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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The Act should make it easier for residents to obtain relevant information. It includes an obligation for the Principal Accountable Person to prepare a strategy for promoting the participation of residents, including the information to be provided to them and consultations about relevant decisions. The strategy must be provided to residents, and there will be provision for residents to be able to request information and copies of documents from the Principal Accountable Person. The type of information and the form in which it is to be provided will be set out in secondary legislation in due course, but the explanatory notes anticipate that it will include:
- Full current and historical fire risk assessments•Planned maintenance and repair schedules
- The outcome of building safety inspection checks
- Information on how assets in the building are managed
- Details of preventative measures
- Details of fire protection measures and the fire strategy for the building
- Information on the maintenance of fire safety systems
- Structural assessments
- Planned and historical changes to the building
The Government has introduced legislation to expand the list of those who can register deaths to include Funeral Directors who are dealing with the funeral arrangements and who has been authorised by a relative of the deceased to register the death. Also, the medical cause of death certificate can be emailed to the Registrar’s office and arrangements made to have a telephone appointment to provide the Registrar with information to register the death. The requirement to attend the Registrar in person to sign the Register has been relaxed so that this is not necessary. It will however still be necessary to register the death within 5 days.
The Thriving at Work Report and the recent NICE Workplace Mental Health Guidelines provide a good baseline for what all organisations should be doing on workplace mental health – this includes some guidance on training. There does need to be a plan in place and we recommend taking a holistic view of the integration of mental health first aiders into a business – ie it should be one component in a strategy that also comprises training for line managers, awareness training and education for all staff, peer support, and a documented framework for support and signposting. It is also worth ensuring you have senior manager sponsorship, strong links with Occupational Health if available and also raising awareness via any works councils or employee forums helps ensure there is buy in at all levels.
We have developed a toolkit to assist with compliance. The Toolkit contains a specimen contract; detailed guidance; step by step guides and flowcharts; details of the factors to take into account for the status determination test; procedures for challenging the determination; and standard letters for the process. Click here to fill in a form and register your interest in the Toolkit, which contains:
- Detailed guidance in the form of Key Facts
- Employment status checklist
- Employment status assessment flowchart
- Status questionnaire and guidance
- Letter confirming self-employed status (agency)
- Letter confirming employed status (agency)
- Letter confirming self-employed status (direct with PSC)
- Letter confirming employed status (direct with PSC)
- Status disagreement process guidance
- Status disagreement process flowchart
- Letter confirming outcome of status disagreement process
- Consultancy agreement
Those who are eligible will be contacted directly by HMRC based on tax returns they have received. If you are eligible you will be asked to fill out an online application. HMRC will pay applicants directly.