The Act was passed at the end of last week and the first commencement regulation was published easing the requirements around certification, registration of deaths and still-births and cremations which are set out in this blog.
The provisions relating to the Coroner and the registration of deaths are designed to reduce the administrative burden on health care staff and to reduce the risk of cross-infection with those who administer the system of registration. At the same time, appropriate safeguards remain in place too.
As the Explanatory Notes set out, although the inquests could be adjourned until the pandemic has passed, this would deprive bereaved families of swift closure and would, in any event, simply delay resource pressure for the future.
Use of video and telephone
The Act extends the use of video technology to criminal proceedings. There is no specific mention of inquests but we anticipate Coroners will be encouraged to hold more video and telephone hearings. The Government believes concerns over the use of technology can be managed in the context of this emergency public health issue.
Jury trials for Covid-19 deaths
Are not to be required. For the purposes of an inquest (only) Covid-19 is not to be considered a notifiable disease requiring a jury.
Managing the process of registration and notification of death: Schedule 13
The provisions contained in Schedule 13 are now in force. The thrust of these provisions seems to be to cut the amount paperwork required if the number of deaths significantly increases and the number of medical practitioners available is seriously compromised.
Notifications of deaths to the Coroner
Amending the existing regulations around the notification of deaths to the Coroner by a doctor to permit any doctor who may not have seen the deceased to certify the cause of death, without the requirement to report such a death to the Coroner – as they would now.
A medical practitioner will still be required to certify the death and report any concerns to the Coroner in the normal way.
Chief Coroner guidance
The Chief Coroner published his guidance last Thursday. The key message is that coroners have discretions and judgements to exercise in various respects and can be expected to exercise them in a pragmatic way which takes account of the effects of the pandemic. To avoid unnecessary repetition, we have permission to republish the summary produced by our colleagues at Serjeants' Inn Chambers.
Registration of deaths and still-births Schedule 13 section 3
A relaxation of the requirements for a face-to-face registration by a qualified informant. Normally a relation. Information may be given by other means, if the local authority decides face-to-face registration should not take place, if the informant is unable to attend in person. It may be that the Registrar is working from home or a face-to-face is not desirable due to illness. The need for the informant to sign the register in the presence of the Registrar may be disapplied.
Health and care providers must liaise with local Registrars' offices to give accurate information to the bereaved families.
Medical certificates of the cause of death
This is the certificate issued by a practitioner who was in attendance on the deceased and which gives the MCCD.
The Act enables further provision to be put in place, if required, to relax this requirement. At the moment arrangements to certify deaths where a patient dies in hospital in the presence of a medical practitioner proceed as usual. Provision will be made, if required, to relax this requirement if necessary. Where no medical practitioner can be deemed to be in attendance, provision will exist for any registered medical practitioner to certify those deaths (to the best of their knowledge and belief, based on the information provided to them).
There may be a need for training in death certification and especially, if there is a need to deal with further enquiry by the Registrar or the Coroner.
The 14 day rule
If a doctor, who has completed the medical certificate, has not seen the patient after death or within 14 days of death, the death must be reported to the Coroner by the Registrar. This is the case even if the death is natural causes (including Covid-19).
This period will be extended to 28 days from death to permit more flexibility during the Coronavirus outbreak.
Cremation: confirmatory medical certificates
Where a cremation is due to take place of a person whose death is not being investigated by the Coroner, the attending medical practitioner currently has to complete a medical certificate (Cremation Form 4), and a confirmatory medical certificate (Cremation Form 5) must be completed by an independent registered medical practitioner.
The requirement for Form 5 will be lifted. Cremations may take place without the need for a secondary medical certification.
Thus reducing the burden on healthcare professionals allowing them to be available to support with other duties. It will also reduce the likelihood of delays to allowing families to be able to make cremation arrangements for the deceased.
Do get in touch if you have any issues you would like to discuss, we have a friendly and expert team ready to help.
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