Virtual Wards – One Year On 2023 Event Recap
Hospital staff explained what a Virtual Ward is, the aims and objectives of a Virtual Ward, what has worked well, what they have learnt and future plans.
Guests from the community were invited to listen and ask questions after the hospitals presentation.
A total of 30 people attended many from local care homes and home care organisations.
About Virtual Wards
Virtual wards allow patients to get the care they need at home safely and conveniently, rather than being in hospital. Virtual wards are in place in many parts of the country, such as COVID virtual wards.
People with other conditions can also be treated in a virtual ward, for example people living with frailty and people with acute respiratory infection. The NHS is increasingly introducing virtual wards to support people at the place they call home, including care homes. In a virtual ward, support can include remote monitoring using apps, technology platforms, wearables and medical devices such as pulse oximeters. Support may also involve face-to-face care from multi-disciplinary teams based in the community, which is sometimes called Hospital at Home.
Key Learning
- Patients for Virtual Wards are currently taken from hospital and onto the virtual ward (their home). Soon there will be trials of admitting patients straight onto a virtual ward after an outside referral (ie from a GP).
- Patients have been very happy with the virtual ward. Main issue patients have faced has been some fear of using the technology, but this has mostly been sorted with a second explanation in their own home.
- The central monitoring hub is now 24 hours, 7 days a week.
- The technology provided does not need WiFi. It will run from data provided by the hospital so patients do not need to use their own WiFi or have WiFi in their homes.
Questions and Answers
Q - Has an equality impact assessment been done. Issues around digitally excluded. Cost of living/wifi?
A - An assessment was undertaken when the virtual ward was being planned, but this is now in the process of being amended, in conjunction with colleagues from SW London. Also, the tablet given to patients runs on 4G (phone signal) so patients do not need wifi or own computers.
Q - What is the definition of a suitable patient?
A - This was related to a clinical assessment, but as we move forward needs to include other factors. Key factors are: have a Kingston or Richmond postcode, be over 18 years of age (although a paediatrics cohort is looking to be trialled soon) and be able to either operate the monitoring kit independently, or have someone with them who can.
Q - Are there plans of for Kingston patients to access elective surgery and support from virtual wards?
A – Virtual wards started off with focus on medical specialties. We are expanding to see where we can impact on emergency surgery. Overtime as the service expands we can have a discussion about how to include elective surgeries into virtual wards model. Likely trials to start from January on patients undergoing neck surgery and from march bariatric surgery to expedite the patient’s return home.
Q - Does virtual wards control room link with 111 services?
A - It is not linked with 111 service, but it does work with them.
Q - I didn't understand the point about packages of care could you explain again?
A - Whilst on a virtual ward those that need a social care package will have this funded by health and not social services as the patient will remain under the care of health. The average stay on virtual ward is 8 days). Once discharged from health, those who are eligible for a package of care will receive this through social care. We have social care representation on our steering committee as well as the Place Based Committee Primary Care Provider Lead, to ensure that the links with primary care and the proactive anticipatory care team are good.
Q Why can't package of care from social care continue? It doesn't make sense from patient and family perspective.
A - There are legal restrictions as to what social care can provide whilst a patient remains under the care of the acute unit. There remains collaboration/liaison with the social care service but the funding sits with health.
Q - Is virtual Wards offered to people who pay for social care privately?
A - As long as they are accessing the hospital as an NHS patient they can access the virtual ward and their private social care would continue as normal.
Q - Do District Nurses continue to visit patients they were already visiting?
A – Yes if needed. This is tailored to patients needs in collaboration between virtual wards and district nurses.
Q - How is the data from the patients handled?
A - Same as normal. There is a consent form for virtual wards and a patient could request their data via the normal notes system. Complaints also dealt with via hospital.
Q – The central remote monitoring hub was not 24 hours at first. Has that changed?
A - It is now 24 hours.
Q - How is medication provided on virtual wards?
A - Put together in the pharmacy and dropped off via home team, cabs or a relative can collect with permission of patients. If the patient needs support with medication it gets provided with the package of care.
Q - Is the service available to mental health patients?
A - The virtual wards is open to all, but must fit the criteria. Hospital has made adaptations for patients on virtual ward. Patients must be able to support themselves or have someone looking after them.
Q - Is there enough funding for the increased demand?
A - Funding comes from SWL and is determined by predictions of demand and throughput. At present the funding is adequate. The hub is managed by Croydon hospital.
Video of the event
You can watch a recording of the event below.
If you want to see what was said in our first Virtual Wards event from 2022 it is available here.
