Hospital Wards vs Virtual Wards

A person’s wellbeing is still the priority, and the modern NHS ward needs to utilise both the hospital ward setting and the virtual ward setting. The future of healthcare cannot afford to limit itself solely to recovery on wards in a hospital. It needs to accommodate people and better identify their needs. Data shows the benefit of familiarity and comfort in a setting, as well as the capacity to interact socially to a degree (with a partner, immediate family etc), is a huge aid to patient recovery through positive mental impact.

The media has come to recognise this over the past few months. They understand the need for the NHS to evolve in order to cope with a population both growing and living longer in a technological age where new medicines and treatments are appearing almost monthly. This evolution needs to be harmonious though, and below we’ll explain the pros and cons of both types of wards and why success will come from operating in tandem – all to the good of the people in need of care.

The key difference between a hospital ward and a virtual ward is that the hospital ward is in a hospital, with patients recovering on a ward actively staffed by clinicians available at a moment’s notice.

A virtual ward is designed to emulate the care provided in a hospital setting, such as regular monitoring of a patient’s vitals, but for those less in need of immediate care. Trials are currently targeting those recovering from respiratory conditions, with the benefit of less stress recovering away from the hospital and better usage of beds that could help those receiving urgent care.

The challenges facing virtual wards are something we have delved into previously. Like all aspects of healthcare, there are inevitably drawbacks – or potential hindrances - with virtual wards. Virtual wards are meant to be an extension of the hospital ward rather than a replacement - an alternative that better suits a patient’s needs – but virtual wards are not always appropriate.

Urgent response: Some patients will not be suited to a hospital at home situation within a virtual ward because of the risk to their health from their condition. Whilst clinicians can be rapidly dispatched, or paramedics, it’s far safer to keep a patient who might need a near immediate response on a hospital ward. This can be mitigated in part by placing a patient into a residential care home, so help is on hand aside clinical monitoring, but this does depend on available spaces.   

Monitoring: A problem with the NHS in general is a staffing shortage. Virtual wards will need to hire new staff, or recruit from elsewhere in the NHS, to fill their roles. Some trusts will do this successfully, and some will struggle. With trusts who struggle, decisions will have to be made regarding who requires what care and can be safely placed at home on the virtual ward based on the availability of staff to monitor and report.

Hardware & Software: Virtual wards need physical hardware – such as   – to be able to take a patient’s readings, along with other wearables. They also need software to be interoperable with existing software. Any hiccups in the data recording chain can hinder monitoring, limiting virtual ward admissions. Regular phone contact or video consultation is an option, and virtual wards should still be utilising clinical visits (typically by nurses) at home, but that may not be the case for all patients.   

Digital Illiteracy: Inclusivity is a buzzword in modern healthcare discussions, but for virtual wards it means the need to ensure that the patients involved can utilise the kit and tools given to them for their own health monitoring.

Virtual ward trials in England, to date, have been strong on offering guidance and support to virtual ward patients, and the telecare kits themselves come with in-built SIM cards to ensure phone signal or wireless internet connectivity.

It’s important that clinician or care worker support continues alongside these solutions. If a patient is incapable of using a device properly, they risk misreporting information or failing altogether, which can then demand more clinician time (a valuable resource) than a hospital ward space would need.

The need for virtual wards has spawned from the fear that hospital wards are outdated as a standalone. Nobody is arguing that recovering in a hospital bed on a ward is a bad thing, but it should not be the default choice. There are concerns that alternatives should be considered and offered to patients, involving them in their own care decisions to give them more confidence in the NHS.

Risk of illness: With repeat usage of antibiotics, it was inevitable that some illnesses or ‘bugs’ would evolve into ‘superbugs’. Things such as MRSA have become more prevalent in recent years, with the BBC reporting on superbugs in European hospitals. Improved cleaning helps, but the fact is that you can’t get a bug if you’re not in the hospital to catch it.

Inappropriate bed usage: Britain’s care sector is extremely short-staffed, whether down to poor recruitment, a loss of staff through Brexit, or other reasons. This means domiciliary care and care home staffing is very limited at present, which has had the knock-on effect of hospitalising those in need rather than caring for them in a home setting. In turn this is bed blocking genuinely urgent care recipients.

Improper usage also should mention those whose hospital stay could be a greater detriment than the care they are receiving. Guy’s and St Thomas’ NHS Trust have an excellent article on the danger of muscle wastage, and the additional care burden that can cause. Beyond that there are also issues with ulcers, mental health, and the quality of rest a patient gets. Hospitals do vital work, but there’s bigger picture wellbeing to consider.

