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Merseyside NHS Hospital Trusts collaborate to provide ‘incredible’ service to keep more patients healthy and closer to everything they love

NHS nurse shows a patient how to use a medical device while she lies in bed

Case finder Nicola talks to a patient about joining the virtual ward

Thanks to a collaboration between three hospital Trusts across Merseyside, patients struggling with respiratory conditions such as COPD and community-acquired pneumonia may find themselves increasingly able to be treated at home instead of spending weeks or longer in a hospital bed.

Services across St Helens and Knowsley Teaching Hospitals NHS Foundation Trust, Liverpool Heart and Chest Hospital and Mersey Care NHS Foundation Trust, offer combined expertise to provide a virtual ward service starting from hospital wards and A&E departments to seeing patients from the comfort of their own home or in an environment that is familiar to them.

Originally developed for COVID-19 patients in 2020, the service was hugely successful despite incredibly trying circumstances.

The ward offers services across respiratory conditions and has allowed vulnerable and frail patients to be treated from the comfort of their own home, so far keeping 444 patients out of hospital.

Dr Sarah Sibley, Clinical Lead for Cheshire and Merseyside Respiratory Clinical Network and Consultant Chest Physician at Liverpool Heart and Chest NHS Foundation Trust said: “Though I was initially unsure of virtual wards, I quickly became an advocate for them when I saw first-hand that you could provide excellent care to patients in their own home with monitoring and treatment that is just as effective as if they were in a hospital bed. Virtual wards can help the NHS, already strained from the COVID-19 pandemic, manage more patients so that we can start to reduce waiting times for routine procedures with long waiting times. What matters most is the patient and giving them the best care. Now due to the development of virtual wards, this sometimes means that people no longer need admission to a hospital when unwell and can be managed entirely in their own homes until they are fully recovered.”

“Older and frailer patients are particularly at risk of deteriorating further due to the unfamiliar environment and by being admitted to hospital as they often reduce their activity levels and independence. With virtual wards, we can provide care to patients in their own home, which is a comfortable, familiar place to them, speeding their recovery back to health.”

The service starts at Whiston Hospital, part of St Helens and Knowsley Teaching Hospitals NHS Foundation Trust, where Case Finders identify eligible patients. When an appropriate patient is discovered, the Case Finder will discuss treatment with the patient’s Consultant before an agreement is made with them and the patient.

The patient is then provided with equipment including blood pressure monitors, pulse oximeters for measuring blood oxygen and a smart phone if the patient does not have one. Any training needed by patients as to how they can take readings and provide them to the service is then provided over the phone from a dedicated Telehealth service team based at Mersey Care. They also inform the patient when to take readings so the team can observe and recommend any further treatment or if patients continue to rest.

Rosie Kaur, Deputy Medical Director from Mersey Care, said: “We can actively monitor the patient from their home and if readings get better, we know that continuing to be treated this way from home is the right way forward. If their readings start to go the way we don’t want them to, we check in with the patient and if needed, they can be transported back to hospital where they can be monitored more closely. The safety of that patient is of the utmost importance to us.”

There is a daily meeting held with the ward’s multi-disciplinary team between Whiston hospital, Mersey Care Foundation Trust and Liverpool Heart and Chest to review patients’ readings and optimise treatment as required.

Emma Rickards, Case Finder and Respiratory Nurse Consultant at Liverpool Heart and Chest, said: “So far this model is working exceptionally well for our Trusts and our patients and so many of them are happy to be able to receive this treatment from the comfort of their own homes. It takes time to adapt to any new ways of receiving treatment so it’s understandable if people aren’t sure, but we wouldn’t follow this path if we didn’t see the benefits to everyone involved.”

Dr Ragit Varia, Consultant Acute Medicine at St Helens and Knowsley Teaching Hospitals NHS Foundation Trust, said: “What matters most in this is that the care that you’ve always known and loved about the NHS is put directly into these virtual wards. It’s not about keeping you and your loved ones far away, it’s about keeping them as fit and healthy as they can be, just as it always has been.”

Michael Gregory, Medical Director for NHS England North West, said: “The North West has shown many great advances in developing virtual wards. Fundamentally, we are seeing terrific results from these services, and it is improving the lives of thousands of people and helping get them back on track so they can live longer, and their families can spend more precious time with them.

Plans for virtual wards have been around for some time but in many cases, the COVID-19 pandemic and subsequent lockdowns provided more incentive and fast tracked many services with more and more coming on board all the time.”