has indicated:
- The CMA will use its discretion as to the prioritisation of its enforcement action to permit some agreements/collaboration which would otherwise potentially give rise to enforcement action (including potentially attracting fines of up to 10% of group worldwide turnover)
- The CMA will use its existing power to exempt certain agreements under the Competition Act 1998 where these are in the public interest
Employees will be reluctant to take unpaid leave or a sabbatical but when faced with the alternative prospect of redundancy may give it some serious consideration. This would remove the cost of that employee from the employer’s business for an agreed period of time. This is an option which can be offered to employees but again, imposing it without agreement creates significant risk.
In some circumstances, visitors and customers are required to wear face coverings, such as those travelling on public transport, shoppers and museum visitors. The government guidance states that:
- businesses must remind people to wear face coverings where mandated; and
- premises where face coverings are required should take reasonable steps to promote compliance with the law.
As part of their duty of care to employees and to uphold a relationship of mutual trust and confidence, employers should consider how employees can ensure that visitors and customers comply with the rules and provide their staff with guidance. They must also seek ways to protect their employees both from the risks of those customers not wearing face masks and potential abuse from customers or visitors who decline to wear a face covering. This may include having signs in place requiring customers and visitors to wear a mask and allowing staff to refuse to serve customers if they do not follow the rules.
However, it is ultimately the responsibility of the police, security and public transport officials to remove customers from premises where they are not complying with the rules on face coverings.
The police and Transport for London have been given greater powers by the government to take measures if the public do not comply with the law relating to face coverings without a valid exemption, such as refusing to wear a face covering. This includes issuing fines which have now been increased to £200 for the first offence (and £100 if paid within 14 days). Transport operators can also deny access to their public transport services if a passenger is not wearing a face covering, or direct them to wear one or leave a service.
- Working with PFI providers to get contingency plans up to date
- If a PFI provider is struggling to achieve service delivery requirements due to Covid-19, then local arrangements should be put in place to:
- maintain unitary charge payments
- revise contract requirements/standards
moderating payment and performance regimes where appropriate.
- In any event, you may wish to review and adjust your requirements to reflect the current situation. It is possible that some requirements can be relaxed, whereas others need to be tightened. For example, there may be an increased need for cleaning and maintenance in certain areas of your PFI premises or the layout of the premises and/or room uses may have temporarily changed. With staff illness and shortage likely to be an issue, you may also wish to consider if the resource can be moved from one area to another to help maintain essential services.
- When putting local bespoke arrangements into place it is vital that:
- Contract requirements or performance standards are not relaxed to the point where health and safety are put at risk.
- It is made clear that the arrangements are temporary and that matters will return to normal as soon as the Covid-19 emergency is over. Indeed the guidance note makes clear that if assets temporarily close they should be kept in such condition that they can be immediately up and running when this emergency is over. In such instances, likely a basic level of maintenance and security will therefore be required as a minimum.
The current guidance issued by Mr Justice Hayden confirms that remote hearings may be conducted using the following facilities and that this will be the default position until further direction:
- By way of an email exchange between the court and the parties;
- By way of telephone using conference calling facilities;
- By way of the court’s video-link system, if available;
- The use of the Skype for Business App installed on judicial laptops;
- Any other appropriate means of remote communication, for example BT MeetMe, Zoom or FaceTime.