These principles, are designed to support clinical teams to take a flexible, compassionate approach and to manage risks appropriately.
- helping people in hospital to get the vital support they need from family, carers or friends is of paramount importance. This should be done in a way that recognises the balance of risks proportionately and has the rights, wellbeing and safety of all concerned at its heart.
- all people in hospital should be able to have daily support in-person during their hospital stay.
- the family members visiting and providing support can change to meet the needs of patient or family.
- in some cases, the family member providing support may need to be accompanied, for example a child visiting a parent or sibling, or a frail older person, or a disabled person who cannot attend the hospital independently. The presence of the additional person should be facilitated and should not prevent a visit taking place.
- anyone who wants to visit a loved one in hospital should carry out an LFD test before every visit and must not visit if the test is positive but should self-isolate immediately and if they have symptoms of COVID-19 organise a PCR test via theNHS Inform website.
- they should not visit if they are feeling unwell, even if the test is negative.
- family, carers or friends attending the hospital to provide support should follow infection prevention and control guidance.
- physical distancing of 2m should be adhered to in communal areas of the hospital wherever possible, but with appropriate infection prevention and control (IPC) measures in place we expect families to be able to have close contact, such as holding hands, when they are with the person they are supporting. A risk assessed approach should be taken as required.
- a person-centred focus should be adopted. The individual views and needs of each patient and, in the case of someone with incapacity, the views of the Power of Attorney or Guardian, should be central to the decision about who provides this support. If an individual lacks capacity, the principles of the Adults with Incapacity (AWI) Act make it clear that attempts should be made to involve the person in whatever way possible, considering past and present views.
- 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.
- recognising the negative impact on patient safety and psychological wellbeing, “blanket” policies for all hospitals, or all patients with particular characteristics, should not be applied This also recognises the fundamental importance of the right to family life.
- visiting should not be restricted because of increased hospital activity or staffing challenges. In such circumstances family support is more important than ever.
- Whilst appointments for visitors may be required in some circumstances, for example to manage numbers of people in multiple occupancy areas, these should not be compressed into limited time slots within a day. A person-centred approach should be adopted to enable people to attend at a time convenient to them and to meet the needs of the patient, as much as is possible.
- current data on community incidence and prevalence of COVID-19 may impact on visiting arrangements, but this should be balanced with the rights, needs and circumstances of the patient and their family.
- in the event of an outbreak in a hospital the local Incident Management Team (IMT) may need to reinstate time limited and specific restrictions in areas to protect patients, families and staff as is normal practice in outbreak situations.
- if COVID-19 cases are so numerous that they are being cohorted within a specific area of a hospital then previous guidance on limiting support to “essential visits” may need to apply for this specific group of patients.
- if frequency of COVID-19 cases is low and limited to an individual patient in a ward or ICU, for example, then local infection prevention and control (IPC) policies should be applied as would be the case for other infectious diseases with a similar risk profile to COVID-19. In these circumstances support from at least one or two people should still be possible in addition to lateral flow testing by the visitor.
- this guidance has been reviewed in conjunction with ARHAI and Public Health Scotland and aligns with policies and recommendations in terms of Infection Prevention and Control (IPC).
If you have feedback on this guidance please email: Annalena.Winslow@gov.scot.
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