Coronavirus Act – key facts

The Coronavirus Act 2020 received royal assent on 25 March 2020. You should check carefully that the specific provision has come into force and check regularly that it remains in force. The government will be able to start and stop the provisions at various times, as needed.

Commencement date = date Act came into force

Provision has been made to allow the temporary registration of the following healthcare professionals:
- a registered nurse
- midwife
- nursing associate
- arts therapists
- chiropodists
- clinical scientists
- dietitians
- medical laboratory technicians
- occupational therapists
- orthoptists
- paramedics
- physiotherapists
- prosthetists and orthotists
- radiographers
- speech and language therapists
Provision has also been made to allow the temporary registration of social workers

Suspension of duties to undertake assessments of need/discharge of patients from hospital

Commencement date = date Act came into force

Trusts are not required to ensure that any assessment of CHC, following the National Framework is completed and/or consultation with social services prior to discharge from hospital
When issuing an assessment notice, trusts are not required to include a statement that there has been consideration of CHC eligibility
CCGs are not under any duty to assess patients for eligibility for CHC or FNC
If a choice is made to assess a person for eligibility for CHC then the duty to consider FNC also applies
The suspension of these duties applies in relation to duties arising before the act comes into force

Commencement date: 31st March 2020

Local authorities are not required to undertake any assessments of need under the Care Act for either persons appearing to be in need of care and support and/or carers’ assessments
The duty to meet an adult’s needs for care and support must continue to be met where it is identified that not doing so would result in a breach of the person’s human rights
When the local authority is responding to an assessment notice they must inform the trust:
1. whether the patient has needs for care and support
2. (where applicable) whether a carer has needs for support
3. which (if any) of those needs the authority plans to meet
4. how the authority plans to meet those needs

Deaths and inquests

Commencement date: 26 March 2020

A registered medical practitioner, who is not the practitioner who attended the deceased person during their last illness may sign a certificate if:
- the practitioner who attended is unable to sign the certificate or it is impractical for that practitioner to sign the certificate; and
- they are able to state to the best of their knowledge and belief the cause of death.
A registered medical practitioner is not required to notify the relevant senior coroner of a person’s death in the circumstances described in regulation 3(1)(e) or (f) of the 2019 Regulations unless the practitioner also reasonably believes that there is no registered medical practitioner who may sign a certificate as set out at (a) and (b) above.

Commencement = date Act came into force

While coronavirus is a notifiable disease, there is no requirement for an inquest to be held with a jury following a coronavirus-related death
This applies to any inquests opened while the Act is in force regardless of the date of the death

Indemnity for health service activity

Commencement = date Act came into force

For any civil liabilities arising in respect of or consequent on death, personal injury or loss that arises out of, or in connection with, a breach of duty of care owed in connection with the provision of health care services, indemnity may be offered by the secretary of state where existing insurance does not cover this.
The secretary of state or a person authorised by the secretary of state will determine whether a qualifying liability has arisen and if so the amount of any payment to be made.
This can cover situations where health services are being delivered to care for or treat a person who has, or is suspected of having, coronavirus, whether or not the negligent aspect of any treatment provided is aimed at the treatment of coronavirus. This includes the diagnosis/determination of whether the person has been infected.
It also includes situations where a replacement health professional is used to diagnose and/or deliver care and treatment (not connected to the treatment of coronavirus e.g. cancer treatment) to patients to whom they would not usually be responsible for delivering care, because the professional who would usually deliver this is unable to do so due to a coronavirus-related reason.

Powers in relation to potentially infectious persons

Commencement: date Act came into force

The Declaration made by the secretary of state on 10 February 2020 = the declaration required by this part so is currently in force.

