Visiting in Care Homes, Hospitals and Hospices Consultation
(Limited Text - Ministerial Extracts only)
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The Minister for Social Care (Helen Whately)
In collaboration with my hon. Friend the Minister of State for Health and Secondary Care (Will Quince), and my hon. Friend the Minister for Mental Health and Women’s Health Strategy (Maria Caulfield), I am making this statement for the benefit of all members of Parliament to bring their attention to the Government consultation on visiting in care homes, hospitals and hospices.
Ensuring that care home residents and hospital and hospice patients maintain contact with loved ones is vital to the health and wellbeing of people receiving care or treatment. Friends and family also provide invaluable practical support and advocacy for those receiving treatment. However, the Government have heard from Members across both Houses, members of the public and campaigners of continued instances of loved ones being denied contact following the lifting of restrictions introduced during the covid-19 pandemic.
Restrictions were implemented during the pandemic to help prevent the spread of covid-19 in health and care settings. While those restrictions were in place at the time to keep people safe and control the risk of transmission from a virus that was not yet well understood, we recognise how detrimental it was for loved ones to have been kept apart and to not have had friends and family advocating on behalf of patients and care home residents. We constantly sought to enable safe visiting wherever possible and made it clear that end-of-life visiting should always be possible. Our guidance is now clear that visiting should be encouraged and facilitated in line with efforts to return to normal.
The Government recognise the efforts that so many health and care settings have made to implement guidance and facilitate visits. NHS England has guidance in place which sets a minimum expectation for visiting in inpatient, outpatient, diagnostic service settings and the emergency department, that hospitals should facilitate a minimum of two visitors to visit patients for at least one hour per day, ideally for longer. Compliance with this guidance is now a requirement in their standard contract for all providers of NHS services.
However, we know that some restrictions continued beyond the lockdown periods and continue to hear of instances where loved ones are unable to see each other for prolonged periods or provide support when someone is attending hospital. We understand the harm this can cause to the health and well-being of those receiving care as well as how distressing this is for their friends and families visiting and, in many cases, providing vital care to loved ones.
The Government are therefore announcing a consultation today that sets out our proposals for going further to tackle this issue. The consultation document outlines the current position, including current Government guidance and data on visiting in health and care settings, as well as further details on current regulations, the Government proposals, the questions for respondents, how to respond and next steps.
Current regulations
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (CQC Regulations) set out fundamental standards which must be upheld by all Care Quality Commission (CQC) registered providers. CQC assesses health and care providers against the fundamental standards and other requirements set out in CQC Regulations. Providers are required to comply with certain fundamental standards of care which implicitly cover visiting.
Although visiting is not explicitly mentioned in the current CQC regulations, it is considered best practice that visiting is not normally restricted, and that any restrictions should be reasonable, proportionate and time limited. CQC has enforcement powers to protect people who use regulated services from harm, the risk of harm, and to protect people’s rights and welfare.
In addition to the fundamental standards, other legislation may allow individuals to take legal action against their providers, set out in further detail in the consultation document.
Policy intention and proposal
DHSC wants to ensure that visiting is protected and that it remains a priority. We are therefore considering putting visiting on a statutory footing. It is important that any visiting requirement is workable, reasonable and proportionate. We therefore propose to do this by introducing secondary legislation to amend CQC Regulations to include a specific visiting requirement. This could be done either by introducing a new regulation specifically for visiting, or by amending an existing regulation to include visiting, such as “person centred care” or “dignity and respect”.
We want the legislation to have as far reach as possible and our proposal is therefore for the new visiting requirement to cover CQC-registered health and care settings. This would include NHS and independent providers—both acute and mental health—care homes and hospices.
This consultation relates to visits from family, friends and volunteers such as befrienders and includes accompanying patients attending outpatient or diagnostic appointments and emergency departments at hospitals. It is not about access to visiting professionals, and any change made regarding visiting would not override pre-existing statutory arrangements regarding visiting professionals, such as the entitlement for people detained under the Mental Health Act 1983 to meet independent mental health advocates (IMHAs) in private if they wish to.
Through this consultation we will hear directly from those most likely to be affected by this policy proposal and will gather the evidence required to determine what action should be taken on visiting in health and care settings.
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