The Department of Health and Social Care has launched a consultation on the proposed development of secondary legislation to amend Care Quality Commission regulations to include a specific visiting requirement in health and care settings.
It seeks views on introducing legislation to protect visiting as a fundamental standard across CQC-registered settings so that no one is denied reasonable access to visitors while they are resident in a care home, or a patient in hospital or a hospice. Visiting patients includes accompanying patients to hospital outpatient and diagnostic appointments and to hospital emergency departments.
Existing guidance and legislation
There is a host of current guidance, legislation and policies that facilitate visits in health and care settings, including care homes and hospitals which you can read here.
Guidance for maternity services is provided and additional considerations are also set out for supporting visiting at end-of-life care.
Chapter 11 of the Mental Health Act 1983 Code of Practice also sets out statutory guidance on visiting patients detained under the Act in hospital.
NHS England has also amended (following a request by the DHSC) the NHS Standard Contract which applies to all providers of NHS services (other than primary care), to include a requirement that providers have in place a clinically appropriate policy for hospital visiting. This is required to, at a minimum, meet the standard described in the existing NHS guidance on hospital visiting.
CQC regulations
The regulator currently carries out assurance regarding visiting as part of their regulation of health and care settings. The fundamental standards set out under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (CQC regulations) must be upheld by all CQC registered providers.
Currently providers are required to comply with certain fundamental standards of care which implicitly cover visiting under the themes of ‘person centred care’ and ‘dignity and respect’ and these include:
- regulation 9 (1) person-centred care: the care and treatment of service users must a) be appropriate, b) meet their needs, and c) reflect their preferences
- regulation 9 (3)(a) person-centred care: the things which a registered person must do to comply with regulation 9 (1) include carrying out, collaboratively with the service user, an assessment of the needs and preferences for care and treatment of the service user
- regulation 10 (2) dignity and respect: a registered person is required to comply with a) ensuring the privacy of the service user, b) supporting the autonomy, independence and involvement in the community or the service user and c) having due regard to any relevant protected characteristics of the service user
Policy intention and proposal
The intention is to ensure that visiting is protected and that it remains a priority for health and care providers so that patients and residents can receive visitors whenever it is reasonable and safe.
It would also cover situations where the person lacks capacity to make decisions about contact with others, and when an application to the Court of Protection might be needed.
The DHSC are therefore considering putting visiting on a mandatory footing. They propose introducing secondary legislation (regulations) to amend CQC regulations to include a specific visiting requirement. This it says would provide CQC with a clearer basis for identifying a breach by a care home or hospital.
With the new legislation, the CQC will be able to enforce the standards by issuing requirement or warning notices, imposing conditions, suspending a registration, or cancelling a registration.
In addition, the proposed legislation has the potential to support other DHSC patient safety initiatives, such as patient safety in mental health inpatient care settings.
Have your say by 16 August
The DHSC wants to better understand the views of those who would be affected by a legislative change, including care home providers, NHS hospitals (including acute, mental health and learning disability settings) independent healthcare providers and hospices.
You can respond to the consultation by completing the online survey.
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