If the secretary of state, after consultation with the chief medical officer or any of the deputy chief medical officers of the Department of Health and Social Care, declares that the incidence or transmission of coronavirus constitutes a serious and imminent threat to public health, then there will be powers conferred on public health officers to:
- direct the person to go immediately to a place specified in the direction which is suitable for screening and assessment;
- remove the person to a place suitable for screening and assessment; or
- direct a constable to remove the person.
Immigration officers and constables can also utilise the above powers, but must first consult with a public health officer to the extent that it is practicable to do so.
A person is ‘potentially infectious’ at any time if:
- the person is, or may be, infected or contaminated with coronavirus, and there is a risk that the person might infect or contaminate others with coronavirus; or
- the person has been in an infected area within the 14 days preceding that time.
A declaration is made by being published online and in the London Gazette and can be revoked at any time in the same way.
There are no limits to the number of occasions on which such a declaration can be made.
A ‘public health officer’ is either an officer of the secretary of state who has been designated in this role or a registered public health consultant.
Powers may only be exercised where the officer considers that there are reasonable grounds to suspect that the person is potentially infectious and that it is necessary and proportionate to do so:
- in the interests of the person;
- for the protection of other people; or
- for the maintenance of public health.
The person being removed needs to be informed of the above reasons and that it is an offence to refuse without reasonable grounds and/or to abscond.
The person can be held for the purpose of screening and assessment for up to 48 hours.
The person can be required to be screened and assessed, which can include taking of biological samples (e.g. blood or respiratory secretions), assessing symptoms and state of health, an assessment of the appropriate measures to take to mitigate the risk that the person may infect or contaminate others with coronavirus and answering questions in relation to travel history and contact with other persons.
The taking of biological samples and undertaking of health assessments would need to be completed by healthcare professionals.
These powers exercisable in respect of persons who are already present in a place suitable for screening and assessment.
Enforcement of the requirement to remain at the location can be undertaken by a public health officer or constable.
A public health officer can direct transfer to another place which is considered suitable for assessment and testing and if so the 48-hour time period starts afresh in that other place.
Where a person is already at a place that is suitable for screening and assessment, constables may hold a person who they believe is potentially infectious for up to 24 hours pending attendance of a public health officer to exercise their powers set out above, and immigration officers may hold a person for up to three hours. Those time periods can be extended for a further 24 hours for constables and nine hours for immigration officers, where it is not reasonably practicable for the public health officer to exercise their powers within the initial timeframe.
The time extensions can be granted by a superintendent or above for the police and by a senior immigration office for the immigration service.
The person must be informed that they are being held, why, timeframes and that it is an offence to abscond.
Where a person in England has been screened and assessed by a public health officer and either:
- the screening confirmed that the person is infected or contaminated with coronavirus; or
- the screening was inconclusive; or
- the officer has reasonable grounds to suspect that the person is potentially infectious;
- the officer may impose requirements and restrictions on the person. This can include requirements to provide information; contact information; to attend for the purposes of further screening and assessment; to remain at a specified place for a specified period or to remain at a specified place in isolation from others for a specified period.
Restrictions can include restrictions on the person’s movements or travel (within or outside the United Kingdom); the person’s activities (including their work or business activities); the person’s contact with other persons or with other specified persons.
Where requirements or restrictions are imposed the officer must inform the person of the reason why those requirements and/or restrictions are in place and that it is an offence to fail to comply.
Any restriction must be for no longer than 14 days and must be reviewed by the public health officer within 48 hours for reconsideration. Requirements or recommendations can be revoked or amended.
Restrictions can be extended for a further 14 days if the public health officer considers that the person will remain potentially infectious at the end of the initial period and/or that it is necessary and proportionate.
In the event of an extension being implemented the officer is required to review the requirement or restriction in place at least once in every 24-hour period and may revoke to otherwise amend the requirements or restrictions.
There are police powers to return any person being held who absconds, and reasonable force can be used to remove the person to and/or keep them at a place for assessment and testing.
A constable may enter any place for the purpose of exercising these powers.
A direction, instruction, requirement or restriction can be given or imposed orally or in writing.
Any individual held under these powers may apply to the magistrates to challenge any requirement or restrictions imposed.

Children

Anyone responsible for a child must, as far as reasonably practicable, ensure that the child complies with any direction instruction, requirement or restriction imposed and the public health officer can direct the responsible person to take the child to a suitable place for the purpose of assessment or treatment.
If a child is unaccompanied by an adult where these powers are being exercised, the officer must, if practicable, contact an individual who has responsibility for the child prior to exercising the power or take reasonable steps after the power is exercised to inform them of this
As above, a direction, instruction, requirement or restriction may be given or imposed orally or in writing.

