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Home Elderly Care Home Care What is a Virtual Ward? Hospital care for the elderly at home

What is a Virtual Ward? Hospital care for the elderly at home

The NHS winter plans this year include 10,000 beds in “Virtual Wards” – to provide hospital care at home primarily for elderly patients with frailty- related issues and/or respiratory illnesses.  A Virtual Ward is a really brilliant innovation – who wouldn’t prefer to be treated in their own home rather than go to hospital?

Virtual Wards

Like a hospital ward, the capacity of a virtual ward is set, and patients are admitted and discharged from those beds. The ward is termed virtual as the beds are not real – not physically located in a hospital – and care takes place at home (or in a care home).  Elderly patients at highest risk of admission to hospital are considered eligible for admission to the ward, as well as those who could be discharged from hospital to continue to be treated at home.

A number of hospitals are already running Virtual Wards, with more to follow this winter.  They are similar to Hospital at Home schemes which provide treatment for elderly frail patients at home (not in a virtual ward).  

What happens on a Virtual Ward?

Patients admitted to a virtual ward have their care reviewed daily by a consultant or GP via a digital platform that allows for the remote monitoring of a patient’s condition and escalation if necessary to a multidisciplinary team.

Patients are monitored through a digital platform, but the care is provided by medical staff assigned to the virtual wards. These are multi-disciplinary teams led by a named consultant or GP. Patients may be given a device to wear, or be given access to tech, that monitors vital signs and reports all information back to the hospital. Clinical teams can see measurements for the patients they are responsible for via a digital dashboard. 

Who is eligible for a bed on a Virtual Ward?

Currently there are quite precise parameters over who can be admitted to a Virtual Ward, which include:

Over 65s with frailty related illness and/or acute respiratory ailments 

Eligible patients for whom it would be an alternative to being admitted to hospital 

The length of stay in a virtual ward is 14 days; so no-one with long-term medical care needs will find themselves “outsourced” to their home.  This also means that only particular and clearly identified medical needs will be treated on a Virtual Ward.

Who is not eligible for a Virtual Ward bed?

Those who are ineligible to be admitted to a Virtual Ward include:

Older people with injuries such as fractures or bone breakages;  those with a mental health crisis;  or someone who needs complex diagnostics that can only be offered in hospital;

And also for safeguarding reasons where being treated at home is determined to be unsafe – perhaps because care support is unavailable. 

What actually happens on a Virtual Ward?

Patients are monitored through a digital platform, but the care is provided by medical staff assigned to the virtual wards.  These are multi-disciplinary teams led by a named consultant or GP. Patients may be given a device to wear, or be given access to tech, that monitors vital signs and reports all information back to the hospital.   

Healthcare professionals still do home visits but support can also be provided via video calls through a tablet to enable check ins and response to urgent calls. 

The NHS remote monitoring – via app or for example tech such as oximeters can include the following:

A Virtual Ward is seen as a successful way to keep people out of hospital, discharge patients early back home, reduce clinical time and give patients autonomy and choice in their own surroundings.  Other benefits include access to multi-disciplinary teams and the opportunity for better communications between different disciplines.  And of course sleeping in your own bed and being in your own home surrounded by everything that is familiar. 

Guidelines for a Virtual Ward

A Virtual Ward is set up and run under very strict guidelines:

  1. Provide acute clinical care delivered by multi-disciplinary team led by a named consultant practitioner or suitably trained GP with clear lines of clinical responsibility and governance.
  2. Have clearly defined criteria to admit and monitor patients supported by daily clinical review
  3. Ensure patients are given clear info on who to contact if their symptoms worsen including out of hours.
  4. Provide patients (and or their carers) with adequate info to allow informed consent and understanding of their care and to support the use of equipment or digital technology such as apps.
  5. Have access to advice and guidance/diagostics equivalent to acute hospital access
  6. Deliver time-limited interventions and monitoring based on clinical need
  7. Be full integrated with eg urgent crisis response or same day emergency care
  8. Be developed for a range of conditions
  9. Risk of exclusion from digital wards through the exclusive use of digital tools

Challenges with Virtual Wards

One of the challenges that has been identified is the availability of integrated social care support for some patients eligible to receive care in a Virtual Ward.  If the support isnt available at home, then a stay in hospital for treatment is the only option.  

A Virtual future?

With the NHS undergoing a digital revolution – digitised patient records and the increasing use of tech and other digital solutions, Virtual Wards is one more step along this way.  It is also a way for patients to have more control, particularly over their surroundings.  The aim longer term is to have 40/50 virtual wards for every 100,000 of the population.  It’s a welcome step for everyone who would prefer to be treated in their own home.   

FAQs on Virtual Wards

Is my elderly parent eligible for a Virtual Ward?

Your parent may be eligible for a bed on a Virtual Ward if they are over 65, are frail and have respiratory related illnesses.  If they have support at home will also be important. 

Do we need to have tech at home to be eligible for a Virtual Ward?

Most patients will be given any additional tech/support needed to become a patient on a virtual ward. 

What happens if Mum's health declines while she is in a Virtual Ward?

Her health will be monitored every day, but if she declines suddenly there will be a process in place for her to raise concerns/the alarm.  

How long can someone stay on a Virtual Ward?

The maximum stay on a Virtual Ward is 14 days.