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Doctors told they 'don't have to record COVID-19' as a cause of death

UK Death Certificate
Leaked guidance given by one NHS Trust says doctors do not have to attribute deaths to coronavirus on patients' death certificates. (Picture: Getty)

An NHS Trust is being urged to change guidance that suggests that doctors do not need to list coronavirus on patients’ death certificates.

The guidance, obtained by the Good Law Project, says it is acceptable for doctors filling in death certificates to attribute a cause of death as “pneumonia or community-acquired pneumonia”, saying there is “no requirement” to cite COVID-19 as the cause of death.

The Good Law Project has launched a petition urging the trust - which it has not named - to change the guidance.

Jo Maugham QC, director of The Good Law Project, told Yahoo News UK: “There’s obviously enormous public interest in how many people are dying of COVID-19.

“If we are interested in how many people are dying we must also properly be interested in those statistics being collated accurately.”

The guidance issued by the unnamed NHS Trust says doctors are not required to enter COVID-19 on the death certificate. (Picture: The Good Law Project)
The guidance issued by the unnamed NHS Trust says doctors are not required to enter COVID-19 on the death certificate. (Picture: The Good Law Project)

He said there was a lot of anecdotal suggestion that doctors were not recording COVID-19 as a cause of death on certificates but this was the first piece of guidance he had come across, and he hadn’t named the Trust involved as he wanted to give them the opportunity to withdraw it.

“One of the reasons why I am not naming the Trust is I want to give it the benefit of the doubt and assume that this is an innocent error,” he said.

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“Once the matter has been properly publicised, once the law is clearly understood, if there is evidence of other Trusts or management in the NHS giving bad advice it would be more difficult to understand.”

He said while he couldn’t speak for every family, if he lost had lost a loved one, he would want records to accurately reflect their cause of death, adding: “If I was unfortunate enough to have lost someone I love I would want the records to show their actual cause of death.”

The document, titled ‘Guidance for death certification of proven Covid 19 patients during the current pandemic’, advises doctors to use a standard Medical Certificate of Cause of Death, known as an MCCD.

It says: “‘Pneumonia’ or ‘community-acquired pneumonia’ are acceptable at 1(a) on the MCCD.

The guidance adds: “There is no requirement to write Covid-19 as part of the MCCD. It may be mentioned at 1(b) on the form, should the doctor wish.”

Jo Maugham QC delivers a statement to the media outside the Court of Session in Edinburgh after a legal petition to gain a court order to make Prime Minister Boris Johnson seek a Brexit extension was dismissed. (Photo by Jane Barlow/PA Images via Getty Images)
Jo Maugham QC, director of The Good Law Project, said he hoped the guidance was an innocent mistake. (Picture: Jane Barlow/PA Images via Getty Images)

The Good Law Project has instructed a legal team to write a letter to the Trust calling for the guidance to be withdrawn.

In the letter, it points out that the guidance appears to contradict NHS guidance, which says: “Medical practitioners are required to certify causes of death “to the best of their knowledge and belief”.

“Without diagnostic proof, if appropriate and to avoid delay, medical practitioners can circle ‘2’ in the MCCD (“information from post-mortem may be available later”) or tick Box B on the reverse of the MCCD for ante-mortem investigations.

“For example, if before death the patient had symptoms typical of COVID-19 infection, but the test result has not been received, it would be satisfactory to give ‘COVID-19’ as the cause of death, tick Box B and then share the test result when it becomes available.”

The Department of Health & Social Care (DHSC) referred Yahoo News UK to a response to the Good Law Project posted on Twitter, which says: “This appears to be an altered version of official guidance.

“Guidance from the UK government is clear that “Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death.”

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