Written question WQ82585

The Welsh Government hospital visiting guidance and supplementary statement were published on 30 November. The health, safety and well-being of patients, staff and the local community remain an absolute priority; it should be remembered that many patients, including frail in-patients, will be clinically vulnerable and more susceptible to coronavirus.

The guidance contains a number of exceptions for visiting patients in non-COVID-19 areas with specific needs, such as frail in-patients. It supports visiting for people with long term conditions or people with specific care and well-being needs that the visitor/carer actively contributes to, for example, feeding, supporting communication needs and supporting rehabilitation. The health and well-being of these patients may benefit from seeing appropriate visitors, as their length of stay is over many weeks. This should be documented in their care plan.

The guidance also permits one visitor at a time for a patient with mental health needs, dementia, learning disability or cognitive impairment, where lack of visiting would cause distress or it is required as a reasonable adjustment to support access to health assessment or intervention.

Some people, particularly frail in-patients, may require essential support assistants for specific additional support. The guidance states that essential support assistants are not to be classed as visitors in the traditional sense; in some circumstances, where people receive care and support from a family member or partner they may nominate this person as their essential support assistant.

The guidance contains an exceptionality clause which provides health providers with discretion to agree to visiting requests not outlined in the guidance where they are satisfied the benefits to the well-being of the patient or visitor in agreeing a visit outweigh the infection control risks and any other practical difficulties in facilitating access.

The accompanying supplementary statement provides health providers with the flexibility to depart from the guidance in response to rising or falling levels of COVID-19 transmission locally.

The Welsh Government hospital visiting guidance and supplementary statement are not mandatory and health providers have the discretion and flexibility to consider individual circumstances when facilitating visiting. Health boards are already relaxing visiting restrictions in line with local risk assessment policies and being mindful of the benefits visitors can provide in patients’ well-being and aiding recovery.

It is important that visiting is risk assessed and agreed locally to ensure infection prevention and control measures can be followed, particularly in light of the new covid variants that are emerging. Health providers need to consider local environmental factors such as room size, equipment, distance between beds and the ability to maintain social distancing when making decisions to agree visiting. It is for these reasons that the guidance provides an element of flexibility to health providers.

Health providers are expected to work with their infection prevention and control teams and Public Health Wales when making decisions to depart from the guidance. This aims to provide a collective reassurance that there is a consistent approach when taking decisions to enhance or relax visiting restrictions.

The guidance was developed with key stakeholders and is kept under regular review.