Standard Operating Procedure for in-patient visiting at Buckinghamshire Healthcare NHS

Trust

1.0 Introduction

This SOP sets out the procedure and process for the restricted inpatient visiting. This guidance

will be reviewed in line with changes to national policy and advice from PHE and the Health and

Safety Executive. This SOP does not cover other people attending our sites for outpatient

appointments, external visitors not visiting patients, contractors or staff.

Definitions

Visitors – will include relatives and friends of patients including parents and guardians.

2.0 Good Practice Principles

The enhanced infection prevention control (IPC) guidance has been implemented to provide

additional assurance to staff and the public that the Trust is actively doing everything it can to

reduce the risk of transmission of COVID19. These measures are additional to the guidance

already in place which includes:

Standard Operating Procedure

Reducing Visiting Restrictions

Target Audience: Staff

Document Reference: Patient Experience/Visiting BHT inpatients

Version: 1.0

Prepared By:

Helen Byrne – Director of Bed Management & Patient Flow

Lesly Clifford – Associate Director of Communication and Engagement

Approval Date: 03/08/2020

Approvals: Silver

Gold

Responsible Officer Karen Bonner – Chief Nurse

Effective good quality hand hygiene measures, including the frequent decontamination

of hands for at least 20 seconds at the correct moments

To maintain wherever possible social distancing measures of 2m.

Self-isolation for those who develop symptoms related to COVID19 and the NHS test

and trace process

The ward staff will be responsible to ensure the ward space is appropriately cleaned

following visiting.

3.0 Revised visiting policy

The Trust visiting policy should be followed and this is summarised as:

Adult wards – The Trust will be following the Rule of One. This means one visitor for one hour,

once a day per patient, from Monday to Friday. The named visitor is not interchangeable, except

with the prior agreement of the ward manager. It’s important that a log of approved named

visitors, including their contact details and their times of visiting, is kept locally in each

department for the purposes of track and trace

The standardised appointment slots for wards will be

13:00 – 14:00

14:15 – 15:15

15:30 – 16:30

16:45 – 17:45

The aim is for a maximum of 25% of patients can have visitors at each of the above times, to

ensure adequate distancing is possible. E.g. if the ward has 20 beds, there will be a maximum

of 5 visitors at any one time

A member of the ward staff will contact the designated visitors to book visits. If practical aim to

book the full week’s visits in one session to control time spent on this task

When booking visits for the first time, the ward staff making the call needs to make sure the

visitor is aware of what will happen when they arrive and what will be expected of them. You will

be provided with a short information leaflet which you can send the visitor in advance or you can

point them to the Trust website for all the relevant details.

With the exception of Maternity, visitors should be asked to come into the hospital through the

following entrances:

SMH – Main entrance by the Rotunda

Wycombe – Main entrance

Amersham – Entrance D

Buckingham – Main entrance

If patients are moved and have a visit booked, the staff of the ward who booked the visit should contact the designated visitor and patient explaining that the receiving ward may not be able to accommodate the exact visit time, but will make every effort to accommodate. If none of the available slots are possible for a designated visitor or if there are no slots available they should be advised of the opportunity to have a ‘virtual’ visit via video call For current in-patients the ward manager is responsible to ascertain the name of the designated visitor, and document on admission to the ward who the designated visitor will be and confirm the designated visitor is happy with this, for all new patients.

3.1 Exceptions

End of life care patients at the end of life are able to have increased number of visitors in the last

hours of life. Staff locally will manage the safe facilitation of visitors.

Supporting a person with a learning disability, or autism, or dementia where not being present

would cause the patient to be distressed

Children and Young People –

Inpatient wards where admissions are less than seven days will continue to permit one

parent / carer per family to be resident with their child.

Inpatient wards where the admission is longer than 7 days are permitted 1 parent or carer

per family at any one time although they may have a named 2nd parent or carer who may

swap out with them every 7 days, maintaining the same parent or career for a 7 day period

Neonatal Unit- one parent to visit at any time.

No siblings to be allowed in the hospital.