Hospital wards being outdated, or a less appropriate approach, leads us nicely onto the advantages of virtual wards. The Access Group has already talked in depth about the benefits of virtual wards but we’ll quickly run down the advantages of virtual wards helping complement hospital wards.

• Improve an individual’s independence
• Improve care outcomes
• Reduce congestion or human traffic within a hospital
• Be more cost effective for treating some recovering patients
• Free up care beds for more critical or urgent usage by other patients
• Complement the existing care from clinicians as part of the treatment and recovery process

We’ve already stated that demand for healthcare is only going up. Medical technology is advancing, and high-quality food is readily available. This allows society to steadily push for healthier lifestyles, and we’re now making moves towards proper ecological and environmental change for sustainability and reduced pollution. All these factors combine and mean that people are living longer. The longer they are alive, the more likely they will need medical care.

Introducing virtual wards: a remote solution that allows for the regular monitoring of suitable patients without forcing them to be in a hospital. Reduced stress from the hustle and bustle of the medical environment. Easier access for family. Greater comfort and familiarity in a home setting. The ability to eat your own food! It  all plays a part in keeping the patient’s spirits up and their stress down, allowing the body to focus on mending to the best it can do.

Beyond the patient’s needs we can then look at the financial possibilities. Again, referring to our previous virtual wards piece, the following monetary benefits were noted:

• 3% reduction in the average hospital stay
• 50% reduction in re-admission rate after using a virtual ward
• £1,047 in estimated savings per patient, per day, when using a virtual ward
• 94% of patients more confident about managing their condition at home
• 5% reduction in unscheduled emergency admissions when using virtual wards
• 484% return on investment for every £1 spent on telecare for patient monitoring

Some of the financial gains are through savings directly, others are through avoiding repeat injury or illness at a later date, and that re-admission unlocks even more bed space for urgent care patients.

This is why despite the initial start-up costs, the long-term planning for NHS trusts really should be planning to establish and incorporate virtual wards. 10 years ago, this was seen as the future, but the future is here now and ready to play its part in stabilising the NHS.

Hospital wards versus virtual wards is not a question that can be answered. You cannot compare hospital wards and virtual wards as rivals. They can never be true rivals because their purposes are not the same. Instead, you must consider them as healthcare opportunities; different options to be chosen from where one is more appropriate and likely to deliver the best patient outcome. 

Hospital wards will always have a place as the go-to for care and recovery. People will always need aid and dedicated expertise in the face of often scary illness. This is a tough but crucial job, and healthcare professionals have shown their dedication for hundreds of years to help others.

We owe it to these clinicians to help them provide the very best care though, and that’s what virtual wards can and should be doing. Virtual wards are designed as an extension of hospital care; an addition that allows for greater patient choice, better patient prioritisation, and most importantly better care.

People shouldn’t see virtual wards as the enemy of hospital wards. They should see them as the sidekick that can help save the day.

At Access, we're the only supplier that can partner with you to join up your care across primary and secondary healthcare, social care and the care sector. Our virtual ward software can provide visibility for your staff so they have the information they need to provide safe, quality care.

With the NHS announcing a nationwide expansion of virtual wards in August 2024, NHSE England (NHSE) has updated its virtual wards operational framework with new guidelines for providers.

The announcement comes after an evaluation of the South East saw the region save more than £10m from virtual wards and prevent over 9,000 admissions, prompting the NHS to set new goals to support the NHS 2024/25 Urgent and Emergency Care Recovery Plan.

The framework mandates that all virtual wards must meet the following requirements:

• Adhere to strict governance with a GP, consultant physician, or consultant practitioner leading the initiative.
• Must be in operation 7 days a week between the hours of 8am to 8pm, with available support after hours.
• Clear criteria for admission and assessment protocols in place.
• Care plans personalised and co-designed with the patient, involving them in the decision-making process.
• Senior clinician-led daily ‘board’ rounds, with input from the multidisciplinary team.
• Availability of hospital-grade diagnostics.
• Delivery of hospital-level treatments and interventions.
• Use of patient monitoring (RPM) and other technologies to deliver high-quality care.
• Pharmacy services focused on medication reconciliation and optimisation.Clear processes for patient discharge and tracking of length of stay.

Read our Virtual Wards guide for more information on setting up a virtual ward and find out how Access solutions can help you reach your goals.