Monday, April 22News For London

NHS virtual wards explained: A new way of healthcare

The government has announced its plans to invest more in virtual wards to help with intense pressures on the healthcare system. Virtual wards are a new approach to healthcare delivery. Many wonder how this could impact the National Health Service (NHS) and the experience if they or family members need to use virtual wards.

How virtual wards work. Credits: Hera Kruja

What are the virtual wards?

The concept is to care for patients with long-term conditions in their homes rather than in a hospital setting. This conception aims to improve the quality of life for patients, reduce the burden on hospitals and ultimately improve health outcomes.

The virtual ward model operates through technology and a multidisciplinary team of healthcare professionals. The team cooperates to monitor patients’ health and provide support and treatment. The technology used in virtual wards includes remote monitoring devices, telehealth, telemedicine services, medical devices, and secure digital platforms for communication and information sharing. 

In practical terms, this means that a patient, located at their home, is monitored remotely by healthcare professionals. The patient receives a kit with the required equipment, including a video calls device. Care may also involve face-to-face treatment from multidisciplinary teams based in the community. 

Implementing virtual wards in the NHS requires the collaboration of several stakeholders, including healthcare providers, technology companies, patient organizations, and government agencies. It is important to ensure that virtual ward programs are well-designed and integrated with existing healthcare services.

Virtual wards explained. Video credits: Hera Kruja. Source: NHS England (Virtual wards enabled by technology.)

When did the virtual wards start?

According to Transform England NHS, the first pilot of virtual wards started during the first wave of the pandemic. NHSX supported the implementation of the trial on Covid-19 patients. It enabled the patients to provide regular data on symptoms to their NHS clinical team while being at home. The approach aimed to reduce hospital pressures. 

This model is called “remote monitoring” or “tech-enabled virtual wards.” The NHS pioneered it. More specifically, Dr. Andy Barlow and Dr. Matthew Knight used it at Watford General Hospital in March 2020. By June 2021, the service was available at 92 hospital sites in England. 

Credits: BMA and OECD.

Why could virtual wards improve access to healthcare? 

According to NHS England: “The NHS service has faced record demand, with the latest data showing more A&E attendances than ever before.” The increased A&E visits resulted in a dramatic deterioration in waiting times for urgent care. In December 2022, the average response time of ambulances for emergency calls was five times longer than the targeted one, exceeding 90 minutes.  

Using virtual wards means that hospitals will be able to have more available bed capacity, which reduces waiting times. The target is to discharge patients earlier and patients to have follow-up treatments at home, but also to avoid hospital admissions.

Healthcare professionals talk about virtual wards in a London hospital. Source: Kingston Hospital / HRCH NHS.

Advantages of virtual wards

A review of virtual wards has shown that they can improve the quality of care for patients with long-term conditions. According to the DHSC (Department of Health and Social Care), there is increased evidence that virtual wards are a “safe and efficient alternative to hospital care, particularly for frail patients.”

One of the key benefits of virtual wards is that they can reduce the time patients spend in the hospital. This can be extremely beneficial. First, it can help to free up beds in hospitals for those who need them most. Second, it can help to reduce the risk of patients contracting hospital-acquired infections. Third, it can help to reduce the costs of healthcare, as patients will not be in the hospital.

Virtual wards can also help to improve the quality of life for patients. Patients can maintain their independence, social connections, and routines by being at home and in a more familiar environment. It has improved patient satisfaction and well-being by reducing anxiety and decreasing the risk of hospitalization or readmission.

Virtual wards have also improved health outcomes for patients. Patients can learn to manage their conditions more effectively by providing ongoing monitoring and support.

Improving access to healthcare is another benefit. Patients do not need to travel to a hospital to receive care. This can be particularly beneficial for patients who live in rural areas or cannot travel. Additionally, virtual ward teams can provide care for more patients than traditional hospital-based care, helping to reduce waiting times.

Challenges

One of the biggest challenges is ensuring that patients have access to the same level of care as they would in a physical ward. Healthcare professionals need to examine patients, so seeing them via video can add complexity to the treatment. In addition, it is vital to secure quick access to emergency care when the patient’s health deteriorates, and no healthcare professional is present.

Another challenge is ensuring that patients can use the technology for virtual wards. Utilizing technology can be difficult for some patients, particularly those who are elderly or have never used similar equipment.

The success depends on numerous factors, including the reliability of technology and infrastructure, the expertise of the multidisciplinary team, and the level of support and engagement from patients, including effective communication.

Moreover, we need to consider the human aspect. How would you feel if you were a patient in a virtual ward? Would you be stressed about being at home without a professional?

Community healthcare professional visits patient at home as part of the virtual wards plan. Credits: Medacs.com

What is the plan for the virtual wards?

The plan is to expand further the measures that were taken in 2021. This includes having virtual wards for patients with various conditions, for instance, heart failure, pneumonia, and services that provide urgent responses to older people. 

The intended strategy is part of a two-year investment of an extra £6.6bn that the government announced. By the end of 2023, it is estimated that up to 50,000 patients a month will be using the service. 

The community care services will expand to ensure care at home, without hospital admission. According to DHSC: “Up to 20% of emergency hospital admissions (are) avoidable with the right care in place.” 

Overall knowledge

Virtual wards aim to improve healthcare services. The NHS is investing billions in them. Their benefits seem promising, considering the impact, reviews, and patient feedback. They also have challenges, and the NHS is trying to mitigate them. Could this be the future of healthcare on a much larger scale in an increased and aging population?