More patients are experiencing delayed discharges from hospitals, but integrated care boards (ICBs) are working with system partners to develop new and innovative ways to address this. In the first of four case studies, Kathy Oxtoby reports on how Central London Community Healthcare Trust is approaching this longstanding issue via virtual ward and Quick Start initiatives.
To reduce unnecessary delays to discharge and needless admissions to hospital, Central London Community Healthcare NHS Trust‘s (CLCH’s) Hospital at Home Service in Wandsworth and Merton operates as a virtual ward.
One of the first community trust-led virtual wards in the country, it combines technology and face-to-face visits to allow hospital-level care, including diagnostics and treatment, to be carried out in a patient’s own home.
Through on-the-spot blood testing, remote monitoring and face-to-face visits from advanced nurses at CLCH, frailty patients receive the hospital-level care they need safely and conveniently and closer to their support networks, the trust says.
Since its launch in December 2021, the trust estimates the initiative has saved approximately 4,836 hospital bed days in Wandsworth and Merton (as of August 2024).
This approach helps to ease urgent and emergency care capacity pressures by improving patient discharge rates, or avoiding admission.
The trust’s Quick Start initiative brings together CLCH’s Hospital at Home and discharge services to provide ‘the right care to patients at home’, the trust says. Patients can be provided with therapy, medical or social care support dependent on their needs, preventing admission to hospital and supporting earlier discharge from hospital.
CLCH works with acute services at the point of admission to ensure that the package of care a patient needs at home will be ready for them as soon as they are well enough to leave hospital, preventing delays due to the absence of safeguarding support or equipment to help their recovery, the trust says.
Dr John Rochford, deputy chief medical officer at Central London Community Healthcare NHS Trust says: ‘In collaboration with South West London Integrated Care System – our partners in acute, primary and social care – we provide tailored support to care for our communities at home.’
He says CLCH and the South West London ICB are ‘enhancing patient care through the use of virtual wards with a focus on ensuring seamless integration of services, pre-hospital care to help patient flow and improving patient outcomes through prevention and early interventions’.
‘The partnership around virtual wards exemplifies a shared commitment to delivering high-quality healthcare in many areas, such as digital solutions to support clinicians to make quicker and safe bedside decisions, to meet the needs of the community,’ he says.
‘This innovative way of working means that we are able to support more patients to get better in their own homes, helping them to avoid unnecessary and lengthy admissions to hospital, which can have a detrimental impact on their health,’ says Dr Rochford.
‘Patients fare better in familiar surroundings, when they can sleep in their own bed, eat the food they like and have friends, family and pets around them whenever they wish,’ says Dr Rochford.
Mark Creelman, Merton and Wandsworth place lead at South West London ICB, says: ‘Across South West London, there are four virtual ward – hospital at home – services covering our six boroughs, all with face to face and remote monitoring capabilities to provide hospital level care for patients who would otherwise be on a ward, in the comfort of their own home where it is safe to do so.
‘We now have 415 “beds” with a central remote monitoring hub operating 24 hours a day, seven days a week to support patients’ own monitoring, and we continue developing our virtual wards to improve services, help ease pressures on urgent and emergency care and contribute to reducing avoidable admissions.’
Further analysis and case studies
Read more about tackling delayed hospital discharge and improving patient flow in this analysis, and discover some of the other inspirational work being done across England in the other case studies in this series:
- Case study 2: Improving the discharge lounge at the Royal Free London NHS Foundation Trust
- Case study 3: A home-first ethos from Mid and South Essex ICB and Mid and South Essex NHS Foundation Trust
- Case study 4: A person-centred HomeFirst model by Leeds Health and Care Partnership
This case study was originally published by our sister publication Healthcare Leader.
