Today (4 August) we launched details of our upcoming clinical summits for those involved in setting up or expanding virtual wards. This innovative approach to delivering hospital care at home is already benefiting thousands of people across England. Dr Shelagh O’Riordan, Consultant Community Geriatrician and Professional Advisor at NHS England shares her tips on how to set up a frailty virtual ward and why clinicians should join her, and colleagues, at the virtual ward clinical summits later this year.
In 2020, our team in East Kent set up a new frailty hospital at home or virtual ward in response to COVID-19, to help people living with frailty have an alternative option to going to hospital. We set this up fast, learnt a lot along the way, and adapted how we work very quickly. It has been hugely rewarding with positive feedback from patients, carers and staff. Since then, the idea of virtual wards has really taken off with investment for all areas to do the same.
A virtual ward or hospital at home provides safe, clinical care for appropriate patients who would otherwise be in hospital. This could either be instead of a hospital admission or by allowing people to continue their treatment at home, whilst receiving hospital level care and monitoring at home.
There are different models of virtual wards. Some will involve staff working remotely, using technology to monitor the patient in real time, but others are much more like a hospital within the home, providing multidisciplinary care and hospital type interventions such as point of care testing and intravenous therapies, face to face.
To get started, read our guidance on virtual wards – this will help you understand the focus on the two virtual ward models developed nationally – frailty and acute respiratory infection. Technology is an essential enabler of all virtual wards but needs to be appropriate for the patients and clinically useful. This guidance explains more about setting up technology-enabled virtual wards.
There is a really good evidence base for frailty hospital at home being clinically as good as or better than traditional care in hospital – it’s preferred by patients and significantly better value for money. As the evidence base continues to grow and develop, there are already lots of excellent examples around the country of frailty hospital at home services. The Hospital at Home Society also has some great resources to get you off the ground.
I would suggest you don’t set up large expensive remote monitoring hubs before you really know what your clinical pathways are and which patients you intend to see. This is tempting as it may seem as a way of rapidly scaling up but could result in little resources left to provide the bespoke care required for different patients. Similarly, try not to invest heavily in technology before identifying the clinical models.
Don’t be put off starting a frailty virtual ward or hospital at home service, thinking it might be too complicated, difficult or you won’t be able to get the staff. When reflecting on the workforce, think about who you can get, who you can train along the way and consider upskilling the staff you already have. Don’t feel you have to start off running enormous services – start smaller and build up as the skills and confidence grow.
Ultimately, this is the right thing to do for patients and I know clinicians across the country are putting their patients first and striving to deliver the best personalised care for their patients.
Virtual wards and hospital at home services are a great example of the NHS delivering innovation that improves not only people’s health but their experience of care. They enable people to remain in the comfort of their own home, family and friends can visit at a convenient time whilst still receiving the clinical care they would have received in hospital.
We’re keen to support you and your team throughout this journey, so why not join our virtual ward community of practice webinars and our clinical summits to hear from other clinicians, who like me, have experienced and seen the benefits of providing hospital care for people in their own home. Hear more about our experiences and what we’ve learnt, and please come along to share your thoughts too.
Our Community of Practice webinars take place weekly on a Thursday at midday. Each week we focus on a different aspect or type of virtual wards such as frailty hospital at home, acute respiratory illness virtual wards, technology, data and digital, and operations. The webinars are for anyone working in health and care with an interest in virtual wards. Find out more about the Community of Practice webinars by joining our virtual wards network on FutureNHS (you will need to register for a FutureNHS account before joining the network) and emailing the virtual wards team at firstname.lastname@example.org.
The first virtual ward clinical summit will take place in the autumn – make sure you reserve your place. We also want to email@example.com and your clinical teams to help shape the content and propose topics.