The Evolution of Virtual Wards: Is it time for care at Home?

Virtual wards work.?

This week NHS England have issued the Virtual Wards Operational Framework https://www.england.nhs.uk/long-read/virtual-wards-operational-framework/ citing evidence that the delivery of virtual wards (care at home) at scale:

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·??????? Improves outcomes compared to inpatient care

·??????? Narrows gap between demand and capacity

The Framework provides a clear and consistent definition of what we mean when we describe a virtual ward:

“A virtual ward is an acute clinical service with staff, equipment, technologies, medication and skills usually provided in hospitals delivered to selected people in their usual place of residence, including care homes. It is a substitute for acute inpatient hospital care.”

The reports says that “greater consistency nationally in the components of virtual wards would maximise benefits for patients and the wider system”

For Integrated Care Boards this means taking a system wide approach:

“ICBs are uniquely placed to develop a consistent offer of virtual wards and pathways across the system, in line with the functions and core components outlined in this framework. This includes implementing consistent ICS-wide admission and discharge criteria. ICBs could consider provider collaboratives to deliver virtual wards across community, secondary and primary care”

“To maximise the impact of virtual wards, virtual ward capacity should be strategically co-ordinated and delivered at a place and system level alongside existing out-of-hospital and physical hospital capacity, ensuring it is used as efficiently and productively as possible. Having a capacity and demand plan for virtual wards across the ICS can be useful, one that considers both CYP and adults and prioritises key UEC demands as well as suitable discharge arrangements including links with social care.

“Good practice suggests virtual wards and their unique requirements are considered as part of wider ICB digital strategies, addressing any variability in digital maturity across all service providers, based on the?What Good Looks Like framework.”

For Providers this means focusing on the clinical benefits and economies of scale

“Ensure closer alignment of both step-up and step-down functions, and consider opportunities for integration and economies of scale when delivering the core components, which may require joint working between acute and community providers (for example, where providers may need specialist medical input from a neighbouring provider). This will increase the flexibility to match capacity and capability to fluctuations in patient needs and demand.”

For technology partners this means providing scalable, repeatable cost-effective solutions

“The use of digital technologies (for example, medical devices, diagnostic equipment, remote monitoring equipment) can enhance the efficiency of virtual wards as part of system-wide approaches to achieve economies of scale.”

At Sopra Steria we are working with our partners, including Marc Engall and the team at ServiceNow to accelerate the evolution of virtual wards by providing technology solutions that enable clinicians to focus on patient outcomes.

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