A new report published for the first time by Healthcare at Home reveals the scale and value of virtual wards supporting NHS patients across the UK. Data from the report reveal insights into the value these services are delivering to both the patient and the NHS, and set out a compelling evidence base for the future delivery of care outside of the hospital setting.
A virtual ward is a service that creates capacity in the system without increasing inpatient beds, by treating people in their own home or usual place of residence. Two virtual ward models are discussed in the report – ‘Recovery at Home’ enables people to return home from hospital earlier to complete their treatment, while ‘Admission Avoidance’ allows GPs to refer people onto the homecare service to prevent admissions in the first place. Importantly, hospital consultants and GPs retain clinical responsibility for the patient – undertaking their care planning and monitoring – while nurse-led multidisciplinary teams provide the care in the home.
In 2014, 21 pioneering NHS Trusts across the UK were using Healthcare at Home’s Recovery at Home model, which treated 15,000 patients, made 175,000 patient visits, saving 130,000 bed nights and creating 379 virtual beds – the equivalent of a small NHS acute Trust.
For patients, the Recovery at Home virtual ward allows them to receive complex clinical care at home, without compromising on the quality of care they receive, while importantly allowing them to continue family life. Additional benefits included enhanced patient wellbeing, experience and satisfaction:
- In the past 12 months, on average, 96% of patients said recovering at home had had a positive impact on their recovery
- 79% said recovering at home reduced their level of anxiety
- 75% said it had increased their level of mobility
For the NHS, bed nights and length of stay are reduced and capacity is released, allowing it to be reinvested in to specialist services:
- Surrey and Sussex Healthcare NHS Trust saved 8470 bed nights between September 2014 and August 2015
- Good Hope Hospital in Birmingham reduced length of stay by an average of 6.1 days per patient from September 2012 to July 2014
- University Hospital Southampton NHS Foundation Trust used the capacity released to invest in specialist services and support its move to become a regional trauma centre
The concept of virtual wards responds to a number of challenges laid down by the NHS’s Five Year Forward View, which included a call for care to be provided closer to home, breaking down barriers in how care is provided between GPs and hospitals, shifting investment from acute to primary and community services and supporting local health communities to choose from radical new care delivery options, including integrated out-of-hospital care. Today’s report helps to quantify the value of virtual wards in responding to these challenges.
If the results of Healthcare at Home’s services at the 21 centres were scaled-up across 145 acute Trusts nationally, the service could serve over 100,000 users and save almost 950,000 bed nights, while also reducing the overall length of stay for these patients. More than 30 clinical pathways have been developed as part of the model ranging from intravenous and subcutaneous medication administration through to physiotherapy and occupational therapy.
Despite these positive steps forward, this report is just the start of the debate about the value of out of hospital services such as virtual wards. Safety and governance are paramount in the delivery of clinical homecare, and as this is a relatively new care model a level of reticence amongst some clinicians and patients remains. A second challenge is awareness and understanding of the scale and value virtual wards can bring to the UK health system, so they become front of mind for caregivers and patients.
Dr Omowunmi Akindolie, Consultant in Ambulatory Paediatrics at King’s College Hospital, worked with Healthcare at Home to pioneer the launch of the first dedicated children’s service. She says, “Clinical homecare provides more flexibility to patients as well as their families and carers along with the added comfort of recovering in their own home. I have been a longstanding advocate for this care model and by partnering with Healthcare at Home, we were able to make this care option a reality for patients at King’s College Hospital with the Children’s Outreach Team service a tailored virtual ward for paediatrics. In addition to the value the service brings to our young patients, hospital beds are made available for children with more acute clinical needs, allowing us to use our inpatient beds more efficiently”.