By Claire Fisher, Chief Nurse at Xyla Elective Care
Targets have been set by the NHS for Trusts to deliver between 40 to 50 virtual beds per 100,000 population by December 2023, with NHS England making £450m of funding available over the next two years to help establish virtual wards.
These ambitious targets don’t come without concerns amongst NHS professionals who are experiencing vast elective waiting lists, increased pressures and a high number of nursing staff leaving the profession.
What are virtual wards?
Virtual wards provide support for patients who would otherwise be in hospital, supplying the acute care, monitoring and treatment they need in their own home rather than receiving this care on a hospital ward. This will enable patients to be discharged earlier from hospital or avoid hospital admission altogether. The patients are equipped with the tools to record and share observations on their health from the comfort of their own home.
Initially launched to support Covid-19 backlog patients, virtual wards are now being rolled out at scale. The most recent guidance from the NHS asks for all integrated care systems (ICSs) to extend or introduce the virtual ward model, setting expectations for ICSs to implement virtual ward models for two pathways – acute respiratory infection and frailty.
The digital technology and advanced data systems will provide the ability to deliver services in new ways that more efficiently meet the needs of both the patients and staff, ultimately freeing up space within NHS Trusts and increasing capacity for other patients who are perhaps in greater need of a hospital bed.
There are currently six million patients on waiting lists for elective care, an increase of 1.6 million since pre-pandemic, with long delays in care leading to the deterioration of existing conditions, as well as loss of independence and inability to continue with work or education.
In addition, a recent report from the Nursing and Midwifery Council (NMC) has disclosed that after a period of steady decline in the number of nurses leaving the profession, this year that number has increased by 3,199.
In the same report, 6.3% of respondents stated staffing levels as being one of the top three reasons for leaving the profession and 18.3% stating that there was too much pressure, resulting in increased stress and poor mental health.
These pressures have been amplified dramatically since the pandemic with many staff reporting feeling undervalued, exhausted, and unable to continue to provide the desired level of care to patients.
Virtual wards provide a capacity solution and also offer benefits to nursing professionals and patients.
Remote and flexible working
The virtual wards model will create new jobs for nurses who are interested in a different way of working which brings added flexibility and the opportunity to work remotely.
The option to work more flexibly could also help with retention, improve job satisfaction and enhance health and social care integrated multidisciplinary team working.
Experienced matrons will be recruited in line with the good practice recommendations set out by the NHS to deliver the virtual wards and the matrons will manage a team of nurses who provide proactive and continuous remote monitoring of patients. The flexibility provided by the remote model will free up time and make the best possible use of staff skills and experience.
Benefits to patients
By providing an in-person element to the service (for example a visit for a blood test) alongside advanced monitoring technology, each solution can be personalised to the individual patient. The virtual ward patients will ultimately be handed back to local services at the time of discharge with guidance on how to coordinate their future care, a review of their medicine and education for patients on their self-care.
There is however a need to be establishing those patients who are eligible for the virtual wards as soon as possible in their journey and recognising those patients who are more likely to require readmission so that work can be done to reduce that risk. By having the virtual wards in place, patients will be closely monitored to detect any deterioration so that early intervention can be given.
Virtual wards are a promising new way of working with advanced technologies and have the potential to address some of the many pressures the NHS are facing today.