Table 3.

Framework for visitation of inpatients receiving palliative care

Stage 1
Patients with no suspected COVID-19 Physical distancing must be maintained	Patients with suspected/confirmed COVID-19 Physical distancing must be maintained PPE and masks must be worn
For patients NOT in deteriorating or terminal phase • Limit of 2 visitors at any one time from a list of 4 nominated visitors drawn up on admission, in discussion with the patient and/or caregiver • Any changes to the nominated visitors should be made on a case-by-case basis • Maintain usual visiting hours as much as possible • Visits should permit a minimum of 2 hours per day • Family members who are under the age of 16 may visit* • Religious, spiritual, or community leaders who are not employed by the health service are permitted to visit but must be included in the maximum of 2 visitors at any one time, although not the list of 4 nominated visitors • “Essential caregivers” may visit in addition to the above, including overnight, by negotiation as required and according to the patient’s care plan, but must be included in the maximum of 2 visitors at any one time, although not the list of 4 nominated visitors	For patients NOT in deteriorating or terminal phase • One visitor per day from a list of 4 nominated visitors drawn up on admission, in discussion with the patient and/or caregiver • Any changes to the nominated visitors should be made on a case-by-case basis • Maintain usual visiting hours as much as possible • Visits are for a maximum of 2 hours per day • Family members who are under the age of 16 may visit* and at these times two visitors are permitted together (the child and the designated adult visitor) to allow for supervision and support • An “essential caregiver” may visit in addition to the above, including overnight, by negotiation as required and according to the patient’s care plan • Every effort should be made to facilitate digital communication wherever possible
For patients in deteriorating or terminal phase Visiting restrictions should be lifted and revert back to usual local practice in terms of numbers and duration of visit. If this is not deemed acceptable due to practical management of visitors in the clinical space, or concerns regarding confusion of public health social distancing directives, then a minimum of 2 visitors at any one time would be required.	For patients in deteriorating or terminal phase As above
Stage 2
Patients with no suspected COVID-19 Physical distancing must be maintained	Patients with suspected/confirmed COVID-19 Physical distancing must be maintained PPE and masks must be worn
For patients NOT in deteriorating or terminal phase • Limit of 2 visitors at any one time, ideally the same two people throughout the admission • Visits are for a maximum 2 hours per day • No visitors under the age of 16 • Religious, spiritual, or community leaders who are not employed by the health service may not be permitted to visit, and so additional planning to meet spiritual needs may be required • “Essential caregivers” may visit in addition to the above, including overnight, by negotiation as required and according to the patient’s care plan but must be included in the maximum of 2 visitors at any one time	For patients NOT in deteriorating or terminal phase • No visitors allowed, except an “essential caregiver,” including overnight, by negotiation as required and according to the patient’s care plan • Every effort should be made to facilitate digital communication wherever possible
For patients in deteriorating or terminal phase As above, and additionally: • The limit of 2 visitors at any one time will be maintained during terminal and bereavement phase • One adult visitor is permitted to sleepover, subject to local protocol but must be included in the maximum of 2 visitors at any one time • Family members who are under the age of 16 may visit*	For patients in deteriorating or terminal phase As above, and additionally: • One adult visitor, ideally the same person throughout the admission • Visits are for a maximum of 2 hours per day • Family members who are under the age of 16 may visit* and at these times two visitors are permitted together (the child and the designated adult visitor) to allow for supervision and support
Stage 3
Patients with no suspected COVID-19 Physical distancing must be maintained Masks must be worn	Patients with suspected/confirmed COVID-19 Physical distancing must be maintained PPE and masks must be worn
For patients NOT in deteriorating or terminal phase • No visitors allowed, except an “essential caregiver,” including overnight, by negotiation as required and according to the patient’s care plan • Every effort should be made to facilitate digital communication wherever possible
For patients in deteriorating or terminal phase • One adult visitor, the same person throughout the admission • Visits are for a maximum of 2 hours per day • Every effort should be made to facilitate digital communication wherever possible

*Where visitors under the age of 16 are permitted to visit, they must:

• Be able to comply with handwashing, not touching the environment, and wearing any required PPE or are babies that can be carried throughout the visit

• Be accompanied by an adult at all times who is responsible to supervise them and ensure compliance with infection control measures

• Limit visits to a maximum of 2 hours, although shorter times may be appropriate depending on their ability to maintain compliance with infection control measures

• Be counted as one of the list of nominated visitors