The doctor is here to see you – online

At the start of the year the UK government announced it was planning to expand the use of virtual wards, with the goal of treating up to 50,000 patients a month. Here Managing Director of Provide Digital, Paul Twyman, explains how this expansion will reduce pressure on the NHS, reduce waiting times, and improve care for patients.

 

Ok, let’s start with answering the question on everyone’s lips. What is a virtual ward?

Virtual wards allow patients to get the care they need at home safely and conveniently, rather than being in hospital.

The idea is that the individual gets hospital-level support which can include remote monitoring using apps, technology platforms, wearables and medical devices and even face-to-face care from multi-disciplinary teams based in the community, without leaving the comfort of their own bed.

There is huge potential for this to become the future of healthcare, designed to allow for greater patient independence, a faster discharge, and to help avoid any health deterioration due to an extended stay on a hospital ward.

But why?

With modern medicine improving life expectancy, we’re witnessing an ageing population.

And with this comes more demand for healthcare than ever.

Virtual wards free up beds for acute conditions while allowing people to be safely monitored with regular checks and interactions with doctors and nurses in a more relaxed setting, with the benefits being reduced stress and improved recovery.

Virtual wards aren’t a replacement for hospital care, they are an alternative.

But what they are doing is allowing the NHS to operate more efficiently, providing the best care possible while being able to properly prioritise urgent and ongoing care.

What’s new then?

In January the government announced it aims to scale up virtual wards, with an ‘ambition’ to treat up to 50,000 people a month.

As well as expanding virtual wards the government says it will expand community services, including falls and frailty teams and urgent community response teams.

NHS England states there is “growing evidence that these are a safe and efficient alternative to hospital care, particularly for frail patients” and the announcements come as part of efforts to reduce intense pressures and record waiting times for NHS services, and ongoing strike action by nurses and ambulance staff.

Can it work?

It’s ambitious. After all, it would represent a five-fold increase on current volumes.

But if the NHS invests properly in systems to manage this increase, there’s absolutely no reason why it couldn’t work well.

But digitalisation of trusts can be a slow process and so far, the NHS has only introduced a patchwork of various virtual ward initiatives and pilots to aid with elective recovery efforts following the pandemic.

According to NHS England, there has been an increase of 7,000 patients cared for through virtual wards, a 50% increase since last Summer.  But it promises a further 3,000 ‘hospital at home’ beds will be created before next winter.

Where is it working?

Glad you asked. We have been at the forefront of technology that will streamline this system further, making sure that the right support is available in the right places to manage people recovering at home.

This is all thanks to technology we developed in the height of Covid-19 – our Bed Bureau.

The software provided the Essex NHS Trust with bed management online that allowed medical staff to quickly determine where beds were available in community hospitals as the pandemic escalated.

A web-based application, it tracked availability of beds on a public dashboard, keeping users updated with information about open beds and unavailable beds for seven days and even determining male and female ward space and categorising infections through a red, amber and green system.

The system is still in place today and used for other scenarios such as beds for stroke patients, ICU and maternity and now, thanks to further tweaks, its ready to support the growing need for virtual wards.

In short, the software – VirtuWard – allows medical staff to log in and see how many virtual ward “beds” are available, what the capacity is in a given area for these patients to be supported and keeps track of discharges.

Staff can allocate beds depending on the type of condition – such as frailty, respiratory of physical ailments and keep track of treatment.

Essex isn’t the only trust adapting either.

In Norfolk and Norwich University Hospital every specialty is being encouraged to create its own virtual ward with a set of junior doctors, consultants, ward clerks, and pharmacists while patients remain on the same IT systems, much the same as patients in a bricks and mortar ward.

Meanwhile NHS Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care Board has launched a virtual ward service for patients on a selection of care pathways.

Keep it digital

The only thing that could scupper progress here is if trusts do not deploy efficient digital software to monitor these patients they are not seeing every day on their rounds.

Clinical safety must be a top priority and virtual wards can help achieve it by providing patients with the sense of security – and a excel spreadsheet won’t cut the mustard.

It is easy to overlook just how central wards are to the smooth running of a hospital. Wards bring order and coordination where there would otherwise be chaos and confusion. So virtual wards apply this sense of order and coordination to patients receiving care at home.

Every ward has certain defining characteristics, including a fixed number of beds, a team that is based on that ward, a set of routines such as theward round, obs round, board round, drugs round, and multidisciplinary team meeting, and a central communications hub.

The same must apply to virtual wards.

And this is where the role of technology is so important – to recreate these characteristics as effortlessly as possible in the virtual world.

Today there is a mature marketplace in virtual ward software, ranging from highly configurable platforms through to specialist, off-the-shelf tools. There is also a growing range of digital devices allowing clinicians to examine virtual ward patients remotely.

But what constitutes a digitally mature virtual ward is continually changing so generally it pays off to work with a bespoke software provider that can adapt innovative technology to make it bespoke.

If this is of interest to you and you want to find out more about our product, book a consultation today.

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