Maternity – 1 birth partner is permitted throughout the antenatal, intrapartum and postnatal

period. Additional support through the use of independent midwives and doulas will be permitted

with prior approval of the head of midwifery or the labour ward coordinator out of hours. (Appdix 1)

NSIC (Appendix 2)

Closed wards to visitors – to reduce the risk of Infection, immunocompromised patients; visiting will

not be permitted on the following wards, however virtual visiting should be arranged;

Ward 16a & 16b

Ward 6

Shellborne

Treatment centre Wycombe Hospital

In addition, it may be necessary to suspend visiting on other wards if there is an increased risk of

infection.

3.2 Visitor process At the designated entrance

All visitors will be required to sanitise their hands and be given a fluid resistant face mask to wear. Visitors will not be allowed on to ward without wearing a face mask.

They should be reminded to regularly clean their hands during their visit and be advised

to make their way to the relevant ward where a temperature screen will be carried out.

At the ward entrance

All visitors will be required to complete a health declaration questionnaire where they will

be required to declare any COVID19 related symptoms (See Appendix 4). They will be

asked to confirm that they are not currently self-isolating or shielding and that you have

not been in contact with someone in the past 14 days who is suspected of having or is

confirmed as having COVID 19.

All visitors will be required to have their temperature taken prior to entering an inpatient

ward.

Ward staff to ensure visitors are given fire evacuation instructions.

Ward staff to ensure visitors are advised as to which public toilets to use by the ward

staff and advised which public toilets to use during their visit and reminded that they

need to wear their mask at all times.

Where visitors refuse to comply with IPC guidance, The trust will have no option but to

ask them to leave the site. Security staff should be involved with this and should manage

the situation in a sensitive but firm way.

3.3. Expectations of visitors on the ward

Visitors are to wear a face mask at all times during the visiting period. They may be

asked to wear additional protective garments by staff where needed.

Visitors are to remain on the ward during the visiting period unless they need to use the

toilet facilities.

Visitors must use toilet facilities that are provided for members of the public only and

must keep their mask on.

Visitors are to refrain from sitting on the beds and must not visit other patients

Visitors are to adhere to hand hygiene recommendations and sanitise their hands on

entering and exiting the ward Visitors must maintain the recommended social distancing

requirements and refrain from having any physical contact with patients.

Visitors must not bring in food parcels, flowers, helium balloons or similar items.

Visitors should be encouraged sanitise their hands on exit from the clinical area and

dispose of their face mask at the main doors

Appendix 3 provides a flow chart decision process for the screening requirements.

Appendix 4 provides the health screening questionnaire for patients and visitors.

4.00 Future requirements

This SOP will be reviewed regularly in line with government advice including advice from NHSE,

PHE and the Health and Safety Executive.

Appendix 1

Background:

On 5th June NHS England/Improvement updated the guidance on visiting healthcare impatient settings during the COVID 19 pandemic. This guidance superseded and replaces the NHS Visitor guidance published 8th April 2020. Visiting shall instead be subject to local discretion by Trusts and other NHS bodies. The Royal College of Midwives (RCM) published a briefing on re-introduction of visitors to Maternity Units across the UK during the COVID 19 pandemic on 15th July 2020 which states: as progress is made on lifting and revising the high level of initial restrictions applied across the UK by Governments and within Healthcare, it is vital that each maternity service applies a safe and appropriate revision of their restrictions and process. Purpose:

To ensure there is a robust process to book, track and trace visitors to Rothschild ward during COVID 19

To support the well-being of the woman and her family during COVID 19

To maintain social distancing between patients Booking process: Visiting will only be permitted between the hours of 1445-1545 and 1615-1715

Visitors for odd number beds can visit between the hour 1445 and 1545

Visitors for even number beds can visit between the hour 1615 and 1715 Patients are not to move bed spaces

1 named Birth Partner (the same birth partner who was present during labour and birth if postnatal)

Inpatients can book their named visitor in between 0900 and 1000 every day

Patients are required to provide the name of their birth partner so that a log can be maintained

Visitors are met by a member of staff at the antenatal entrance to Rothschild ward who will log the name of the visitor and ensure that the following recommendations are understood and followed:

Visitors are to confirm that they are not currently self-isolating or shielding and that you have not been in contact with someone in the past 14 days who is suspected of having or is confirmed as having COVID 19.

