Publication - Advice and guidance

Coronavirus (COVID-19): outpatient guidance for people on cancer pathways

Scottish Government guidance on outpatient visiting for people on cancer pathways during the coronavirus pandemic which applies from 1 April 2021.

Published:
31 Mar 2021
Coronavirus (COVID-19): outpatient guidance for people on cancer pathways

This guidance has been established as part of the Scottish Government’s ‘Recovery and Redesign: an action plan for cancer services’ published in December 2020.

Effective from 1 April 2021, this advice will continue while the NHS is on an emergency footing and applies at all of the five COVID-19 Levels but may be changed during a national lockdown.

In line with national visiting guidance, a carer or interpreter – or someone else fulfilling a similar or necessary function – should not be considered a visitor.

Purpose

The health, safety and wellbeing of cancer patients and NHS Scotland staff is crucial and remains our priority. The existing outpatient and primary care consultations principles highlight several circumstances where one dedicated person may attend with a patient, including where a person is receiving a cancer diagnosis or discussing cancer treatment options. This guidance seeks to provide further clarification for cancer-specific outpatient appointments and visits. Health boards are encouraged to:

  • support application to their local guidance on patient visiting and accompanying to appointments for cancer treatment, discussing treatment options and when receiving news
  • provide a person-centred approach to treatment and clinical discussions  
  • explain virtual alternatives, via an electronic platform or by phone, where a supporting person is unable to attend in person
  • apply these principles in a flexible and compassionate way

Key principles

In line with the wider outpatient guidance:

  • visitors (including those categorised as ‘essential’) must not have symptoms of COVID-19 and must not attend if they are self-isolating for suspected or confirmed COVID-19 or have recently returned from a country requiring quarantine
  • before visiting, appropriate arrangements and timings to support maintaining physical distance should be discussed with the clinical area during initial consultation or by contacting the clinic. This would include a discussion should the person be exempt from wearing a face covering.
  • visitors should wear face coverings or any other PPE as indicated by the clinical team and must adhere to strict hand and respiratory hygiene by using alcohol based hand rub on entering and leaving the ward/department or following any patient contact, covering the nose and mouth with a disposable tissue when sneezing, coughing, wiping or blowing the nose. These should be disposed of immediately in the bin and hand washing performed immediately afterwards. 
  • all visitors should consult their local health board’s guidance and Transport Scotland guidance for advice on how to travel safely to hospital

Cancer specific outpatient guidance

Most boards currently ask patients to attend appointments alone wherever possible so that social distancing can be maintained. There are several exemptions where one dedicated person may attend with a patient, including where a person is receiving a cancer diagnosis or discussing treatment options.

The following seeks to clarify when this is appropriate and how this can be facilitated. Patients and clinicians should discuss this during their first virtual consultation ahead of any outpatient appointments to ensure that appropriate preparations are in place.

Currently, many initial appointments will be conducted remotely. Depending on discussions and decisions to refer, follow up conversations may take place remotely (using telephone or video consultation) or face-to-face.

Clinical discussions (incl. receiving news or diagnosis and discussing treatment)

One dedicated person may support a patient who is attending a face-to-face appointment when discussing a cancer diagnosis, news or treatment options. Due to social distancing measures and waiting room capacity, supporting people may be asked to wait elsewhere and be called back to join the appointment.

Near Me, a video consulting service, is an important option in supporting our health boards to deliver person-centred care. Patients should be provided the option to attend appointments remotely or in person, when safe to do so. This preference should be recorded at the earliest opportunity available.

Near Me can also support group calling to allow a supporting person to attend from a different location. Read more about Near Me support group calling.

Similarly, where a supporting person is unable to attend a face-to-face appointment alongside a patient, they can attend remotely using Near Me services, conference call or using the patient’s person mobile device.

Patients who wish to record appointments for their own record or to share with friends or family members may do so with the consent of their clinician.

Treatment and tests

Due to social distancing, most treatment and test delivery areas are unable to accommodate additional visitors. Patients are advised that they should attend these appointments alone, however nursing staff are available to provide support for patients who requires assistance. 

Following an outpatient procedure (e.g. day surgery or endoscopy) patients can be met at the front door of the hospital by a supporting person. If further clinical discussion is required following the procedure, patients can invite someone to join for support.

For radiology appointments, patients may bring support following a discussion with the department. Although, it’s recommended that patients attend alone where possible.

Near Me services are currently being used to reduce the number of patients having to attend in person at outpatient clinics (e.g. for toxicity monitoring or follow up). Supporting persons are welcome to attend these appointments.

Following a discussion with their clinician and where appropriate, a patient may use their personal mobile device to remotely connect with supporting persons during treatment or tests.