The Government has launched an open consultation on a proposal to give patients in care homes, hospitals, hospices, mental health units, and other health and care settings the legal right to receive visitors.
The Department of Health and Social Care (DHSC) said it wanted to ensure that visiting, including accompanying patients to hospital appointments, was protected as "a priority for health and care providers, so that patients and residents can receive visitors whenever it is reasonable and safe".
Although current guidance from the Government and NHS England stipulates that all health and care settings should be allowing visits, there have been reported cases where visiting access was "unfairly denied".
A literature review in June 2021 revealed that visiting restrictions across a variety of healthcare settings during the COVID response had multiple negative consequences for patients' health, including reduced nutrition, increased symptoms, more pain, and mental health consequences such as loneliness, depression, agitation, aggression, reduced cognitive ability, and overall dissatisfaction.
The health and wellbeing of family members also suffered, with greater worry, anxiety and uncertainty. Neonatal intensive care unit parents reported less bonding with their child and disturbed family relationships. For care providers, visiting restrictions added to the burdens of ethical dilemmas, demands for communication with families, and providing social support to patients and relatives.
Extreme Distress for Family Members
One study in 37 UK hospitals reported that family members unable to visit loved ones in ICU experienced "severe distress", with 1 in 5 suffering resulting severe-to-extremely severe anxiety or depression.
The DHSC said that after COVID restrictions were eased, many health and care settings made efforts to return to pre-pandemic visiting. "There are however still instances where families and friends continue to face issues with visiting across the health and care sector."
In March this year , a group of relatives locked out of UK care homes while their loved ones died in isolation called for the legal change to introduce guaranteed visitor access. They also expressed anger that nearly 3 years after the first lockdown, some care homes were still restricting visits. Diane Mayhew, co-founder of the campaign group Rights for Residents, told the Guardian newspaper: "Too many are still stopping families from seeing their loved one, even in end-of-life situations. It is causing extreme distress and it has to stop."
The consultation would inform the proposed development of secondary legislation to make visiting rules mandatory "for the good of service users", DHSC said. It would amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to add visiting as "a fundamental standard" against which Care Quality Commission (CQC) inspect care and health settings.
CQC to be Given New Powers of Enforcement
It would give patients in hospitals and residents of care homes a right to have visitors "in all circumstances" and provide the CQC with "a clearer basis to take enforcement action against providers who are unduly restricting visiting". The care regulator would have new powers to make sure providers were allowing families to visit loved ones.
"The Government recognises the contribution that visiting makes to the wellbeing and care of patients attending hospitals, and residents of care homes, as well as the emotional wellbeing of their families," it said in a statement. "For health settings, regulations will be reviewed in both inpatient and outpatient settings, emergency departments and diagnostic services in hospitals, to allow patients to be accompanied by someone to appointments."
Minister of Health, Will Quince, asked patients to share any experiences of unjust visiting bans. He said: "Most hospitals and care homes facilitate visiting in line with guidance, but we still hear about settings that aren’t letting friends and families visit loved ones who are receiving treatment or care.
"We want everyone to have peace of mind that they won’t face unfair restrictions like this, so we want to make it easier for the CQC to identify when disproportionate restrictions and bans are put in place and strengthen the rules around visiting."
Minister for Care, Helen Whately said she was "determined to make sure we change the law on visiting".
'Heartbreaking Instances' Still Being Reported
"Many care homes and hospitals have made huge progress on visiting and recognising carers since the pandemic. But I don’t want anyone to have to worry about visiting any more, or to face unnecessary restrictions or even bans."
In her foreword to the consultation, she said: "We continue to hear of heartbreaking instances where care home residents and hospital patients were unable to see their family and friends for prolonged periods of time or be accompanied when they attend hospital.
"We understand the harm this can cause to the health and wellbeing of those receiving care as well as how distressing this is for their friends and families visiting."
Asked to comment on the proposal, Caroline Abrahams, charity director at Age UK, told Medscape News UK: "One of the greatest tragedies of the pandemic was the fact that so many older people living in care homes were cut off from their loved ones for such long periods of time, so we are delighted that the new regulations proposed will make visiting a legal requirement for hospitals and care homes.
"There is nothing more important for the mental health of older people who live in a care home, and that of their families and friends too, than being able to have regular contact with their loved ones."
The consultation closes at 11:59 pm on 16 August 2023.
