Virtual wards saved trust £1.3m a year

It found around £1.3m was saved per year by the “hospital at home” service at West Hertfordshire Teaching Hospitals Trust.

Expanding virtual wards, where some acute services are delivered in patients’ homes, have been a big feature of government and NHS England health policy since covid-19.

Yet some experts question the cost-effectiveness of the policy, and early studies have yielded mixed results.

Niall Keenan, one of the researchers on the study from West Herts, and chair of the East of England clinical advisory group for virtual wards, told HSJ the new research is believed to be the largest to date in England.

It comes after NHS leaders told HSJ earlier this year that virtual wards were being targeted for cuts this year in a bid to balance the books.

Study

About 980 patients on the virtual ward run by West Herts and community provider Central London Community Healthcare Trust, which serves the same area, were evaluated over the course of 2023-24. The patch has been one of the leading adopters of virtual wards.

The patients had been admitted to hospital beds on pathways for airways disease, heart failure and acute respiratory infection.

Researchers compared their experience against a control group of patients, taking into account factors such as demographics and diagnosis.

They found there was a reduced length of hospital stay by 3.14 days on average for patients in the admission diversion cohort, who were admitted to a virtual ward after less than 48 hours in an inpatient bed. This was a reduction of 2.7 days for those on the early supported discharge cohort, who had been in a hospital bed for longer.

While patients tended to stay longer on the virtual ward pathway in order to monitor recovery, the study found virtual wards were cheaper to run than a traditional hospital setting.

The virtual ward worked out at around £118.50 per bed day, in comparison to £569 for inpatient care. The evaluation found net savings of £1.33m over 12 months.

The findings were shared with HSJ ahead of a presentation at the NHS Confederation Expo on Thursday. A three-year study is due to be submitted for publication at a later date.

WHTH chief executive Matthew Coats said the evaluation “underlines the enormous value, impact and benefit” of virtual wards, also often known as “hospital at home”.

“Not only does it reduce hospital stay and save significant sums which can be spent on supporting other vital services, but it also results in an overwhelmingly positive patient experience,” he said, stating that more than 95 per cent of patients preferred virtual ward care.

Other studies

The study comes months after the author of the first evaluation into the cost-effectiveness of virtual wards told HSJ their findings had shifted over time. 

The initial research, which looked at more than 300 patients in the North West, found virtual wards to be more expensive than inpatient care, although the results were contentious. Its author said the cost had since dropped to be roughly the same as inpatient care, in its second year of monitoring.

Another study, published this year, found net cost benefits of a virtual ward in Liverpool.

Dr Keenan said there had been some scepticism about virtual wards. But he said the new research shows “it is possible to do things differently”.

Central London Community Healthcare Trust CEO James Benson said: “We welcome the findings of this study with WHTH which clearly demonstrates how the NHS is changing.”