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His Royal Highness The Duke of Edinburgh, 10 June 1921 to 9 April 2021

Read about the arrangements following The Duke of Edinburgh’s death

Purpose

This supplementary statement should be read in conjunction with the Welsh Government Hospital Visiting Guidance during Coronavirus and annexes issued on 15 July 2020, as amended (“the Guidance”). The Guidance was issued to provide a framework for Health Boards, Trusts and providers of hospice care to facilitate visiting within healthcare settings during the pandemic. 

Background

When the Guidance was issued it was considered, given the level of COVID-19 transmission in communities across Wales, that national guidance was both appropriate and desirable in order to promote a consistency of approach.  

More recently, a changing picture has emerged with significant variations in community transmission across different parts of Wales. We recognise how restrictions on visiting can impact adversely both on patients and their loved ones. The health, safety and wellbeing of patients, communities and health care provider staff remains an absolute priority.  

Consequently, the Welsh Government reiterates that the Guidance sets out the current baseline for visiting in Wales during the pandemic.  

We recognise, however, that providers of health care to which the Guidance applies may: 

  1. in response to rising levels of COVID-19 transmission in their localities, including levels which result in a national lockdown, and/or evidence of nosocomial transmission within a particular setting; or
     
  2. falling levels of transmission in their local area, 

depart from the Guidance.

Further guidance on such departure is provided below, but all decisions to depart from the Guidance should be made by the Health Board, Trust or Hospice’s Executive Team with their own infection prevention and control teams in collaboration with Public Health Wales. Engaging with Public Health Wales to inform local decisions provides a collective reassurance that there is a consistent approach when taking decisions to impose visiting restrictions, which go beyond those set out in the Guidance or indeed when relaxing the principles in the Guidance. 

Decision making in collaboration with Public Health Wales is also a feature of the updated guidance on care home visiting that was issued on 23 September.  
 

Further restrictions on visiting

It may be necessary for Health Boards, Trusts and Hospices to restrict visiting beyond that stated in the Guidance within national lockdowns, rising levels of COVID-19 transmission in their communities and/or where there is evidence of nosocomial transmission within a particular setting.   

This decision would need to be made by the Health Board, Trust or Hospice’s Executive Team with their own infection prevention and control teams in collaboration with Public Health Wales, based on a risk assessment process to assess whether the rate of infection within the local community or within a particular setting is high enough to justify the further visiting restrictions being contemplated. Any decision to depart from the Guidance must be kept under regular review.   

When further restrictions are being contemplated, the balance between the need to protect public health and the impact on patients and their loved ones caused by restricted access will need to be considered along with any reasonable adjustments to support access to health assessment or intervention.  

It is recognised that a Health Board, Trust or Hospice may need to restrict visitors from a neighbouring area where there are rising levels of COVID-19 transmission, even if the area where their premises is located does not have high levels of COVID-19. 

Health Boards and Trusts may consider whether there is a need to restrict the accompanying of patients to scheduled and unscheduled appointments. Again any such decision will need to be made by the Health Board or Trust’s Executive Team with their own infection prevention and control teams in collaboration with Public Health Wales, based on a risk assessment process to assess whether the rate of infection within the local public community or within a particular setting is high enough to justify the restrictions being contemplated.  

Any departure from the Guidance will need to be communicated clearly to patients and visitors prior to scheduled appointments.   

Health Boards, Trusts and Hospices will be responsible for updating their local visiting guidance to set out any departures from the Guidance that impose further restrictions on inpatient visiting and any further restrictions on accompanying patients and for responding to queries from patients and the public.  

Easing of visiting restrictions

The visiting restrictions in the Guidance may be eased beyond those stated, where  Health Boards, Trusts or Hospices consider that the community transmission rate in the local area where premises are located, is at a level where it is considered that the benefits of allowing increased visitation, outweighs the COVID-19 transmission risk.  

This decision would need to be made by the Health Board, Trust or Hospice’s Executive Team with their own infection prevention and control teams in collaboration with Public Health Wales based on a risk assessment process to assess whether the rate of infection within the local community or within the setting is low enough to justify easing the visiting restrictions.  Any decision to depart from the Guidance must be kept under regular review. 

Health Boards and Trusts should also consider whether there is a need to ease restrictions on accompanying patients to scheduled and unscheduled appointments. This will need to be communicated to patients and visitors prior to scheduled appointments.  

Health Boards and Trusts will be responsible for updating their local visiting guidance to set out the easing of restrictions and responding to queries from patients and the public. 

Informing the public

Local communication strategies should be developed by Health Boards, Trusts and Hospices to ensure they inform the public prior to the introduction of further restrictions or an easing of restrictions, for visiting or accompanying patients to scheduled or unscheduled appointments in healthcare settings.  

Information on accompanying patients to scheduled appointments should be clearly set out in appointment letters or if there is insufficient time prior to an appointment, it may be necessary to telephone the patient or, where a patient lacks capacity or has specific communication needs, a nominated relative, carer, interpreter or friend. 

Information on further restrictions or the easing of restrictions for visiting should be widely publicised without delay on Health Board, Trusts and Hospice websites and social media prior to implementation. Information on restrictions should be clearly displayed/available to inform patients and visitors.  

Informing the Welsh Government

Health Boards and Trusts should inform the Office of the Chief Nursing Officer immediately prior to the introduction of further restrictions or an easing of restrictions for visiting or accompanying patients to scheduled or unscheduled appointments in healthcare settings. Please email OCNOMailbox@gov.wales 

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