Virtual wards offer a crucial solution to NHS capacity challenges, and enabling innovative and personalised nursing care, writes Natasha Phillips
I left the NHS earlier this year after three decades of service. As a nurse I worked at every level across secondary and primary care culminating in working at the national level for the past three years. Throughout all stages of my career, I have been driven to improve the experience of patients and staff, and increasingly those improvements had a digital and data component.
My experience has given me a deep understanding of the NHS, what is working well and what needs help. My operational and senior nursing roles in acute hospitals left me very aware of the issues of high bed occupancy and the impact on patients and staff.
We are underbedded as a nation and need more bed capacity urgently. While creating more physical beds is one option, it takes time, but much more significantly, we’d never be able to staff them – currently, we have a shortfall of more than 50,000 nurses, which is why virtual wards are so important to the NHS.
It is what patients are asking for
And even better, patients love them. Home has huge advantages especially when using digital tools providing home monitoring and it is interesting that the big surveys on public opinion published this summer demonstrate that very clearly indeed; if anything the public is ahead of the NHS on this.
Seventy-nine per cent of people of all ages said they would be happy to use different types of health monitoring equipment to help manage their health if an NHS professional recommended it to them. This readiness only increased with age – 89 per cent of people aged over 75 were willing to do so.
These statistics are from a large survey undertaken by Ipsos and released at this year’s NHS Confederation conference in June 2023. This was a survey of more than 1,000 adults in the UK – a third of whom live with one or more long-term conditions – commissioned by the NHS Confederation and Google Health.
New old-fashioned nursing
One of the aspects of this new model I find most exciting, is the opportunity it brings to deliver nursing care in new ways. I was interested to learn from chief nurse information officer Emily Wells that the virtual ward at Norfolk and Norwich University Hospitals Foundation Trust had no staff sickness at all in its first year of operation, and wanted to talk to the nursing team led by Claire Beard about why this might have been. Sister Beard and her team told me how rewarding this way of nursing was for them as they saw their acute patients really flourish on returning home.
They explained that on the wards they often felt they had many different aspects to juggle, whereas their time on the virtual ward meant they could give their full attention to each patient and deliver, as one nurse put it, “proper old fashioned nursing care”. This ability to give focused and personalised care is what the team loves so much, and it’s made possible by remote monitoring technology and virtual consultations.
This point was echoed by Becky Ashworth, lead nurse for Doccla, in a recent webinar I chaired, attended by more than 100 nurses, as she outlined a “day in the life” of a remote monitoring nurse. The audience was fascinated about how this new way of nursing is becoming part of nursing careers and were keen that student nurses have opportunities to shadow nurses working in this way.
So virtual wards really do matter, we need to continue the great start that has been made with more than 6,000 people cared for this way each month currently, and provision in every integrated care system.
Going beyond virtual wards
It is without doubt that this will relieve some pressure on our hospitals but to achieve real impact we must move beyond “virtual wards” to remote models of care as a first offering, to avoid people going to the hospital in the first place. Moving the entry point from hospitals to communities, we need to continuously grow the numbers of people who are offered this model of care, think creatively about pathways so that more conditions can be supported at home and get seriously into support of other types of digital home care such as long-term conditions monitoring, support in care homes and in urgent care pathways such as ambulance response teams and community urgent care. This is how we will really impact flow, improve ambulance handover delays, reduce pressure in emergency departments, and reduce bed occupancy to levels that can cope with peaks in demand.
This summer virtual wards became a deeply personal mission when my mum had a fall and subsequently died in hospital. I believe passionately that this was avoidable, in a tech-enabled care system mum could not only be more closely monitored but the information could be shared more seamlessly and elements of care, like fall prevention, could be delivered remotely. All of this is possible today and we must work harder to broaden virtual wards beyond early discharge to a medley of technology-enabled care delivery models that don’t just tackle our capacity issues but improve outcomes and experience.
The time is now
We have talked about moving to more home-based care since I joined the NHS, what is different this time is we have the technology to give us much more visibility of people at home, to be more present in their homes. We must act more swiftly to prevent stories like mine and give the NHS the space it needs to flourish and be sustainable. That’s why I think that virtual wards matter so much.