UK Covid-19 Inquiry Module 3 report: Scottish Government response

Recommendation 2 - Guidance for visiting restrictions

Chair’s recommendation:

The UK Government, Scottish Government, Welsh Government and Northern Ireland Executive should publish guidance for the implementation of visiting restrictions in hospitals in the event of a future pandemic. The guidance should identify the circumstances in which visiting restrictions should be introduced, escalated, decreased and removed alongside the measures and exemptions at each level. The guidance should be led by the following core principles:

• Measures applied should be the least restrictive possible, both in terms of severity and the length of time for which they apply
• Restrictions should be decided upon and applied at the most local level possible
• Unless restrictions are applied at a specified level, trusts and health boards should take decisions on the severity of restrictions based on local risk assessments
• Communications with the public must clearly explain the measures in place and the reasons why restrictions apply

The guidance should be reviewed every three years in line with the Inquiry’s Module 1 Report (Recommendation 4).

Scottish Government response:

The Scottish Government accepts this recommendation.

The Scottish Government’s Hospital Visiting: Guidance for Health Boards, developed during the Covid-19 pandemic and updated as restrictions eased, recognises that support from those who matter most to a patient is fundamental to wellbeing, recovery and quality of care.

The Scottish Government recognises the evidence presented to the Inquiry and wider research published since the pandemic demonstrating the adverse consequences of overly restrictive visiting arrangements, including impacts on patient wellbeing, care quality, family involvement and psychological outcomes for patients, relatives and staff. The experiences shared by bereaved families have directly informed our response and further reinforced the importance of ensuring that people can maintain in-person contact with those who matter most to them. Recent comments from CIREG further emphasise the importance of visiting and the need to ensure that guidance is universally understood and consistently applied across all adult and children’s settings. Collectively, these findings reinforce Scotland's commitment to maintaining access to those who matter most to the patient.

In response to learnings from the pandemic, Scotland has taken proactive action to strengthen oversight and governance arrangements relating to hospital visiting. This includes the development of a national risk assessment process and escalation arrangements to ensure that any restrictions introduced by NHS Boards are proportionate, justified, time-limited and subject to appropriate scrutiny. Where restrictions are considered necessary, NHS Boards are expected to continue facilitating essential in-person visiting wherever possible. Essential visiting is in-person support from a person whose presence is necessary to ensure the patient's wellbeing, care, safety, communication or compassionate support, including during periods of restricted visiting.

The Scottish Government will continue to review and strengthen its guidance and supporting arrangements to ensure that, in any future pandemic or similar public health emergency, hospital visiting restrictions are applied consistently, transparently and proportionately, while protecting patient wellbeing, maintaining access to people who matter most to the patient and supporting compassionate care.

Actions and implementation timescale(s):

We are now strengthening in-person visiting in NHS settings, bringing the NHS into closer alignment with the principles set out in Anne’s Law in adult care homes in Scotland as a priority. We will work in partnership with the four nations to develop a common set of principles for visiting in healthcare settings.

We are taking forward work to strengthen support for in-person visiting in NHS settings, by enhancing our guidance and working to include a new Health and Social Care Standard specifically for visiting in NHS settings. We will engage with families and carers and other key stakeholders, as we develop this work to help us ensure the new standard is meaningful and meets their needs as best we can.

Once in place, regulators and ministers will be able to use existing legal powers to ensure NHS Boards implement the new standard. This work is expected to be completed by the middle of 2027.

We are also planning to inform NHS Boards of proposed changes and

encourage early action to reduce differences in access for those who matter the most to the patient. This will be completed by October 2026.

Accountable Officer:

The Director General for Health and Social Care, working with the Directorate for the Chief Operating Officer, NHS Scotland within the Scottish Government, will be accountable for the implementation of the Scottish elements of this recommendation.