TITLE Standard Operating Procedure for visiting in Maternity during COVID 19

Mat Reference:

MAT

Version: 1

Prepared by Kerie Eastgate Maternity Matron

Effective Date 5th August 2020

Review Date 5th August 2023 or sooner if local or national guidance changes

Approvals Heidi Beddall Head of Midwifery

Aparna Reddy SDU lead

Visitors are to wear a face mask at all times during the visiting period. They may be

asked to wear additional protective garments by staff where needed.

There will be no repeat entering and exiting of the ward

Visitors are to refrain from sitting on the beds with partners and must not visit other patients

Visitors are to adhere to hand hygiene recommendations and wash their hands on entering the ward are; before and after helping care for mother and baby and rub with alcohol based gel when they leave the ward.

Visitors must use toilet facilities that are provided for members of the public only

Visitors must maintain the recommended social distancing requirements

Visitors must not bring in food parcels, flowers, helium balloons or similar items

Safety

The information for visiting form (see Appendix 1) will need to be signed and contact details provided so that staff can account for who is present on the ward in case of fire and the need to evacuate. These details may be used by Public Health England as part of the “Track and Trace” strategy, should there be a necessity following a visit

On arrival visitors are to be given fire evacuation instructions by the ward staff.

Babies are not to be taken out of the ward at any time. Babies are required to stay with their mother at all times.

Any concerns for the physical safety of mothers and babies or staff on the ward, the security team are to be called at any time.

The ward reserves the right to decline permission for partners or companions to visit the ward at these times or if there are significant concerns that will compromise the safety of mothers, babies and staff.

Buckinghamshire Healthcare NHS Trust operates a zero tolerance policy on violent, disruptive or aggressive behaviour. It is a criminal offence to cause a nuisance or disturbance on NHS premises. .

Exceptions Exceptions will continue to be made for women who:

Are under 18

Have a learning disability, cognitive impairment or autism

Are experiencing a pregnancy loss

Exceptions will be considered individually for women:

With mental health problems

With communication challenges including hearing or visual impairment

For whom English is not their first language

Responsibilities:

All staff have a responsibility to ensure this SOP is adhered to

The Inpatient Matron will have overall responsibility for visiting

References:

RCM Briefing on Re-introduction of visitors to Maternity Units across the UK during the COVID-19 pandemic (15

th July 2020)

NHSE/I Visiting healthcare impatient settings during the COVID 19 pandemic (5th June 2020)

Miss Aparna Reddy

O&G Service Delivery Unit Lead

Heidi Beddall Head of Midwifery

Women & Children’s and Sexual Health Division

Information for visiting on Rothschild Ward

It is important that you read, understand and sign this document if you choose to visit the ward

If you have any symptoms such as a cold, cough, flu, breathlessness, tiredness or

vomiting and diarrhoea, then please do NOT visit.

Please speak to the Midwife in charge or member of staff at the antenatal entrance to Rothschild ward on arrival.

Anyone who is perceived to be under the influence of alcohol or drugs will not be

allowed to visit.

Infection control

Visiting will only be permitted for one hour between the hours of 1445 – 1545 and 1615 -1715. Your allocated visiting time will be explained to you.

Visiting will only be permitted for one named Birth Partner (the same birth partner who was present during labour and birth if possible)

On arrival, you will:

Need to confirm that you are not currently self-isolating or shielding and that you have not been in contact with someone in the past 14 days who is suspected of having or is confirmed as having COVID 19

Need to wear a face mask at all times during the visiting period. You may be asked to wear additional protective garments by staff where needed.

Need to remain on the ward during the visiting period (no repeated entering and exiting the ward)

Please do not sit on your partner’s bed or visit other patients

Adhere to hand hygiene recommendations and wash your hands on entering the ward area; before and after you help care for your partner and baby and rub with alcohol based gel when you leave the ward

Ensure you only use toilet facilities that are provided for members of the public that are located off the ward

Maintain the recommended social distancing requirements

Do not bring in food parcels, flowers, helium balloons or similar items

Safety

You will need to sign this form and provide your contact details so that we know you are present and can account for you in case of fire and the need to evacuate. These details may be used by Public Health England as part of the “Track and Trace” strategy, should there be a necessity following your visit

If the fire alarm sounds please follow instructions given by the ward staff. Do not attempt to leave the ward.

