Hospital visiting: guidance for health boards

Key principles

These principles are designed to support local NHS clinical teams to take a flexible, compassionate approach whilst managing the clinical environment safely. A flexible person-centred approach should always be taken.

• helping people in hospital to get the vital support they need from family members is of paramount importance. This should balance risk proportionately whilst considering the rights, wellbeing and safety of all concerned
• all people in hospital should be able to have visits from family and carers during their hospital stay
• the number of people visiting at any one time should be managed appropriately. The need for family support should be balanced with the need for dignity and privacy of other people, especially in multiple occupancy areas, and maintaining a safe environment where clinical teams can go about their work. For example, two family members visiting at a time is generally a helpful approach, but this should not be inflexible and there may be times when it is appropriate have more or less
• mealtimes are particularly important for family support, especially if the person in hospital is frail, has a cognitive impairment such as dementia or a learning disability
• if a family member or carer is unwell, they should not visit unless there are extenuating circumstances, such as at the end of life or other major life events
• local clinical teams should feel empowered to make the right decision to meet the needs of the person in hospital and their family in any given circumstance. If in doubt, the default position should be to err on the side of compassion and facilitate visits
• acknowledging the fundamental human right to family life and recognising the negative impact on patient safety and psychological wellbeing, blanket policies restricting visiting should not be used

Additional considerations

• there are specific clinical circumstances where visits do need to be more carefully managed. For example, when an individual is severely immunocompromised following organ donation or bone marrow transplantation
• in the case of someone with incapacity, the views of the Power of Attorney or Guardian, which should be central to the decision about who provides support as well as individual views and needs of each patient. If an individual lacks capacity, the principles of the Adults with Incapacity Act make it clear that attempts should be made to involve the person in whatever way possible, considering past and present views. A person-centred focus should still be adopted
• visiting should not be restricted because of increased hospital activity, staffing challenges or breakdowns in staff-family relationships. In such circumstances family support is more important than ever. Restricting visiting has been shown to have negative impact on patient safety and on care experience resulting in poorer outcomes, increased tension and poor relationships with families, as well as increased complaints
• in the event of an outbreak of infection the local Incident Management Team (IMT) or Infection Prevention and Control Team may need to temporarily instate specific restrictions in areas to prevent spread and to protect patients, families and staff. This is normal practice for outbreak management. Even in these circumstances essential visits should be able to continue
• some examples of essential visits are given below but this list is not exhaustive, and a flexible compassionate approach should always guide decision-making
  • when someone is reaching the end of their life
  • if someone has dementia and needs family support
  • support for someone with a learning disability
  • a family member who has informal caring responsibilities
  • parents of a child in hospital
  • support during pregnancy and childbirth, including outpatient appointments, ante-natal and post-natal care
  • situations where someone is receiving life-changing information