Offences

The following are offences which can result in a fine of up to £1000.00:
- Failure (without reasonable excuse) to comply with any direction, reasonable instruction, requirement or restriction either to themselves or in respect of a child for whom they are responsible
- Absconding or attempts to abscond
- Knowingly providing misleading information
- Obstructing a person exercising or attempting to exercise these powers

Impact on NHS employers

Pensions

Commencement: date Act came into force

The Bill suspends the application of a number of provisions in the NHS Pension Scheme Regulations for all three of the NHS Pension Schemes (1995, 2008 and 2015 Schemes) which would otherwise act as financial barriers for individuals returning to NHS employment.
The amendments would allow individuals to continue or return to NHS employment without infringement on their NHS pension in payment that would otherwise apply.

Emergency volunteering leave

Commencement: TBC by Regulations

The Bill creates a temporary new form of statutory unpaid leave for employees and workers who wish to volunteer, to be called emergency volunteering leave.
The clause also includes certain rights and protections for employees and workers who take emergency volunteering leave, including, for example, the maintenance of terms and conditions of employment during any period of leave and protection from detriment or dismissal for taking the leave.
The clause also provides an obligation on the secretary of state for health and social care to establish a compensation scheme, to compensate eligible volunteers for some loss of income and expenses incurred.
To mitigate the impact on business of employees becoming volunteers, the maximum amount of emergency volunteering leave an individual can take is four weeks in any volunteering period of 16 weeks. Agency staff can also become volunteers under the scheme.
The government hopes that significant numbers of suitably qualified or experienced individuals will come forward to act as volunteers and that this will significantly benefit the NHS as it attempts to treat those who contract coronavirus.

Statutory sick pay

Commencement: date Act came into force

May be claimed on the first day of incapacity
Extended to those who are quarantined or self-isolating due to coronavirus, either because they have symptoms; or because they live with someone who has symptoms; or because they are following the direction of a medical professional or government guidance.

Changes to the Mental Health Act 1983

Commencement: TBC by Regulations

Applications for detention under section 2 and section 3

AMHPs can make applications for detention under s.2 or s.3 founded on a single medical recommendation if they consider obtaining two medical recommendations would be ‘impractical or would involve undesirable delay’. This must be set out in the application.
The single medical recommendation needs to be completed by a section 12-approved doctor but there is no requirement for previous acquaintance with the patient.
Statutory forms can continue to be used with appropriate amendments where they do not fit with the modified provisions.
Upon scrutiny, if the hospital managers are not satisfied that the single medical recommendation is sufficient, then a fresh medical recommendation can be obtained within 14 days of the patient’s admission.

Holding powers

Doctors’ holding powers extended from 72 hours to 120 hours.
The report can be completed by any registered medical practitioner or approved clinician where ‘it is impractical or would involve undesirable delay’ for the clinician in charge of treatment to complete this.
Nurses’ holding power extended from 6 hours to 12 hours.

Treatment - administration of medicine to persons liable to detention in hospital

SOAD not required to certify continuation of medication after three months if the AC in charge of treatment considers that this would be ‘impracticable or would involve undesirable delay’.
Consultation can take place with one other person rather than two – requirements are:
- the person must have been professionally concerned with the patient’s medical treatment; but
- not a nurse, registered medical practitioner, RC or AC in charge of the treatment in question.

Detention in place of safety

Section 135 and 136 timeframes extended from 24 hours to 36 hours.
12-hour extension can still be given after 36 hours if the criteria are met.

Patients concerned with the criminal justice system

Time limit of ‘12 weeks in all’ for patients remanded to hospital under sections 35 and 36 is removed, so there is now no total time limit in place. It will remain the case that a person cannot be remanded to hospital for more than 28 days at a time.
Courts can rely on one medical recommendation for the following sections:
- s.36, s.37, s.38, s.51
Courts can rely on one medical recommendation for s.45A, but the practitioner must have given evidence orally.
Once a decision has been made to admit a patient to hospital under one of the above sections, the time limit for transfer has been amended to include ‘or as soon as it is practicable after the end of that period’ but this is limited to a further seven days.
Prison transfers under s.47 or s.48 can be granted on the basis of one medical recommendation.
The timeframe for transfers to be completed under s.47 or s.48 is extended from 14 days to 28 days.