Information

Coronavirus (COVID-19): hospital visiting guidance

Enabling family support for people in hospital in Scotland.

This document is part of a collection


Areas with COVID-19 

In the event of an outbreak, standard outbreak management policies will be applied by the local Incident Management Team (IMT) which may include limiting family and carer support to essential visits only in the ward, department or area concerned. In a situation where an individual patient with COVID-19 is being cared for outwith an outbreak situation, it may still be possible to safely manage support from at least one person as would be the case with other infectious diseases with a similar risk profile to COVID-19. These decisions should be made based on each individual case by the clinical team at local level.

If a decision is taken to prevent family support in this situation the reasons why should be clearly communicated to the family and patient, including why it is not possible for the person providing family support to continue to visit taking the same IPC precautions as staff attending the patient.

If it does become necessary to restrict visiting, the below examples of “essential visiting” which were supported earlier in the pandemic should be maintained (bearing in mind these are illustrative examples only, and not exhaustive):

  • a birth partner supporting a woman during hospital visits
  • a person receiving end-of-life care – we expect this to be defined as flexibly and compassionately as possible, to support patients at the end of life spending meaningful time with their loved ones in their final days, weeks or months
  • to support someone with a mental health issue, or dementia, or a learning disability or autism, where not being present would cause the patient to be distressed
  • to accompany a child in hospital
  • in general situations when someone is receiving information about life-changing illness or treatments
  • In these and other similar situations where support from another person is essential for advocacy and wellbeing, family support should be facilitated.

These examples are illustrative rather than exhaustive. A flexible, compassionate approach is encouraged, and healthcare staff should be supported to facilitate family support in any situation where they assess that it is important to involve family or carers for ethical, safety, or other reasons. Individual healthcare professionals and clinical teams should feel empowered to make the right decision to meet the needs of the individual patient and their family in any given circumstance. If in doubt, the default position should be to err on the side of compassion and facilitate family contact.

If a patient has suspected or confirmed COVID-19, those providing essential support should be provided with the appropriate PPE as is the case for staff who have close contact with COVID-19 patients. Those providing family support in these situations should not be required to self-isolate following visits if they have followed the IPC and PPE procedures, however, this may require discussion with test and protect staff.

Where a COVID-19 positive patient is receiving care that results in the creation of aerosols in the clinical environment (such as non-invasive ventilatory support or invasive mechanical ventilation) local risk assessments should be carried out to facilitate family support where possible and as safely as possible.  This includes a careful consideration of the clinical condition of the patient and good communication with family members involving discussion of risk and benefit. Other factors that should be considered include, the health status of the visitor, including their general health and immune status with regard to COVID-19, along with any other relevant details.

Physical distancing must be maintained in the communal areas of the hospital where possible, according to national guidance and local IPC risk assessment.

Virtual visiting

Where in-person support is not possible for any reason, a patient can be supported by other alternatives such as person-centred “virtual visiting” using tablets or mobiles. However, it is important to bear in mind that this virtual approach will not be appropriate for some people and it should not be used to replace in-person support.

The virtual option is available for circumstances where in-person support is prevented either for clinical reasons or by geographical distance or because the visitor is isolating. The first option should always be to aim to facilitate in-person support from family, carers or friends.

Contact

If you have feedback on this guidance please email: Annalena.Winslow@gov.scot.

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