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Found 21 results
  1. Content Article
    Maintaining meaningful contact with family and friends is essential for the health and wellbeing of people in care settings. Following the COVID-19 pandemic, the Department of Health and Social Care (DHSC) introduced Regulation 9A, a new Care Quality Commission (CQC) fundamental standard on visiting and accompanying in care homes, hospitals, and hospices. This regulation came into force in April 2024 and aims to ensure that: people in care homes, hospitals or hospices can receive visits from people they want to see care home residents are not discouraged from taking visits out of the home people attending outpatient appointment can be accompanied by a family member, friend or supporter if they would like to be. The Department of Health and Social Care (DHSC) has conducted a post-implementation review to assess the effectiveness of the regulation, gathering evidence from individuals, professionals, organisations and advocacy groups. The call for evidence provided vital information which has informed the overall review outcome. The review found strong consensus that visiting and accompanying are vital for wellbeing, trust and recovery, and that restrictions can cause distress and harm. While Regulation 9A has helped to clarify expectations, reinforce good practice and provided legislative protection for visiting and accompanying, the review found mixed views on its effectiveness in practice. DHSC has identified 6 important areas for development: data awareness and understanding decision making processes communication of restrictions by providers distinction between ‘visitor’ and ‘care supporter’ monitoring and enforcement. The outcome report sets out the findings of the review and the work DHSC will take forward to address these gaps. This work aims to ensure Regulation 9A is more effective and support a change in culture and practice to embed Regulation 9A in health and care settings. This is vital to ensuring that the rights of people in health and care settings to see their loved ones are upheld consistently and transparently, supporting person-centred care and meaningful connections.
  2. News Article
    The government is facing criticism over its guidance on safe visits to care homes in England. Labour and a number of charities have described the suggestions, including floor-to-ceiling screens, designated visitor pods and window visits, as impractical. Alzheimer's Society has said it "completely misses the point". Justice Secretary Robert Buckland told BBC Radio 4's Today programme the guidance was "non-exhaustive". The updated government advice, which came into effect on Thursday, says care homes - especially those which have not allowed visits since March - "will be encouraged and supported to provide safe visiting opportunities". Labour's shadow care minister Liz Kendall said many care homes would not be able to comply with the government's requirements which meant "in reality thousands of families are likely to be banned from visiting their loved ones". She said instead of suggesting measures such as screens, the government should "designate a single family member as a key worker - making them a priority for weekly testing and proper PPE". Kate Lee, chief executive at Alzheimer's Society, said: "We're devastated by today's new care home visitor guidance - it completely misses the point: this attempt to protect people will kill them." She said the pandemic had left people with dementia isolated and thousands had died. The guidelines "completely ignore the vital role of family carers in providing the care for their loved ones with dementia that no one else can", she added. She said the "prison-style screens" proposed by the government with people speaking through phones were "frankly ridiculous when you consider someone with advanced dementia can often be bed-bound and struggling to speak". That view was echoed by Caroline Abrahams, charity director at Age UK, who said she was "acutely aware" that the methods being sanctioned were "unlikely to be useable by many older people with dementia, or indeed sensory loss". Read full story Source: BBC News, 5 November 2020
  3. News Article
    A senior judge has said friends and family can legally visit their loved ones in care homes, in an apparent challenge to recent government policy that has in effect banned routine visits in areas of high COVID-19 infection. Mr Justice Hayden, vice-president of the court of protection which makes decisions for people who lack mental capacity, said courts are concerned about the impact on elderly people of lockdowns. He has circulated a memo that sets out his analysis that regulations do “permit contact with relatives” and friends and visits are “lawful”. He was responding to guidance from the Department of Health and Social Care (DHSC) last month telling thousands of care homes in England that visiting should be stopped in areas with tier 2 and tier 3 lock down restrictions, apart from in exceptional circumstances such as the end of life. It triggered blanket prohibitions by some councils and sparked anguish from relatives who warn a lack of contact is leading to misery and early death in some cases. Within a week, Gloucestershire county council told care homes in its area to stop visits until next spring. With the England-wide lockdown starting on Thursday, care home providers, families and groups including Age UK and Alzheimer’s Society, have called on ministers to this time make clearer provisions for visiting. Hayden said exceptions in the existing regulations mean contact with residents staying in care homes is lawful for close family members and friends. He said the court of protection was concerned about “the impact the present arrangements may have on elderly people living in care homes,” citing their suffering. Read full story Source: The Guardian, 2 November 2020
  4. News Article
