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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This will depend on the particular facts and the employee’s circumstances but an employee should co-operate with the employer so far as is necessary to enable compliance with any statutory duty or requirement relating to health and safety.
In addition, conduct outside of work can result in an employee’s dismissal if the conduct pertains to the employment relationship. If an employee breaches their lockdown rules and it affects their ability to work, such as it being no longer safe for them to attend work, or the reputation of the employer, these may be grounds for disciplinary action and subsequent dismissal.
The CMA is particularly concerned about certain activities, its guidance highlights:
- Exchange of commercially sensitive information where this is not necessary in response to the crisis
- Collaboration which unfairly excludes third parties
- Abuse of a dominant position (including a dominant position held as a result of the crisis) – particularly to charge excessive prices
- Seeking to maintain prices or prevent reductions in prices
- Cooperation going beyond what is necessary to respond to the crisis in the interests of consumers
Ultimately closing a service will be a decision that is taken at the highest level and that decision will depend on risk appetite. Often these types of higher risk are mitigated by way of insurance but that still depends on an insurer being willing to accept that risk. This decision will depend on accepting a known risk and its consequences.
Undeniably and understandably BAME staff, as well as those staff who are identified as being at a higher risk, are going to have high levels of stress and anxiety. For some, this may become of such severity that those staff should be considered to be disabled under the Equality Act 2010. The question as to whether someone is disabled is one that should be answered in conjunction with appropriate medical advice. But the question about how to support any staff suffering with stress and anxiety should not be left until that stage. Proactive steps need to be taken and expert advice obtained on what support measures should be put in place. We know that many NHS organisations are already giving the mental wellbeing of their staff the highest priority.
From our perspective, we would ask managers to be mindful that stress and anxiety is likely to feature in how an individual reacts to questions about the level of risk to their health and the impact on their duties. The conversations with some staff may not be easy to have and may be met with challenge.
For those staff who’s stress and anxiety is such that it would qualify as a disability, reasonable adjustments will need to be considered to the processes that you are applying.
An additional point to consider – it might be worth writing to all staff, asking them to come forward if they have any health conditions that they think you ought to be aware of, assuring them that such information is being given in the strictest confidence. You want to make sure that you are taking the appropriate measures to ensure their health and safety.
With the outbreak of coronavirus leading to a requirement for more employees to be working remotely, especially following Government advice that all non-essential travel including to and from work should be avoided, there has been an increased requirement for businesses to be more flexible in their approach to signing contracts.
The traditional approach has been for contracts to be printed and signed with a “wet ink” signature. However, this is not a strict legal requirement in the majority of circumstances and contracts can be formed without this degree of formality. English law recognises that contracts can be formed by electronic means – including the exchange of emails or the typing of a name into a document to signify agreement to it.
Whilst this approach offers a lot of flexibility, more sophisticated electronic signature tools are recommended for important documents, to enable the identity of the signatory to be validated and reduce the possibility of fraud.
If businesses are considering changing their contracting processes because of coronavirus, or because of a general shift towards paperless working, it is important to ensure that proper approval processes remain in place, and to consider whether a software tool should be used to complement them. Systems such as DocuSign are widely used.
There also remain some situations where legal advice is recommended before relying on an electronic signature:
- Where the other party is abroad – as local laws that are different from English law might apply
- If executing a deed – the law requires certain types of document to be executed as a deed (for example, transfers of land and powers of attorney), and the issues around electronic signature and witnessing are more complicated here