COVID-19 Scotland: Healthcare implications of the Coronavirus Act

The Coronavirus Act 2020 was given Royal Assent on 25 March 2020. This emergency legislation will be in place for two years and will be reviewed by ministers every six months. In her recent article Gemma Brannigan set out the key healthcare implications. Here, we look at how some of the key provisions – and their implications – of the Act differ in Scotland. 

1. Emergency registration of health and social care professionals: the Act provides for temporary registration of those who perform primary medical services, in order to increase capacity. Interestingly, there is no mention of dentists: the vast bulk of dental services have ceased for the duration of the lockdown. There are different registration procedures, but this is the same list as England.
   
   The Act also allows for temporary registration of social workers; student social workers in their final year of training may register as a temporary social worker.  In England, there is no reference to student social workers nor to those on career breaks – those who are fit, proper and suitably experienced can temporarily register. It seems that Scotland has been given wider powers here.  
2. Indemnity: the Act provides that those involved in caring, treating or diagnosing coronavirus may be indemnified by Scottish Ministers in respect of any death, personal injury or loss arising out of a breach of duty of care owned in one of these services. This is however only applicable where there is no other arrangement in place. So a GP with indemnity cover must turn to their defence organisation first, with the risk of impact on premiums that this would bring.
3. Mental Health Act: the Act provides for relaxing of various requirements, and an increase of powers, under the Mental Health Act. The key provisions include an extension of the emergency detention period in hospital from 72 hours to 120 hours and a nurse's ability to detain for six hours instead of three; the ability of a medical practitioner to grant a short term detention certificate without consulting a mental health officer; the application for a compulsory treatment order to be made by one medical practitioner instead of two; an extension of an assessment order to 12 weeks instead of 14 days; and the ability for medicine to be administered without a certificate from a medical practitioner.
4. Registration of deaths: the Act again provides for a relaxation of requirements. The key provisions are: a suspension of the requirement on a local authority to make enquiries as to surviving relatives and a suspension of reviews of medical certificates of cause of death (including the stopping of reviews already commenced). With staff shortages and focus needed elsewhere on caring for those with the virus, these provisions are important in being able to speed up the process. In England, the powers enable a medical practitioner to notify a death where they may not have seen the deceased, without notifying a Coroner.
5. Local authority duties: the Act provides that various duties of a local authority which fall under the umbrella of assessing needs are suspended where it would not be practical to comply with them or would provide unnecessary delay in providing community care. In England, a local authority no longer needs to perform an NHS Continuing Healthcare Performance Assessment. This allows the NHS to simply discharge a patient.
6. Health protection regulations: the Act provides that regulations may be made which would impose requirements on healthcare professionals to record and notify cases or suspected cases of infection or contamination. Crucially the Scottish Ministers are given powers to make further regulations to introduce additional measures – bringing them into line with powers which already existed in England.

The Act will increase capacity and flexibility of healthcare professionals. Together with the indemnity provision, this will hopefully help to alleviate some of the pressure at an already pressure-filled time. The relaxing of various requirements will also allow those on the frontline to focus more on mitigating the impact of the virus.