    A GP commissioning leader has publicly criticised hospital visiting rules at local hospitals, after hearing that a stroke patient was denied seeing family or friends for six weeks. Philip Stevens, a locality chair at Northamptonshire Clinical Commissioning Group (CCG), described the situation reported to him by one of his patients as “heartbreaking”, and has challenged visiting policies at Northampton General Hospital and Kettering General Hospital trusts. During a CCG governing body meeting, Dr Stevens called for explanation from the county’s director of public health, Lucy Wightman, who said trusts could choose their own rules. Dr Stevens, who is also a GP at Brackley Medical Centre, argued that visitors were permitted in neighbouring counties, where he claimed there were similar covid case rates to Northamptonshire, which remains in tier 1 restrictions under the government’s framework. He said: “I’ve been dealing this week with a family who, the wife’s husband, has been in Northampton General for six weeks now and has had no visitors at all during that time. He’s had a profound stroke and when he comes home he’ll need considerable community support which ordinarily the family would have been trained in but discharge is planned without any of that training.” Mr Stevens said in an “adjacent county” hospital policy was that each patient would have ”one hour, one visitor each day” with 30-minutes in between visiting slots. While not named, trusts in neighbouring Cambridge and Lincolnshire both have policies that permit pre-booked visitors. He added: “When I heard this story it seemed heartbreaking to me for this woman and her husband and I just wonder whether that this is a situation we should be challenging, particularly since it appears that the public health advice in an adjacent county may be different to that which is being offered within Northamptonshire.” Read full story (paywalled) Source: HSJ, 27 October 2020
  5. News Article
    A group of experts in nursing and infection prevention and control (IPC) is today warning against the use of IPC measures as a “rationale” for stopping safe and compassionate visits in care homes during the Covid-19 pandemic. In a new open letter published in Nursing Times, the specialists say that preventing people from visiting loved ones in social care settings in the name of IPC is a “misinterpretation and at times even abuse” of IPC principles. The letter is the brainchild of independent global health consultant and former Infection Prevention Society (IPS) president, Jules Storr. Among the signatories are five former IPC presidents, current president Pat Cattini as well as incoming president Jennie Wilson. Dr Ron Daniels, chief executive of the UK Sepsis Trust, is also on the list, Helen Hughes, chief executive of Patient Safety Learning, as well as leading IPC nurse specialists, nurse academics, a GP and carers. Ms Storr, a nurse by background, and the hub topic lead, said she was motivated to take action after hearing “the most heart-breaking” stories from health professionals and relatives of residents about restricted visits in the UK in the wake of COVID-19. Some had not seen relatives for weeks or months, whilst others were only allowed to see their loved one once a week for 20 minutes at a distance, she said. One individual had told her how when their father had died only one family member was permitted in the home and they were not allowed to sit close enough to hold his hand. Ms Storr said these practices were “absolutely outrageous and wrong from an infection prevention point of view”. Read full story Source: Nursing Times, 16 October 2020
  6. News Article
    Sweeping bans on visiting at thousands of care homes risk residents dying prematurely this winter as they give up hope in the absence of loved ones, experts in elderly care have warned. More than 2,700 care homes in England are either already shut or will be told to do so imminently by local public health officials, according to a Guardian analysis of new government rules announced to protect the most vulnerable from COVID-19. Care groups are calling for the government to make limited visiting possible, including by designating selected family members as key workers. Since Friday any care homes in local authority areas named by Public Health England for wider anti-Covid interventions must immediately move to stop visiting, except in exceptional circumstances such as end of life. It also halts visits to windows and gardens and follows seven months of restrictions in many care homes that closed their doors to routine visits in March. The blanket bans will result in the “raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case”, warned the charity Age UK and the National Care Forum (NCF), which represents charitable care providers. Read full story Source: The Guardian, 23 September 2020
  7. News Article
    To help stop the spread of the coronavirus that causes COVID-19, the majority of hospitals have stopped or severely restricted visits. This article explains how you can still help a loved one even when you can't see them face to face. During the coronavirus crisis, most hospitals and care homes in the UK have stopped visits. If you have a loved one in a healthcare setting, not being able to go to see them will be incredibly difficult. But these temporary measures have not been taken lightly. Restricting visits to hospitals and care homes is important to reduce the spread of the virus that causes COVID-19 as much as possible. This way hospital and care home residents, and healthcare staff, can be better protected during the pandemic. Read the full article here
  8. Content Article
    This episode of HSJ’s Health Check podcast considers concerns raised in Coroners Prevention of Future Deaths reports about the impact of pandemic hospital visiting restrictions on patient care and patient safety. In this podcast the presenters discuss how vulnerable patients have been adversely affected by hospital visiting restrictions put in place during the Covid-19 pandemic. They consider how trusts are still having to balance patient visiting with reducing the spread of Covid. One of the cases they refer to in this discussion is that of Azra Hussain, who died by suicide while a patient at Mary Seacole House, operated and staffed by Birmingham and Solihull Mental Health Foundation Trust. In the Prevention of Future Deaths report, the Coroner raised patient safety concerns relating to her family being unable to participate in a multidisciplinary team meeting prior to her death due to Covid-19 visiting restrictions.
