Virtual ward service for respiratory patients across Merseyside

Thanks to a collaboration between three hospital Trusts across Merseyside, patients struggling with respiratory conditions such as COPD and community-acquired pneumonia are 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. 

Dr Sarah Sibley, Clinical Lead for Cheshire and Merseyside Respiratory Clinical Network and Consultant Chest Physician at Liverpool Heart and Chest NHS Foundation Trust has became an advocate for virtual wards after seeing first-hand that it’s possible to 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.  

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, patients can receive care 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. 

Patients are actively monitored from their home and if 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. 

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.”