The NHS plan for virtual wards to beat winter crisis

Patients with respiratory infections to be given wearable devices that allow doctors to monitor them at home

NHS app seen on a smartphone, July 2023
NHS to ‘pivot’ towards virtual model more in the future
(Image credit: Jaap Arriens/NurPhoto via Getty Images)

The NHS could roll out more virtual wards to treat flu and Covid patients this winter, after the treatments watchdog gave the green light to the plan.

Also known as “hospitals at home”, virtual wards could free up beds at a time of year when the NHS is under added pressure, and save millions of pounds in the process.

If it proves successful, it is a model that the NHS is likely to “pivot towards” in the future “as more emphasis is placed on preventing patients needing to attend hospital and stay for ongoing treatment”, said Sky News’s health correspondent Ashish Joshi.

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How would it work?

In new draft guidance the National Institute for Health and Care Excellence (Nice) said tens of thousands of patients suffering from respiratory infections such as flu and Covid could be treated at home over the winter using digital technologies.

Patients on virtual wards will be given wearable devices to monitor vital statistics such as temperature, heart rate, breathing, blood pressure and oxygen. This data is then fed through an app or platform that connects them to their doctor, who will monitor them remotely. A telephone support line will also be available and patients will receive home visits where necessary from community nurses.

In January, NHS England set out plans for integrated care systems to expand their virtual capacity to 40-50 virtual beds per 100,000 people – around 24,000 in total – by December.

What are the benefits?

The expansion of virtual ward capacity has been “prioritised by NHS England as a way to relieve pressure on acute hospital services”, reported Nursing Times.

There are a record 7.6 million patients on the NHS waiting list and health leaders “are nervous about the coming winter, which could have a bad flu season amid continuing strikes by doctors” said Practice Business. Last winter around 300,000 people were admitted to hospital with either flu or Covid, and it is hoped virtual wards will relieve some of this strain.

The virtual wards could also “reduce pressure” on GPs and emergency departments, said The Telegraph, as “a significant proportion of people needing urgent care from their GPs or in hospital are because of these [respiratory] illnesses”.

It will also save money, with analysis by Nice finding virtual wards saved about £872 per person compared with inpatient care, and £115 per person compared with home care without the use of technology.

Crucially, evidence presented to Nice found that there were similar outcomes for patients treated in a hospital or at home.

Are there any obstacles?

“Home care is important, but it isn’t the answer to everything,” writes Brian Bostock, a registered nurse and independent healthcare management consultant, for The Guardian.

Virtual wards “can ease bed numbers, but not staffing issues”, he argued, while data remains “an imperfect way to gather feedback on a patient’s recovery”.

The success of this programme is “dependent on the recruitment and retention of trained staff”, agreed Joshi, citing an existing shortage of nurses and workforce crisis that extends across the NHS. It also “does not address the long-term crisis in social care which is driving the pressure on hospitals who are unable to discharge medically fit patients”, he added.

What do the public and NHS staff think?

In March 2023, the Health Foundation surveyed over 7,000 members of the public and over 1,200 NHS staff to find out what they thought about virtual wards and important factors for making sure they work well.

It concluded that the UK public is, overall, supportive of virtual wards (by 45% to 36%) with 19% unsure whether they are supportive or not. Nearly three-quarters of the public would be open to being treated in a virtual ward “under the right circumstances” suggesting that, “if implemented well, virtual wards should be acceptable to a large majority of service users”.

Support was highest among disabled people and those with a carer, while those from lower socioeconomic groups were far less supportive.

Two-thirds of NHS staff surveyed were supportive of virtual wards, provided people could be admitted to hospital quickly if their condition changed, and could talk to a health professional if they needed help.

A consultation on Nice’s recommendation is under way and will run until 1 September.

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