We are are supporting our local healthcare systems to prepare for the expansion of virtual wards, which are a way of helping people to safely manage their care at home, rather than in hospital.
This webpage outlines key information about virtual wards, including links to relevant resources. It also highlights the support available from the West of England AHSN.
What are virtual wards?
Virtual wards are a pathway for patients who would otherwise have been in hospital: which might include components of admission avoidance and early supported discharge. Virtual wards provide acute clinical care at home (including care homes) for up to 14 days as an alternative to care in hospital.
Virtual wards are developed across systems and provider collaboratives based on partnerships between secondary, community, primary and mental health services, alongside consideration to the independent sector. Patients admitted to a virtual ward have their care reviewed daily by a consultant practitioner (including a nurse or allied health professional consultant) or suitably trained GP via a digital platform which allows for remote monitoring of a patient’s condition and escalation to a multidisciplinary team.
As per national guidance, virtual wards should be used for patients who would otherwise be admitted to an NHS acute bed or to facilitate early discharge. Consideration must be given to remote monitoring technology and wider digital platforms as these enable delivery of effective and efficient virtual wards.
Read the national guidance and standard operating procedure:
The national ambition
As of January 2022, there are 53 virtual wards across 38 integrated care systems (ICSs) primarily supporting acute respiratory infection and frailty (known as Hospital at Home) but there are others that support general acute conditions. The NHS@Home ambition is to support the national expansion of virtual wards based on evidence which suggests 16% of admissions could be supported through a virtual ward. The aim is for ICSs to achieve 21 virtual ward ‘beds’ per 100k population by October 2022 and 40-50 by December 2023.
Further guidance can be found in the operational planning and virtual ward guidance below:
- Guidance note: Frailty virtual ward (Hospital at Home for those living with frailty)
COVID virtual wards and Oximetry @home
In January 2022, systems received a letter (C1041-letter-supporting-hospital-discharge-covid-virtual-wards-13-jan-21.pdf) recommending that all ICSs immediately establish COVID virtual wards to support the earlier and safe discharge of COVID-19 inpatients in addition to their work on Oximetry @home pathways.
A number of COVID-related resources developed by the AHSN Network may be useful to support COVID virtual wards:
- System learning: Safer-care-during-COVID-19-AHSN-Network-report.pdf;
- Safety concerns: NationalPatientSafety-Presentation-v3.pdf
- Learning specific to tech-enabled support
- Sharing best practice through connecting people and systems together
What is the role of the AHSN Network?
The AHSN Network (to March 2022) were commissioned through the Patient Safety Collaboratives (PSCs) to support the rapid expansion of the (non-COVID) virtual ward model, using a system approach across the regional footprints.
This support consisted of a 3-month collaboration between regional NHS England and Improvement leads, AHSNs, PSCs and local system partners to co-ordinate a regional understanding of need and a standardised approach to delivery, informed and supported by local systems.
What’s happening locally?
Our local support offer makes use of our existing infrastructure and resources. We have been undertaking a rapid scoping exercise to understand use of virtual ward-based models across the region. As scoping is completed, we’ll begin working with individual systems, tailoring our support based on the findings of the review and local ambitions.
Whilst part of our remit is to capture challenges and insight, we are equally keen to share learning from the good work already happening in our region, so please do contact us if you have resources or learning to share.
All relevant NHS documents and further information can be found on the NHS@Home NHS Futures platform.
The following examples of work have been carried out in the West of England and may be useful to consider in the context of virtual ward roll-out:
- Short videos We produced a free series of short videos to support staff working in care providers to measure observations. We are exploring how to adapt these videos for use in virtual wards.
- Free RESTORE2 training Read more about our free training programme in RESTORE2 mini and RESTORE2 for care providers based in the West of England.
- Local coaching and expertise We have identified local team members who can provide coaching to implementing teams. We can also connect via our existing networks (e.g. West of England Learning Disabilities Collaborative, Mental Health Collaborative) to access experts by experience and to test local resources (e.g. safety netting advice and patient-facing materials).
- Webinars Throughout the pandemic response, the West of England AHSN have hosted webinars for local partners to learn and share from each other, and we can host webinars to support virtual ward implementation. We have supported the AHSN Network and Royal College of GP joint national webinars on various topics relating to COVID, including physiological observations, care homes, and COVID-19 and children.
- NHSX is supporting a programme of work to increase use of remote monitoring across the South West region. The West of England AHSN will work across this programme and the virtual ward implementation to ensure clear and consistent messaging.
Other local resources include the West of England Academy (with expertise and access to expert speakers around Quality Improvement topics), connections into industry and digital partners, and a grey literature evidence repository.
For further information, please contact Senior Project Manager, Eleanor Powell.