What is the right to follow-up in health services?
- in the emergency services of the NHS, everyone is recognized and guaranteed the right to be accompanied by a person indicated by him/her, and the citizen must be informed of this right during admission
- Pregnant women admitted to a health facility have the right to be accompanied during all stages of labour by any person chosen by them
- The right to family accompaniment is recognized for children hospitalized in health facilities, as well as for people with disabilities, people in situations of dependency and people with incurable diseases in an advanced and end-of-life state
- In cases where the clinical situation does not allow the patient to freely choose the companion, the services should promote the right to follow-up, and for this purpose may request proof of the relationship or relationship with the patient invoked by the companion
- The nature of the relationship referred to in the previous point cannot be invoked to prevent monitoring
- When the hospitalized person is not accompanied, the administration of the health facility must provide personalized care appropriate to the situation
- It is not allowed to accompany or attend surgical interventions and other examinations or treatments that, by their nature, may see their effectiveness and correctness impaired by the presence of the companion, unless express authorization is given for this purpose by the clinician in charge
- Follow-up must not compromise the technical conditions and requirements to be met in the provision of medical care
- In the cases provided for in the previous points, it is the responsibility of the health professional responsible for providing health care to inform and explain to the companion the reasons that prevent the continuity of the follow-up
What are the rights of the companion?
The companion has the right to be adequately informed and in a reasonable time about the patient's situation, in the different phases of care, with the following exceptions:
- otherwise expressly indicated by the patient
- matter reserved for clinical secrecy
What about the duties of the companion?
The companion must behave with civility/urbanity and respect and comply with the instructions and indications, duly substantiated, of the service professionals.
What happens in case of breach of the duties of the companion?
In the event of violation of the duty of civility/civility, disobedience or disrespect, the services may prevent the companion from remaining with the patient and determine his/her departure from the service, and another companion may be appointed in his/her place.
What are the conditions for monitoring pregnant women during childbirth?
- The right to accompaniment can be exercised regardless of the time of day or night in which labor occurs
- To the extent necessary to comply with the provisions of this law, the companion shall not be subject to the hospital regulations for visits or their conditions, and shall be exempt from paying the respective fee
- Follow-up may exceptionally not be effective when, in serious clinical situations, it is inadvisable and expressly determined by the obstetrician
- Accompaniment may not be exercised in units where the facilities are not in agreement with the presence of the companion and with the guarantee of privacy requested by other parturients
- In the cases provided for in the previous paragraphs, the persons concerned must be correctly informed of the respective reasons by the responsible staff
In case of caesarean section, what are the follow-up conditions?
- Whenever the medical team of a hospital institution decides to perform a caesarean section, the obstetrician in charge must assess the existence of a serious clinical situation that advises against the presence of a companion in an operating room and must transmit this information to the parturient
- Whenever there is no serious clinical situation under the terms referred to in the previous number, the parturient, in the exercise of informed, informed and free consent, must previously express her authorization or refusal (in both cases given in writing) for the father, or another significant person (identified in the written informed consent), hereinafter referred to as the "companion" is present
- The companion, in the exercise of informed, informed and free consent, must express in advance his/her willingness to be present during the cesarean section
- Hospital institutions with a delivery unit must ensure the following conditions for the exercise of the right to follow-up during the caesarean section:
- the existence of a proper place where the companion can change clothes and deposit his/her belongings properly
- the provision of adequate training and compliance with all the rules relating to equipment, personal protective equipment and hygiene inherent to the presence in the operating theatre
- the definition of a circuit in which the companion can move, without jeopardizing the privacy of other users or the functioning of the service
- The member of the team assigned to the reception of the companion must provide prior information about the phases of the surgery and the usual procedures that take place during it, as well as indicate when to enter the room (once the preparation of the parturient and the room has been completed), and the place where he/she should position himself or herself during the surgery, so as not to jeopardize the quality of care and the safety of the parturient and the child
- By order of the obstetrician, the presence of the companion ends whenever, during the cesarean section, unexpected complications arise that justify interventions aimed at preserving the safety of the mother and/or child
- The companion should be given the opportunity to attend the observation of the newborn, carried out by the pediatrician, whenever the pediatrician does not identify clinical contraindications
- It should also be possible for the companion to remain with the newborn during recovery and until the mother is transferred to the hospital, provided that this does not endanger the newborn or the normal functioning of the service
Hospital institutions with a delivery unit must have already implemented the necessary measures to comply with the rules referred to in the previous points. The necessary measures are taken to ensure cooperation between the pregnant woman, the companion and the services, which must in particular provide adequate information on the course of the birth, as well as on the medically necessary actions.
What is the right to family accompaniment of the hospitalized child?
The right to family accompaniment of the hospitalized child is the guarantee that:
- Children up to the age of 18 who are hospitalized in a health establishment have the right to permanent monitoring by their father and mother or by a person who replaces them
- A child over the age of 16 may designate the accompanying person, or even dispense with him or her
- The exercise of follow-up is free of charge, and the health establishment cannot demand any remuneration and the hospitalized person, or his legal representative, must be informed of this right at the time of admission
- In cases where the hospitalized child has a communicable disease and where contact with others constitutes a risk to public health, the right to follow-up may end or be limited, on the written indication of the responsible clinician
What is the right to family accompaniment for people hospitalized with disabilities or in a situation of dependency?
The right to family accompaniment of hospitalized persons who have disabilities or are in a situation of dependency ensures that:
- Persons with disabilities or in a situation of dependency, with an incurable disease in an advanced stage and people in an end-of-life stage, hospitalized in health establishments, have the right to permanent monitoring of an ascendant, descendant, spouse or equivalent and, in their absence or impediment or by their will, of a person designated by them
- the family accompaniment of the persons identified in the previous number:
- The exercise of follow-up is free of charge, and the health establishment cannot demand any remuneration and the hospitalized person, or his legal representative, must be informed of this right at the time of admission
- In cases where the person with a disability or in a situation of dependence has a communicable disease and where contact with others constitutes a risk to public health, the right to follow-up may be terminated or limited, on the written indication of the responsible clinician
What are the conditions of follow-up in case of hospitalization?
- Permanent family monitoring is carried out during the day or night, in compliance with the instructions and technical rules regarding applicable health care and the other rules established in the respective hospital regulations
- It is forbidden for the companion to attend surgical interventions to which the hospitalized person is submitted, as well as treatments in which the person is detrimental to the corruption and effectiveness of the same, unless authorization is given for this by the responsible clinician
- Health professionals must provide the companion with appropriate information and guidance so that he/she can, if he/she so wishes, under the supervision of the companion, collaborate in the provision of care to the hospitalized person
- The accompanying person must comply with the instructions given to them by health professionals under the terms of this law
- the companion of the hospitalized person, as long as he/she is exempt from paying a user fee in access to health services within the scope of the NHS, is entitled to a free meal, in the health establishment, if he/she stays in the institution 6 hours a day, and whenever one of the following conditions is met:
- the hospitalized person is in danger of death
- the hospitalized person is in the postoperative period and up to 48 hours after the intervention
- when the companion is a mother and is breastfeeding the hospitalized child
- when the hospitalized person is isolated for reasons of medical-surgical criteria
- when the companion lives at a distance of more than 30 km from the place where the health establishment where the hospitalization takes place is located
The information contained in this document does not have binding legal content nor does it dispense with the reading of the applicable diplomas.
Source: Shared Services of the Ministry of Health (SPMS)