Do not take your baby out of the ward at any time. We need to ensure that babies stay with their mother at all times.

If there are concerns for the physical safety of mothers and babies or staff on the ward, the security team will be called to assist at any time.

We reserve the right to decline permission for partners or companions to visit the ward at these times or if there are significant concerns that will compromise the safety of mothers, babies and staff.

Buckinghamshire Healthcare NHS Trust operates a zero tolerance policy on violent, disruptive or aggressive behaviour. It is a criminal offence to cause a nuisance or disturbance on NHS premises.

.

I have read, understood and agree to adhere with the above conditions. Signed:

Print Name:

Date:

Contact Details:

Bed Number:

Division of Women, Children & Sexual Health Services

Appendix 2

Background:

On 5th June NHS England/Improvement updated the guidance on visiting healthcare impatient settings during the COVID 19 pandemic. This guidance superseded and replaces the NHS Visitor guidance published 8th April 2020. Visiting shall instead be subject to local discretion by Trusts and other NHS bodies. Purpose:

To ensure there is a robust process to book, track and trace visitors to the NSIC during COVID 19

To support the well-being of the patient and family during COVID 19

To maintain social distancing between patients Booking process: Visiting will be allocated between the hours of 09:00 - 12:00 and 14:00 - 17:00

Inpatients can book their named visitor in between 0900 and 1000am every day

Patients are required to provide the name of their designated visitor so that a log can be maintained

Visitors will enter through the main entrance by the Rotunda where they will be asked to sanitise their hands and given a fluid resistant mask to wear for the duration of their visit. They will then make their way to the relevant ward where they will be met by a member of staff at the entrance who will log the name of the visitor and ensure that the following recommendations are understood and followed:

Visitors are to confirm that they are not currently self-isolating or shielding and that you have not been in contact with someone in the past 14 days who is suspected of having or is confirmed as having COVID 19.

Visitors are to wear a face /mask at all times during the visiting period. If Visitors may be asked to wear additional protective garments by staff where needed.

Visitors are to remain in the area designated during the visiting period. For all patients who are able to leave the ward visits will take place in Horatio’s garden (no repeated entering and exiting the area)

Only patients who are unable to leave the ward will receive visitors in the clinical area.

Visitors are to refrain from sitting on the beds with partners and must not visit other patients

TITLE Standard Operating Procedure for visiting NSIC during COVID 19

NSIC Reference:

NSIC

Version: 1

Prepared by Zoey Pullar Matron

Effective Date 5th August 2020

Review Date 5th August 2023 or sooner if local or national guidance changes

Approvals Head of nursing Penny Jackson

Visitors are to adhere to hand hygiene recommendations and sanitise their hands before and after leaving the ward or garden. Visitors must use toilet facilities that are provided for members of the public only

Visitors must maintain the recommended social distancing requirements

Safety

The information for visiting form (see Appendix 1) will need to be signed and contact details provided so that staff can account for who is present on the ward in case of fire and the need to evacuate. These details may be used by Public Health England as part of the “Track and Trace” strategy, should there be a necessity following a visit

On arrival visitors are to be given fire evacuation instructions by the ward staff.

The ward reserves the right to decline permission for partners or companions to visit the ward at these times or if there are significant concerns that will compromise the safety of patients and staff.

Buckinghamshire Healthcare NHS Trust operates a zero tolerance policy on violent, disruptive or aggressive behaviour. It is a criminal offence to cause a nuisance or disturbance on NHS premises. .

Exceptions Exceptions will be considered individually for those:

With mental health problems

With communication challenges including hearing or visual impairment

For whom English is not their first language

Have a learning disability, cognitive impairment or autism St Francis Ward will continue to allow the following:

Inpatient wards where admissions are less than seven days will continue to permit one parent / carer per family to be resident with their child.

Inpatient wards where the admission is longer than 7 days are permitted 1 parent or carer per family at any one time although they may have a named 2nd parent or carer who may swap out with them every 7 days, maintaining the same parent or career for a 7 day period

No siblings to be allowed in the hospital.

References: NHSE/I Visiting healthcare impatient settings during the COVID 19 pandemic (5th June 2020)

Information for visiting NSIC Inpatient wards

It is important that you read, understand and sign this document if you choose to visit the ward

If you have any symptoms such as a cold, cough, flu, breathlessness, tiredness or

vomiting and diarrhoea, then please do NOT visit.

