The Department of Health issued a press release confirming that families of health and care workers on the frontline in England will benefit from a new life assurance scheme during the Coronavirus (COVID-19) pandemic. Details of the scheme, which were first published on 27 April, are now beginning to become clearer.
On 11 June 2020, the Chief Coroner published his Guidance No 38, ‘Remote Participation in Coronial Proceedings via Video and Audio Broadcast’. This guidance builds upon Guidance No 35 dealing with hearings during the COVID-19 pandemic which we have commented on in previous blogs.
Since the lockdown began most inquests have been postponed, with coroners opening inquests and holding documentary inquests where no witnesses are called to give evidence.
The current pandemic has seen the increase in use of partially remote hearings where the court is satisfied that it is just to do so.
In the past few months, one of the dominant news stories has been that of the effect of the COVID-19 pandemic on the social care sector. This has mostly focused upon the issues surrounding elderly care.
However, the Care Quality Commission (CQC) has this week published an analysis regarding deaths of persons with a learning disability and/or autism. The analysis is based upon notifications from providers registered with the CQC where the death certificate indicates the deceased had a learning disability. This shows in the period 10 April to 15 May there was a 134% increase in deaths in comparison to the same period in 2019.
Our recent blogs have consistently focused on this developing saga as COVID-19 continues and as we as a nation compare ourselves to our counterparts, we are increasingly coming up short. There is a stark message coming through that our most vulnerable have been forgotten: the elderly in care homes, the detained in mental health units and those with learning disabilities.
During yesterday’s daily Downing Street briefing, Matt Hancock was asked by the BBC about his party’s election manifesto promises concerning social care reform.
Prior to the December general election, the Conservative party manifesto promised to reform social care. Matt Hancock was asked at the briefing yesterday by the BBC whether the government was still planning a cap on care fees that have to be met directly, and whether he accepted that social care reform could not be put off again.
The COVID-19 pandemic has shone a light on the resourcing of care homes that is long overdue.
Following exchanges in the commons and a study by LSE it appears that 22,000 care home residents have died in England and Wales to date as a result of COVID-19 but statistics will no doubt continue to be debated with the lack of testing being a stumbling block for absolute clarity.
On 6 May it was announced that five residents had died at a care home on the Scottish island of Skye at the centre of a COVID-19 (C-19) outbreak on the island. 57 residents and staff at this care home have tested positive for C-19. Ten deaths have also recently been reported at a care home in East Dunbartonshire.
Statistics from the National Records of Scotland show that by Sunday 3 May there had been 2,795 deaths in Scotland where C-19 is mentioned on a death certificate. More than four in ten of those deaths (42.8%) have been in care homes. The proportion of deaths in care homes has also been growing, accounting for almost 60% of C-19 deaths between 27 April and 3 May.
The Chief Coroner for England and Wales issued further guidance on 28 April 2020 in the form of guidance sheet number 37 addressing COVID-19 deaths and possible exposure in the workplace. This will be of significance to those involved in inquests or investigations relating to COVID-19 deaths.
He confirms that the vast majority of deaths from COVID-19 arise from the natural progression of this naturally occurring disease and therefore will not be referred to the coroner. He reminds his coroners of the Ministry of Justice guidance on the Notification of Deaths Regulations 2019 which confirms that a death is to be typically considered unnatural if it has not resulted entirely from a naturally occurring disease process, importantly it goes on, where nothing else is implicated.
We have recently written several blogs regarding various COVID-19 related problems the care sector is facing. In particular the supply of PPE and the effect of COVID-19 generally on staffing levels and management of service users are critical issues.
The Chief Executive and Registrar at the Nursing and Midwifery Council (NMC) recently expressed concern that as result of the COVID-19 pandemic, there had been reports of blanket advance care plans, including do not attempt cardiopulmonary resuscitation (DNACPR) orders, being applied to specific groups of people. This is concerning as such decisions have been made without the individual’s involvement or an assessment of their specific needs. These decisions seemed to ignore the requirement that decisions must involve the patient unless to do so would cause harm and if the clinician’s decision is that attempting CPR is futile there is an obligation to tell the patient that this is the decision.
In light of these alarming reports and due to the increasing pressures on healthcare professionals to make urgent and complex clinical decisions, the NMC and the General Medical Council (GMC) issued a joint statement on 15 April 2020 to highlight the continuing importance of advance care planning for individuals during these unprecedented times. At the same time the Department of Health & Social Care (DHSC) also issued guidance on 15 April 2020 confirming that it is unacceptable for advance care plans, including DNACPR to be applied in a blanket fashion. DHSC guidance 15 4 20