Tier 4 restrictions on hospital visiting introduced

The government’s decision to move Gloucestershire into Tier 4 from today, 31 December, has an impact on visiting restrictions in the county’s hospitals.

The NHS in Gloucestershire is therefore introducing new restrictions from today, in line with tier 4 requirements.

The restrictions mean that visitors can comply with The Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 and the NHS can ensure that safety is maintained for our patients, their families and colleagues.

Professor Steve Hams, Director of Quality and Chief Nurse at Gloucestershire Hospitals NHS Foundation Trust, said:

“While we recognise the value that visiting has to the recovery of our patients, we also have to ensure we comply with the new national requirements to limit movement and have therefore made further restrictions to visiting. We hope our patients and visitors will appreciate that these decisions are not taken lightly, and are always taken in the best interests of the people we care for, the people who work in and visit our facilities and our communities.”

John Trevains, Director of Nursing, Therapies and Quality at Gloucestershire Health and Care NHS Foundation Trust, said:

“Since the earlier part of the year, we have introduced digital visiting options at hospitals in the county and we encourage visitors to take advantage of those options, as well as keep in touch with their loved ones by phone, in the first instance. We will always ensure that if there is a particular need for a visit, such as on compassionate grounds, this will be supported on a case by case basis.”

The Trusts also ask all visitors, as well as patients attending appointments, to wear a face covering and comply with social distancing and hand hygiene guidance as advised by our staff. During a period of self-isolation, visiting is not allowed under any circumstances in accordance with the national regulations.

It is important that people of all ages still attend medical appointments and patients can be reassured that, due to careful infection prevention and control procedures, transmission rates in our hospitals remain very low. Those attending appointments are encouraged to attend alone whenever possible, to reduce the number of people in hospital buildings.

The restrictions come into effect from Thursday 31 December.

All visitors are reminded:
• When visiting, please ensure you wear a face covering at all times
• If you have a medical exemption for wearing a face covering, please consider whether your medical condition makes you more vulnerable to infection if visiting and use digital options where possible
• Social distancing and hand washing remain very important everywhere – particularly in hospitals

The updated restrictions will apply to Gloucestershire Royal Hospital (GRH), Cheltenham General Hospital (CGH) and seven community hospitals in the county:
• Cirencester Hospital
• The Dilke (Cinderford)
• Lydney Hospital
• North Cotswolds Hospital (Moreton-in-Marsh)
• Stroud Hospital
• Tewkesbury Hospital
• Vale Hospital (Dursley)

They are also applicable to the county’s mental health and learning disability inpatient units:
• Wotton Lawn (Gloucester)
• Charlton Lane (Cheltenham)
• Berkeley House (Stroud)
• Laurel House (Cheltenham)
• Honeybourne (Cheltenham)
Contact details can be found on the Trusts’ websites.

Restrictions from 31 December

Adult in-patient settings (including mental health and learning disability inpatient units)
• General visiting to adult wards is suspended during the Tier 4 Period for Gloucestershire
• By arrangement with the nurse-in-charge and agreement with the multi-disciplinary team, limited visiting is allowed for adults who require support in special circumstances (where the individual likely to be seriously adversely affected by separation). This can be by an established carer who is a household member or a member of their support bubble as described below:
o Patients with dementia, delirium or cognitive impairment who require support from an established carer in accordance with the principles of John’s campaign
o Patients with mental health needs who require support from an established carer
o Patients with autism or learning disabilities who require support from an established carer
• Visiting is allowed for those receiving especially bad news or for those patients who are at the end of their life. This should be limited to household members or members of the person’s support bubble and will be limited to two individuals at a time.
• Visiting COVID-19 wards or patients exposed to COVID-19 is not permitted. It is expected that the majority of those wishing to visit a patient with confirmed COVID-19 would be self-isolating. However, if any requests are made to visit patients with COVID-19, they must come through the nurse in charge of the ward, who will take advice from the Infection Prevention and Control Team.

Maternity
All those attending appointments and anyone accompanying them must wear a face covering and comply with social distancing and hand hygiene guidance as advised by staff.

(A) Antenatal and Labour
• one birth partner can accompany you during certain antenatal appointments, scans and Maternity Triage appointments
o This accompanying person must be a household member or a member of a woman’s support bubble
• one person may accompany you during the induction of labour for two hours from the start of induction and then once labour is established (they may have to leave in between)
• one birth partner may accompany you during labour
o By arrangement with the midwife-in-charge, those that require support in special circumstances such as mental health needs, learning disability or other support needs may be permitted additional support in labour by an established carer who is a household member or a member of their support bubble
o In special circumstances, a professional involved in your care may also accompany the person in labour – speak to your midwife about these arrangements.
• In the event that your birth partner is self-isolating or has Coronavirus, they cannot attend your appointments or labour, so we suggest that you choose an alternative partner who you prepare for this by bringing them into your support bubble or household

(B) Postnatal visiting
• 1 birth partner can visit you each day after you have given birth for a maximum of 2 hours by arrangement with the midwife-in-charge. Visiting times will be allocated by the ward.

Children’s Wards and Neonatal Intensive Care
• Visiting is restricted to parents, carers or guardians only and must be household members or a member of the support bubble.
• Only two visitors are allowed per child at any one time. This should be the same two visitors on each occasion
• No siblings or other family members should visit
• Only two visitors are permitted on the neonatal ward at any one time, this should be parents or guardians only; if parents, both can visit at the same time

Accompanying someone to an Emergency Department, MIIU or other urgent care attendance
Patients can be accompanied in the Emergency Department waiting room until they have seen the triage nurse at which point the visitor will be asked to leave if required to do so.

Accompanying someone to an outpatient appointment
Patients can be accompanied to an outpatient appointment if there is a need to do so such as supporting with impaired mobility, cognitive impairment or other needs.