NHS England looks to virtual wards to help ease pressure on emergency care

UP to 50,000 people a month are to be supported by clinicians at home in “high-tech virtual wards” as part of NHS England plans for urgent and emergency care.

Government says that the number of patients that can be cared for in this way has increased by 7,000 (50 per cent) since last summer and another 3,000 ‘hospital at home’ beds will be created before next winter.

The NHS has already rolled out virtual wards – treating patients in their own homes – and cites growing evidence that these are a safe and efficient alternative to hospital care, particularly for frail patients.

Health and Social Care Secretary Steve Barclay said: “The health and care service is facing significant pressures and, while there is no quick fix, we can take immediate action to reduce long waits for urgent and emergency care.

“Up to 20 per cent of hospital admissions are avoidable with the right care in place. By expanding the care provided in the community, the most vulnerable, frail and elderly patients can be better supported to continue living independently or recover at home.”

Healthcare organisations have welcomed moves to increase virtual wards but point out that resourcing clinical staff remains a major issue.

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, commented on the plans: “Hospital at Home services must be developed and resourced in addition to existing services, not instead of existing services, and they cannot be resourced at the expense of existing services, particularly in the hospital sector.

“These services require the input of adequate numbers of well-trained medical, nursing, rehabilitation therapy and care staff. We do not have sufficient numbers of such staff at present.

“Many older people, particularly those with sensory impairment or cognitive impairment or both, will not be able to access the technology used to manage a “virtual ward”. Ethical issues surrounding the use of remote monitoring, particularly consent, also require consideration. The person should also be able to exercise choice – if they prefer hospital admission they should be offered it.

"Sudden decline of an older person at home often reveals unmet support needs or unaddressed medical problems. New services based at home must be able to seamlessly address these needs and problems.

“Health care is relational not transactional. So called ‘virtual wards’ must maintain the strong relational support that is often necessary to see older people through a period of intercurrent illness, particularly when they are already socially isolated. No amount of technology can replace.”