The NHS is increasingly introducing virtual wards to support people at the place they call home, including care homes. Tara Donnelly and Matthew Winn discuss the growing virtual ward movement, how this is benefiting patients, and how the NHS is supporting the expansion of more virtual wards.
We know there are real benefits to helping people to be cared for at home. There is strong evidence that if people stay too long in hospital, they can experience serious deconditioning that can be hard to recover from. It can be very disorienting and distressing being away from familiar surroundings. The home environment is generally the best place to accelerate recovery and morale.
To enable more people to benefit we need to mature the care models used, and support our services and clinicians to enable people to stay at home for their treatment and care. Clinicians working on a virtual ward combine face-to-face care in someone's home, with new technologies that provide information on people's vital signs while they recover. Together, this approach enables patients to have all the benefits of home, with the safety net of a dedicated clinical team reviewing them face to face and remotely. Clinical teams can be based in the hospital or in the community as best meets local needs.
The hospital is brilliant. But it's not like being at home, is it?
Already, over 2,500 people a week are being supported at home in this way. Patient feedback has been extremely positive. As virtual ward patient David Whitlock told BBC News: "The hospital is brilliant. But it's not like being at home, is it?". Another virtual ward patient, Leigh Jones, says he is "indebted" to the service that enabled him to recover at home, with his cats and his grandchildren, calling it "game changing" and "technology at its best!".
NHS staff too tell us they are enjoying this new way of working, reporting high levels of satisfaction and low levels of negative indicators such as staff sickness. Sam Higginson, chief executive of Norfolk and Norwich University Hospitals NHS Foundation Trust, said: "We have yet, in nine months of operation, to have a single day of staff sickness on the ward." Flexibility of roles enable supervision from home, particularly useful if they need to self isolate, or might support retention, attracting clinical staff considering retiring at 55, using their skills in new ways.
The NHS is likely to experience extra demand for years to come. Providing hospital at home intensity of support within a virtual ward will help us to help those with long term conditions manage them at home; avoid admission to hospital unless absolutely needed and intervene to support people whose health is deteriorating earlier than currently happens. We know, though, that this model could help many more people. We were delighted that the NHS planning guidance for 2022/23 articulated the NHS' support for the virtual ward model. It included an ambition to expand this service in England, backed up for £200m for integrated care systems in 2022/23, on a fair shares basis. Guidance on establishing virtual wards, tech-enabled virtual wards, an e-learning package for staff and a new community of practice were also launched.
The hospital at home model of care within virtual wards should be rolled out wisely and be built on the services already available in every local area.
As leaders of NHS provider organisations, you are in a great position to encourage and support this work. The hospital at home model of care within virtual wards should be rolled out wisely and be built on the services already available in every local area. Please do read the published guidance and learn from those who have successfully implemented the model. Their advice includes appointing great clinical and operational leadership, a dedicated project team, funding both the change and technology, treat it in all ways like a regular ward - visibility on electronic patient information systems; bedstates; dedicated staffing and most critical of all, have a highly committed leadership team.
Why not watch this short film made with Norfolk and Norwich University Hospitals NHS Foundation Trust on the benefits of virtual wards for patients, staff and the system, ask your teams to join our virtual wards online community, or drop us as an email at england.virtualward@nhs.net to stay connected as this programme grows. We want to hear from you and support hospital at home services and broader virtual wards across the whole country in the next year.
About the authors