Please speak to the Nurse in charge or member of staff at the entrance to the ward on arrival.

Anyone who is perceived to be under the influence of alcohol or drugs will not be

allowed to visit.

Infection control

Visiting will only be permitted for designated time slots as follows

09:00–12:00 and 14:00–17:00. Your allocated visiting time will be explained to you.

Visiting will only be permitted for one named visitor throughout your stay

On arrival, you will:

Need to confirm that you are not currently self-isolating or shielding and that you have not been in contact with someone in the past 14 days who is suspected of having or is confirmed as having COVID 19

Need to wear a face mask at all times during the visiting period. You may be asked to wear additional protective garments by staff where needed

Visitors are to remain in the area designated during the visiting period. For all patients who are able to leave the ward visits will take place in Horatio’s garden (no repeated entering and exiting the area).

Only patients who are unable to leave the ward will receive visitors in the clinical area.

Please do not sit on the patient’s bed or visit other patients

Adhere to hand hygiene recommendations and wash your hands on entering the ward area; and when you leave the ward

Ensure you only use toilet facilities that are provided for members of the public that are located off the ward

Maintain the recommended social distancing requirements

Safety

You will need to sign this form and provide your contact details so that we know you are present and can account for you in case of fire and the need to evacuate. These details may be used by Public Health England as part of the “Track and Trace” strategy, should there be a necessity following your visit

If the fire alarm sounds please follow instructions given by the ward staff Do not attempt to leave the ward.

We reserve the right to decline permission for partners or companions to visit the ward at these times or if there are significant concerns that will compromise the safety of patients

and staff.

Buckinghamshire Healthcare NHS Trust operates a zero tolerance policy on violent, disruptive or aggressive behaviour. It is a criminal offence to cause a nuisance or disturbance on NHS premises.

.

I have read, understood and agree to adhere with the above conditions. Signed:

Print Name:

Date:

Contact Details:

Bed Number:

NSIC Specialist Services Division

Appendix 3- Decision process – Visiting requirements

Appendix 4

Information for visiting Inpatient wards

It is important that you read, understand and sign this document if you choose to visit the ward

If you have any symptoms such as a cold, cough, flu, breathlessness, tiredness or

vomiting and diarrhoea, then please do NOT visit.

Please speak to the Nurse in charge or member of staff at the entrance to the ward on arrival.

Anyone who is perceived to be under the influence of alcohol or drugs will not be

allowed to visit.

Infection control

Visiting will only be permitted for designated time slots as follows:

13:00 – 14:00, 14:15 – 15:15, 15:30 – 16:30, 16:45 – 17:45. Your allocated visiting time will be explained to you.

Visiting will only be permitted for one named visitor throughout your stay

On arrival, you will:

Need to confirm that you are not currently self-isolating or shielding and that you have not been in contact with someone in the past 14 days who is suspected of having or is confirmed as having COVID 19

Need to wear a face mask at all times during the visiting period. You may be asked to wear additional protective garments by staff where needed

Visitors are to remain in the area designated during the visiting period.

Please do not sit on patients bed or visit other patients

Adhere to hand hygiene recommendations and wash your hands on entering the ward area; and rub with alcohol based gel when you leave the ward

Ensure you only use toilet facilities that are provided for members of the public that are located off the ward

Maintain the recommended social distancing requirements

Safety

You will need to sign this form and provide your contact details so that we know you are present and can account for you in case of fire and the need to evacuate. These details may be used by Public Health England as part of the “Track and Trace” strategy, should there be a necessity following your visit

If the fire alarm sounds please follow instructions given by the ward staff. Do not attempt to leave the ward.

We reserve the right to decline permission for partners or companions to visit the ward at these times or if there are significant concerns that will compromise the safety of patients and staff.

Buckinghamshire Healthcare NHS Trust operates a zero tolerance policy on violent, disruptive or aggressive behaviour. It is a criminal offence to cause a nuisance or

disturbance on NHS premises. .

I have read, understood and agree to adhere with the above conditions. Signed:

Print Name:

Date:

Contact Details:

Bed Number: