Background The COVID-19 pandemic caused disruption to standard healthcare practice and global lockdowns which led to restricted visiting in healthcare settings. This service evaluation reviewed visiting policies across Scottish specialist palliative care units to observe the impact of these on staff wellbeing, and the perceived impact of restricted visiting on the delivery of palliative care.
Methods This snapshot cross-sectional electronic survey in November and December 2020 was sent to healthcare professionals in specialist palliative care units across Scotland. The survey comprised of mixed methodology with quantitative questions and free text qualitative questions.
Results Analysis of 46 responses showed variation of visiting policies across Scotland’s specialist palliative care units. All allowed flexible visiting at the end of life and person-centred exceptions to their policy. Most (38/46) felt their team worked well making visiting decisions, but those experiencing team conflict were more commonly using a senior-led decision model. Two-thirds felt restricted visiting negatively impacted the delivery of good quality palliative care through increased social isolation, altered staff-patient-family relationship or avoidance of admission. Overall there was a strong theme that staff felt restricting visiting had been ‘stressful’ secondary to the emotional burden and practical difficulties of enforcing this.
Conclusions There were frequent reports of distress amongst specialist palliative care healthcare professionals during COVID-19 as a result of restricted visiting, and a perception that it prohibits delivery of palliative care to the accepted standard. Staff report ethical, moral and practical challenges with enforcing restricted visiting which has directly affected the wellbeing of most staff.
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