What is the NICE guidance around clinical decision-making?

The now defunct Guidance for the Tier system suggested that the clinically extremely vulnerable would be treated in the same way as those who were shielding in Lockdown 1. This means that anyone who is clinically extremely vulnerable and cannot work remotely, will be entitled to SSP. These employees should receive a letter confirming that they are deemed to be clinically extremely vulnerable/shielding and you should ask for a copy of it as evidence to support a claim for SSP. It is likely that the Lockdown 3 Guidance will be the same.

You could also furlough an employee in the clinically extremely vulnerable category. Again we do not anticipate this changing.

Under usual rules, workers are entitled to a minimum of 28 days holiday including bank holidays, each year. Except in limited circumstances, it cannot be carried between leave years meaning that workers lose their holiday if they do not take it.

The government passed emergency legislation relaxing the carry-over of the 20 days leave entitlement provided under EU law. Where it is not reasonably practicable for an employee to take leave in the relevant leave year as a result of the effects of the coronavirus then they could be entitled to carry over the untaken leave into the next year.

All employers in the UK are eligible to participate in the scheme. The purpose of the scheme is to allow employers to claim back employment costs if they have furloughed employees arising from the coronavirus crisis. Importantly this means the scheme is not limited to cases where the employee would otherwise have been made redundant.

Key points:

• Between 1 November 2020 – 30 June 2021, the government will reimburse employers for 80% of wage costs, up to a cap of £2,500 per month, with employers expected to contribute 10% of that 80% in July 2021 and 20% of that 80% in August and September 2021. Employers will still need to pay employer NICs and employer pension contributions (these cannot be claimed for).
• The scheme now also allows employees to return to work part time being on furlough for the remainder. See flexible furlough above for more information.
• The employer can agree to pay the employee more than it will be reimbursed but it cannot reclaim the additional amount or any other costs associated with the additional amount.
• The workers covered by the scheme are those who have been “furloughed” which is a leave of absence.
• Workers must be told about and agree to this change of status (see below).
• Employers have to continue to pay the furloughed workers and the Government will reimburse the employer.
• HMRC is administering the scheme and it has been extended until the end of September 2021
• Those who left employment and are re-employed and subsequently furloughed by agreement are eligible (please see the FAQ regarding redundancy and furlough above).
• Payments may be withheld if claims are based on inaccurate or dishonest information, or are found to be fraudulent. HMRC has put in place an online hotline for employees and the general public to report suspected fraudulent claims.
• The Government has made alternative help available for employers to continue to pay employees while the scheme is set up.

The only potential negatives are the potential for MHFAs to become overloaded, or for MHFAs to overstep the boundaries of their role. Both would be avoided if a suitable framework is in place around them, and if adequate ongoing support and training is provided.

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.