Care home and key worker deaths to be investigated by Crown Office

In a statement to MSPs, Mr Wolffe said the Crown Office was establishing a dedicated unit to conduct the work, but was unable to say how long the probes would take.

He said doctors would now be required to report all deaths of care home residents who had died of coronavirus contracted in the home. 

Deaths from coronavirus possibly caught in the workplace would also be registered with the Crown, including care home workers, frontline NHS staff, public transport employees and emergency services personnel.

The Lord Advocate is responsible for investigating sudden, unexpected and unexplained deaths in Scotland.

At the start of the pandemic in March, doctors were told they did not need to report Covid-19 or suspected Covid-19 deaths to the Crown unless there were substantive reasons for doing so in order to avoid overwhelming the medical system.

However Mr Wolffe said deaths still had to be reported if the circumstances would give rise to public anxiety.

He said: “My officials have been keeping and the situation under review, and I have concluded that two categories of Covid-19 or presumed Covid-19 deaths meet this [public anxiety] criterion and should accordingly be reported to the Crown.

“Those categories are, firstly, all Covid-19 or presumed Covid-19 deaths where the deceased may have contracted the virus in the course of their employment or occupation.

“Whilst not exhaustive, this may include deaths of care home workers, frontline NHS staff, public transport employees and emergency services personnel.

“Secondly, all Covid-19 or presumed Covid-19 deaths where the deceased was resident in a care home and the virus was contracted.”

He said he was working closely with the Chief Medical Officer to get the changes underway, following which a letter would go to all medical practitioners advising them to report deaths.

He said that the investigation process would also apply retrospectively to relevant deaths, but with Crown officials checking on past cases to reduce the burden on doctors.

“These steps will ensure that all deaths within the two categories will be registered within the current system of death investigation, and each of these deaths can be investigated.

“The nature and extent of that investigation, the nature and the extent of the investigation which is required into any particular death or group of deaths will depend on the particular circumstances. 

“In some cases, the investigation required may be quite limited, in other cases it may be more extensive.

“In that regard it would be premature for me to speculate at this stage whether a fatal accident inquiry into any particular death or categories of death from Covid-19 would or would not be appropriate.

“Those are decisions that will fall to be made on the basis of the circumstances of each particular case once it has been investigated.”

He said he was “acutely conscious” of the interested of bereaved families facing sudden loss and promised the Crown would be sensitive to them and keep them informed. 

He said the Crown would also work alongside the Heath & Safety Executive, councils, the Care Inspectorate, the police and others to ensure the right agencies undertook the right investigations and decide whether the Crown needed to investigate further.

He said: “I’m confident that these arrangements will help to make sure that in due course we will, as a society, better understand the circumstances of these deaths,

“And where there are lessons that we can as a society learn for the future, we will learn those lessons, knowing as we do that every one of these deaths is an individual tragedy which calls for, from each one of us, profound sorrow, compassion and respect.”

He said that in the “great majority” of cases the new measures should not delay funerals.

The announcement was welcomed by the opposition parties at Holyrood.

Asked by Tory MSP Liam Kerr how long loved ones would have to wait for investigations to conclude, Mr Wolffe said every investigation would be different, but the vast majority of non-pandemic cases were closed in a “very short time” with answers given to the families.

He said: “I don’t expect that situation to be different in the context of the pandemic deaths.

“There will be deaths that require a more extensive investigation, but we anticipate that most death investigations will be able to be concluded relatively quickly.”

Labour MSP James Kelly said it was “particularly tragic” that NHS and care workers had died trying to protect others, and so they should be prioritised for fatal accident inquiries.

Mr Wolffe agreed each death was a tragedy, but said the investigation system did not require an FAI in every case.

However he said that where the law or public interest required an FAI it would be instructed, and that decisions not to hold an FAI could be subject to a review process driven by the next of kin.

Green MSP John Finnie said: "I welcome confirmation from the Lord Advocate that deaths in care homes and those of people who are believed to have contracted Covid-19 at their workplace will now be reported to the Crown Office.

"It’s essential that frontline workers are offered every protection in their workplace, and investigation must take place if there is any doubt that hasn’t been the case.

"It’s vital that residents in care homes, some of our most vulnerable citizens, are offered the highest levels of protection.  

"The Crown will be required to work collaboratively with the Health and Safety Executive, the Care Inspectorate and other appropriate bodies and I welcome the Lord Advocate’s commitment that he will seek to proceed in such a manner.”