  9. Content Article
    The findings of this study, published in the Patient Experience Journal, indicate that the policy to allow for visitors, or subjective advocates, individuals with a vested interest in the well-being of the patient, is beneficial not only for the patient, but also in sustaining high quality of care. Recommendations are given for how hospitals might achieve improved quality and safety outcomes even in instances when organisations believe visitation needs to be disallowed or restricted. The results of this study suggest those decisions should be made with great care and in only the most extreme circumstances.
  10. Content Article
    In a new series for the hub, Martin will be interviewing healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Learning from frontline staff is crucial, now more than ever. Prior to a predicted second wave hitting us, the government and leaders must listen to what has gone well but, most importantly, not so well for both staff and patients. Martin is a passionate nurse working on a covid unit and wants to promote learning to ensure patient and staff safety. This initially started as a way of connecting and not feeling alone but what Martin has found is that there are many voices that need and want to be heard but just don’t know how to speak up and out. In all of the interviews the healthcare professionals wanted to remain anonymous which is indicative of their fear of reprisals from their organisation. In this first interview, Martin interviews a new student district nurse who has been working within the community in the South West. Their role involves supporting care homes with end of life care and assisting in keeping people with long term conditions at home. 
  11. Content Article
    The COVID-19 pandemic is challenging health care systems worldwide; none more so than critical and intensive care settings. Significant attention has been placed on the capacity of intensive care units (ICUs) to respond to a COVID-19 surge, particularly in relation to beds, ventilators, staffing and personal protective equipment. This position statement has been produced by the Australian College of Critical Care Nurses and the Australian College of Infection Prevention and Control (ACIPC) to guide critical care nurses in facilitating next-of-kin presence for patients dying from COVID-19 in the ICU.
  12. Content Article
    An open letter has been published in the Nursing Times from infection prevention and control experts, together with interested and concerned individuals and organisations, about the restrictions enforced in nursing, care and residential homes. Restrictions are being imposed in relation to COVID-19 across too many nursing, care and residential homes in the UK and beyond, in the name of infection prevention and control. A number of experts in this field, led by Jules Storr, independent global health consultant and former Infection Prevention Society (IPS) president, summarise in an open letter why infection prevention and control should be an enabler not a barrier to safe, compassionate human interaction in nursing, care and residential homes. By adding their voice their intention is to accelerate action to end this uncompassionate treatment of people in homes as well as for their families and other loved ones. Presented in the letter are six actions targeted at nursing, care and residential home managers, governments/local authorities, the infection prevention and control community, health care leaders, families and campaigning groups, to help everyone move forward with revised decisions. Nursing, care and residential homes: Allow normal family interactions by stopping restrictions and instead continue to inform and support families on the steps to take for safe contact in a spirit of trust and cooperation. Be confident that restricting visits should not be used as a replacement or shortcut for inadequate infection prevention and control measures – address gaps in safe practices where they exist. Commit to using infection prevention and control as an enabler that will protect staff, residents and families. Government, local authorities/public health departments: Remove any statements that may be seen to justify “blanket bans” on visiting. Instead actively vocalize the need for local decision makers to facilitate safe, normal interaction, appropriate to the local situation. Even where an outbreak occurs and some restrictions may be warranted, make it clear that safe, compassionate exemptions must still prevail and be actively facilitated. Continue to address gaps in safe practices and lack of resources, in order to facilitate infection prevention and control. Infection prevention and control community: Speak up in support of safe family interactions now and apply infection prevention and control with compassion. Actively facilitate safe family interactions and support planning to ensure adequate infection prevention and control supplies, and the implementation of training and communication activities/materials. Healthcare leaders: Speak up and support infection prevention and control with compassion, respect infection prevention and control expertise but help apply it in support of the ethos of this letter. Families: Understand, respect and adhere to the infection prevention and control recommendations requested of you to support the safety of yourself, your loved ones and care home staff. Campaigning groups: Use this letter to support your efforts.
