Who is liable to pay the fine for not wearing a face mask at work, the employer or the employee?

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.

The Chief Coroner adopts the approach taken by the Lord Chief Justice in that no physical hearing should take place unless it is urgent and essential business, and it is safe for all involved. If a hearing is to take place, social distancing must be maintained. All hearings that can take place remotely should do so, if it is not possible for social distancing requirements to be met. The expectation is that some hearings will go ahead, most notably Rule 23 hearings. Coroners are reminded that they must however conduct any remote hearings from a court. Decisions as to the most appropriate approach will be left to the senior coroner in that jurisdiction.

As we have already seen, some inquests will be adjourned, most notably those with multiple witnesses and/or a jury.

The guidance stresses the need, when dealing with medical professionals, for coroners to recognise their primary clinical commitments, particularly in these high-pressured times. This could mean avoiding or deferring requests for lengthy reports/ statements and accommodating clinical commitments if clinicians are called as witnesses.

The guidance encourages proactive reviews of outstanding responses to Prevention of Future Death reports and extending timescales for Trusts to respond.

• Be alert to the fact that guidance on treating Covid-19 may change with emerging knowledge/scientific data and this may require subsequent modifications to treatment.
• Critical care staff should support healthcare professionals who do not routinely work in critical care but need to do so.

In the unfortunate event that there will be a significant number of deaths, planning will fall to the local resilience forum; which includes all relevant local organisations and statutory bodies, who will have prior experience in working in excessive death scenarios.

It is for the coroners to ensure that they are familiar with the local resilience forum plans and discussions required. This will include issues regarding storage capacity and post-mortem examination capacity.

The General Medical Council (GMC) have published guidance online for doctors during this time of uncertainty.

Alongside this, their website displays guidance for temporary registration to approximately 15,000 doctors, who left the register or gave up their licence to practise in the last three years.

These clinicians have been contacted to assist with the growing pandemic, outlining the process they would follow and informing them of their right to opt-out. The Secretary of State for Health can ask the GMC to grant such registration under Section 18a of the Medical Act 1983, in an emergency.