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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 are the consequences of the shake up of the planning Use Class system?

The Town and Country Planning (Use Classes) (Amendment) (England Regulations) 2020 were laid before Parliament and come into force on 1 September 2020. They apply in England only.

The changes include the revocation of the following Use Classes;

  • A1 – shops
  • A2 – financial and professional services
  • A3 – restaurants and cafes
  • A4 – drinking establishments
  • A5 – hot food takeaways
  • B1 – business. Also revoked are the sub parts of B1;
    • B1(a) – offices
    • B1(b) – research and development of products and processes
    • B1(c ) – industrial process
  • D1 – non residential institutions
  • D2 – assembly and leisure

The changes include the amendment of the following Use Class;

  • B2 (industry)

The changes include the introduction of the following Use Classes;

  • E – commercial, business and service
  • F.1 – learning and non-residential institutions
  • F.2 – Local community

There are no changes to the following Use Classes;

  • C1 – hotels, boarding and guest houses
  • C2 – residential institutions
  • C3 – dwellinghouses
  • C4 – small HMO

From 1 September 2020;

  • Small retail shops (not more than 280 sq metres net sales area) selling essential goods including food and at least 1 kilometre from another shop will cease being an A1 use and will become a F.2 (local community) use;
  • Other A1 shops will become an E (commercial, business and service) use;
  • A2 uses will become an E (commercial, business and service) use;
  • A3 uses will become an E (commercial, business and service) use;
  • A4 uses will not be in a Use Class, they will be sui generis, ie not in any use class;
  • A5 uses will not be in a Use Class, they will be sui generis, ie not in any use class;
  • B1 uses (included B1(a), B1 (b) and B1 (c) will become an E (commercial, business and service) use;
  • B2 uses will either be B2 uses or will be Class E uses.
  • Clinics, health centres, creches, day nurseries and day centres (previously D1 uses) will become an E (commercial, business and service) use;
  • Schools, non residential education and training centres, museums, public libraries, public halls, exhibition halls, places of worship, law courts (previously D1 uses) will become an F.1 ( learning and non-residential institutions) use;
  • Cinemas, concert halls, live music performance venues, bingo halls and dance halls (previously D2 uses) and will be sui generis, ie not in any use class;
  • Gyms, indoor sport, recreation or fitness not involving motorised vehicles or firearms principally to visiting members of the public (previously D2 uses) will become an E (commercial, business and service) use;
  • Hall or meeting place for the principal use of the local community (previously D2 uses) will become an F.2 (local community) use;
  • Indoor or outdoor swimming baths, skating rinks, outdoor sports or recreation grounds (not involving motorised vehicles or firearms) (previously D2 uses) will become an F.2 (local community) use.

Changes of use within a Use Class do not constitute development. That being the case, provided the Order is applicable, its operation not having been restricted by planning condition, Agreement or Article 4 (1) Direction for example, planning permission would not be required, development as defined not happening.  If legally binding confirmation is required that planning permission is not required this can only be obtained by way of a successful application for a Certificate of Lawfulness. In the absence of such, there is some risk.

It remains the case that planning permission may be required for operational works to buildings. It also remains the case that other consents and permissions may be necessary for example licenses. Furthermore amendments to leases may be required if the property is rented.

The Regulations additionally include transitional arrangements because of permitted development rights for changes of use in the Town and Country Planning (General Permitted Development) (England) Order amongst others.  To respond to this Regulations introduce a ‘material period’ which is defined as meaning the period beginning 1 September 2020 and ending 31 July 2021. It is expected during the material period the Orders giving permitted development rights for changes for use which do constitute development will be amended / updated to reflect the new use classes.

Click here to view the Regulations.

The above is based on our understanding of the new Regulations at the time of issue and in advance of planning practice guidance being issued.

Would it be appropriate to suspend someone who refuses to restrict their duties?

Suspension should always be a last resort and not a knee jerk reaction. We would not advise suspension unless a the above steps around the risk assessment have been undertaken. Depending on your local policies, suspension could then be an option on the basis that their health and safety and the health and safety of others are put at risk by their actions.

How do you ensure clinical governance around MHFAs?

MHFAs are not qualified mental health medical professionals and they should not be diagnosing or giving medical advice, however, their training will equip them to provide initial support to those experiencing symptoms of mental ill health, and to signpost to further professional help when needed. The MHFA training makes the boundaries of the MHFA role very clear and there should be clearly defined role specifications, procedures and support pathways in place to ensure that individuals are referred on appropriately. There should be peer support in place for MHFAs and a system in place to ensure no individual or individuals are overloaded.

What is happening with public transport?

Government guidance is that public transport should be avoided wherever possible. Transport providers will be expected to follow government guidance to make their services more COVID-19 secure.

Agreeing or imposing changes

A reduction in hours or salary or changes to hours or patterns of work is a contractual change – you can’t just impose it without significant risk. The same applies for lay-off or short-time working where there is no existing contractual right to impose these.

In summary, the process that an employer should follow to implement these measures is as follows:

  1. Communicate the Company’s position clearly and the urgent need to achieve temporary cost-saving to ensure the ongoing financial viability of the organisation
  2. Explain the proposed changes in detail and seek the employee’s agreement, and
  3. Record the agreed changes in a letter which is counter-signed by the employee.

If employees will not agree then employers will be at substantial risk of claims for unlawful deduction of wages, breach of contract and/or constructive unfair dismissal if they seek to impose these changes unilaterally. Employers should be mindful that this approach is likely to cause significant employee relations issues and dissatisfaction if only some employees agree to a reduction in pay. Employers should have a clear strategy for what their approach will be if this is the case – for example, they may wish to instead explore a different measure such as redundancies. This may form part of the employer’s communication when explaining the reason for the changes and seeking the employee’s agreement.

Unions: Employers should also be aware that where there is a recognised trade union in respect of any part of the workforce which is being asked to agree to a change to terms and conditions, the recognition agreement or collective agreement will require the employer to consult and/or negotiate with the trade union in the first instance.

Collective consultation: Where 20 or more dismissals are proposed at one establishment in any 90-day period, there are stringent collective consultation rules which apply (regardless of whether the employees have two years’ service or not). All dismissals count towards this total unless the dismissal is “not related to the individual concerned” – therefore dismissals for things such as conduct or capability do not count, but most other dismissals will count. This will include where you are imposing changes to the contract such as reduced hours or pay.

The rules on collective consultation set out a prescriptive and time-consuming process which must be followed, and minimum timescales before any redundancies can take effect. The cost of any claims relating to failure to follow collective consultation requirements are substantial, and specific advice should therefore always be sought before seeking to implement collective redundancies. We will be publishing further guidance on this on the Hub shortly.