10th May 2022
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Make more use of virtual wards, NHS England tells ICSs
All ICSs will be expected to introduce virtual wards for two pathways, acute respiratory infection and frailty, the guidance says
“Virtual wards allow patients who otherwise would be in hospital to receive acute care, monitoring and treatment at home. This can have benefits for individual patients and their outcomes, as well as for the flow of patients through the wider health and care system by helping to prevent avoidable admissions and support safe and timely discharges." Chris Hopson, chief executive at NHS Providers
New guidance from NHS England and NHS Improvement states that all Integrated Care Systems (ICSs) should either introduce or extend the use of virtual wards.
The document, ‘Supporting information for ICS leads: Enablers for success: virtual wards including hospital at home’, represents the start of a two-year transformation to support the development of virtual wards in England. Clinical guidance is also being developed to support local organisations to make the wards operational. This will be available on the FutureNHS website.
Virtual wards use remote monitoring technology to allow patients who would normally be in hospital to receive the care and treatment they need at home. They offer the opportunity to discharge patients from hospital early or even to avoid patients being admitted to hospital at all. As well as reducing pressure on NHS hospital beds, virtual wards benefit patients by enabling them to be cared for in the comfort of their own home.
NHS England’s 2022/23 priorities and operational planning guidance asked ICSs to deliver virtual ward capacity equivalent to 40 to 50 beds per 100,000 population by December 2023 in. In total, this is equivalent to 24,000 virtual ward beds.
The new document states that each ICS should implement virtual ward models for two pathways: acute respiratory infection and frailty. Virtual wards should be developed across ICSs and provider collaboratives, it says, rather than in individual institutions.
In 2022/23, £200m of funding will be made available from the Service Development Fund (SDF) to introduce or extend virtual wards. A further contribution of £250 million, on a match-funded basis, will be available in 2023/24.
A significant change to the way the NHS delivers care
To access the funding, ICSs will need to submit two-year comprehensive rollout and delivery plans up until April 2024. These will include detailed financial plans with projected workforce staffing and expenditure.
The document also offers five good practice recommendations for adopting virtual wards:
- Appropriate clinical leadership and governance in place
- A competency-based approach, avoiding assumptions about professional boundaries and early investment in workforce development and training
- Integrated working across health and social care
- Appropriate use of technology with training and supervision
- An incremental approach to improvement and growth
Chris Hopson, chief executive at NHS Providers, said the organisation welcomed the guidance: “Virtual wards allow patients who otherwise would be in hospital to receive acute care, monitoring and treatment at home. This can have benefits for individual patients and their outcomes, as well as for the flow of patients through the wider health and care system by helping to prevent avoidable admissions and support safe and timely discharges.
“Virtual wards represent a significant change to the way that the NHS delivers care in the community and will require joined up working across the health and care system. Given the scale of the challenge, access to sufficient funding and support will be essential to ensure that the benefits of virtual wards are delivered for patients.”
FCC Insight
“Virtual wards can offer real value to both the NHS and patients, reducing pressure on bed space and enabling patients to receive monitoring and treatment in the comfort of their own homes. But there is also a risk that cost savings will come at the expense of patient wellbeing. In person appointments may still represent an essential part of a care pathway, for example, physical checks of a person with diabetes’ feet. Any implementation of a virtual ward should follow good practice guidelines, and outcomes should be tracked, so that patient safety always comes first.”