  13. Content Article
    Danielle, Critical Care Outreach Nurse at Southend University Hospital, share's her 'We're Listening' leaflet as part of the trust's Call for Concern service. This leaflet will be displayed in all hospital areas. This service has been developed so that patients, friends and family can alert the Critical Care Outreach team if they have concerns that need listening to and gives a telephone number to call and outlines the next steps. You may also be interested in: Call 4 Concern leaflet - Royal Berkshire NHS Foundation Trust
  14. Content Article
    When someone you love is hospitalised, it can be scary-even terrifying-for the patient and for family and friends. A hospital may seem like a foreign land. Sounds, smells, and the culture are unfamiliar; even the medical terminology sounds like a different language. Understanding the hospital environment and knowing how to navigate its complicated pathways can make you a strong champion for your loved one. You are as critical to your loved one's recovery as the doctors and nurses. Your role is different, but vital. In some cases, you can make the difference between life and death. Hospital Warrior de-mystifies the process and provides the tools, understanding and insight you need to get the best care for your loved one. Based on the author, Bonnie Friedman's own experiences, Hospital Warrior lays out in direct, simple terms hard-learned and time-tested tactics to help ensure a loved one's medical needs are met. Hospital Warrior also includes checklists and interviews with doctors and other healthcare professionals who provide essential tips and advice for the reader. Bonnie Friedman is passionate about hospital healthcare. Her expertise is hard-won, based on more than 24 years of advocating for her husband through 14 separate hospitalisations – some fairly routine, some quite dramatic and some truly life-and-death experiences.
  15. Content Article
    Age UK explain what Telecare is and how it could help you live independently and stay in control of your health and wellbeing.  What will I learn? What is telehealth? How could telehealth help me? What is telecare? How could telecare help me? How to get telecare products and services What do I need to consider when buying telecare products? What should I do next?
  16. Content Article
    Call for Concern is an initiative from the Royal Berkshire NHS Foundation Trust enabling patients and their families to directly refer patients to the critical care outreach team. Mandy Odell, Nurse Consultant, Critical Care, Royal Berkshire NHS Foundation Trust, Reading, has implemented this initiative in her hospital and beyond. Five years following the introduction of a whole-hospital, 24-hour critical care outreach (CCO) service, an additional service was introduced that enabled patients and their families to directly call the CCO team if they had concerns that were not being acknowledged by the patient’s clinical team. The aim of this review, published in the Journal of Nursing, was to report on 7 years of patient and family referrals using quantitative and free text data extracted from the CCO referral database.
  17. Content Article
    The Covid-19 pandemic resulted in more falls with harms (FWH) in hospitalised patients; it has also resulted in an increased number of patients staying in isolation and receiving fewer visitors. This study aimed to look at the relationship between patient falls and visiting restrictions. The results suggest a moderately strong association between hospitalised patient FWH risk and severe visitor restrictions. This association was reduced in phases where even minor allowances for visitation were made by health services. 
  18. Content Article
    “Don't go to the hospital alone” has been the advice that safety experts have promoted for many years as a way that patients can help protect themselves. Family members provide an important safety net for patients in the hospital, and across the entire continuum of care—another slice of the Swiss cheese in our defenses against errors. As safety professionals, we hate to have to rely on that safety net, knowing that not all patients and families are able to provide it. Yet, given what we know about the frequency of medical errors, we still recommend it because families provide an additional cross-check of our care. But the COVID-19 pandemic has stripped away the layer of protection provided by families. At the start of the pandemic, visitation was heavily curtailed or stopped entirely due to the risks of spreading the virus. These decisions were not made lightly—concerns about protecting patients and the workforce drove them. Risks of visitation have included risks of infection to visitors and staff, particularly when not enough personal protective equipment (PPE) was available, and added strain on nurses to manage the presence of visitors and visitors’ compliance with PPE protocols. These infection concerns have not borne out, especially after adequate PPE supplies became available.1.,2. Those decisions at the start of the pandemic were necessary, given the uncertainties and the PPE shortages. However, now is the time to learn from that experience and reassess the risks and benefits of limited visitation. Further reading It’s time to rename the ‘visitor’: reflections from a relative Visiting restrictions and the impact on patients and their families: a relative's perspective Q&A: Dr. Tejal Gandhi on refocusing COVID visitation policies through a safety lens
  19. Content Article
    Call 4 Concern is a patient safety initiative enabling patients and families to call for immediate help and advice when they feel concerned that they are not receiving adequate clinical attention. Here is the University Hospitals Dorset Trust's leaflet.
  20. Content Article
    The Meaningful Connection, Visiting and Anne’s Law Project was set up by the Care Inspectorate with funding from Scottish Government to support and promote the importance of all types of meaningful connection for people who live in adult and older people’s care homes, and to help prepare the sector for the implementation of Anne’s Law. The project is based on the core principle that experiencing connection which is valued, meaningful and person-centred, is essential to everyone’s health, wellbeing and personhood, and fundamental to human rights.
  21. Content Article
    Anne’s Law is a piece of planned Scottish legislation which is intended to strengthen the rights of people living in adult and older people’s care homes to see and spend time with the people who are important to them, even in the event of an outbreak of infectious disease. It recognises that meaningful contact is a fundamental right and is essential to supporting health and wellbeing.

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