Virtual Ward Model of Care
Virtual wards are a hot topic in modern healthcare, with the UK government keen to roll out these alternative care opportunities across NHS trusts in England and beyond. NHS Scotland already has Hospital at Home in place, and the analysis of the results of these wards is that they can be very beneficial to care outcomes when used appropriately and for suitable patients.
In 2022, NHS England (NHSE) stated there will be a “…a two-year funded transformation programme to support the development of virtual wards, operating to standardised clinical models, across every area of England.”
In addition to this, “ICSs have been asked to deliver virtual ward capacity equivalent to 40 to 50 virtual ward ‘beds’ per 100,000 population (equivalent to the delivery of up to 24,000 virtual ward beds), by December 2023.”
At The Access Group we’re strong advocates of virtual wards. The virtual ward model of care is an important part of implementing a virtual ward, so in this article we will explain the basics – such as what virtual wards are – as well as moving onto models of care, the implementation and operation of virtual wards, and how our software solutions can help the NHS succeed.
What is a Model of Care?
A Model of Care is a plan of action for delivering one or multiple health services. The Model instructs the best practices for patient care and staff actions, while also accounting for local needs, the wider population, and specific demographic needs.
Health New South Wales (Australia) states that “It aims to ensure people get the right care, at the right time, by the right team and in the right place.”
Like virtual wards and Hospital at Home, there are other terms and phrases used to describe the flexible care at home a hospital can provide. These include:
- Health Home Model
- Patient Centred Medical Home Model (PCMH – US only)
- Advanced Primary Care Model
- Primary Care Medical Home Model
Please note that the NHS has Primary Care Mental Health (PCMH), which shares the same acronym as the Patient Centred model. These are two different models of care.
What are virtual wards?
A virtual ward, often referred to as Hospital at Home, is a patient treatment plan where recovery happens in a home environment.
The logic is that it can both save bed space for urgent care, but also that the home comforts of family, food, and familiarity can help reduce stress which in turn improves the speed and success of care and recovery.
Virtual wards have been trialled since 2009 in one format or another, and were gaining traction between 2018 and 2020, but since the Covid-19 pandemic there has been a quick realisation that major incidents affecting a population might need alternative approaches to traditional care plans – such as helping people recover away from a hospital.
Virtual Ward model
Virtual wards are a model of care. Virtual wards themselves are a plan of action for delivering health services; they have guidelines for best practices and staff responsibilities and are used where appropriate. Virtual ward care itself sits under the purview of an Integrated Care Board (ICB) and operates within an Integrated Care System (ICS).
There are several factors behind the driving forces for this model of care; among them being an increasingly ageing and frail population with associated cognitive problems and complex needs, a flatline of length-of-stay, and a reduction in the number of hospital beds available.
Services have always strived to provide care at home where possible, whether to avoid an inpatient admission, where safe to do so, or in order to expedite discharge. There is ample evidence of hospital-acquired harms, such as MRSI, falls, delirium and institutionalisation. The post-Covid-19 healthcare landscape has highlighted the role technology can play in keeping people safe at home during an acutely unwell episode.
As such, within this model of care are two NHS England pathway priorities for care – acute respiratory infection and frailty. These are the initial avenues of care best suited to the emergence of virtual wards, though pathways for paediatrics, heart failure, and diabetes are progressing through the guidance development stages.
Research shows that, at worst, clinical outcomes are similar to those in traditional, hospital-based models of care, and may be associated with a substantial reduction in the risk of hospital readmission at six months, and "little to no difference" to mortality at six months as a result of admission avoidance.
There is also an evidence-base that supports the benefits of a Hospital at Home model of care from the patients' perspective. Provision of hospital-level care in the home is well received by patients, their caregivers and healthcare providers. Some of the reasons referenced include a more personal style of care and a feeling that staying at home was therapeutic. The Hospital at Home model also offers cost savings by delivering care at a similar or lower cost than an equivalent admission to an acute hospital.
Delivering the Virtual Ward model
Virtual wards are only now able to be rolled out on a larger scale because of modern healthcare technology, which begs the question: how do you deliver your virtual ward?
There are many virtual ward technologies available to monitor patients remotely. The Access Group initially offers Access Assure, which is a solution combining a home hub, wearable monitoring devices, and software to record vitals and report them back to the care provider.
Other virtual ward appropriate technology includes:
- Access Adam Care Commissioning
- Access Patient Flow Manager
- Access Rio EPR
- Access Elemental
For more information on these, please read our virtual ward technology article.
Virtual wards will evolve, and when they do the NHS will need to reassess its software standing: can the solutions currently being used adapt and evolve with your needs?
The Access Group has a partner scheme to work with other software providers and their solutions to establish interoperability between programs to benefit Trusts and local authorities. We understand the importance of collaboration in healthcare when considering the tight budgets that departments are working to and the need to work within existing systems.
We know the importance of flexibility and being able to pick and choose from providers to see who can deliver, who can be trusted, but at The Access Group we know that our software solutions can adapt. Our solutions are constantly improving the more we learn from healthcare professionals. We’re already ahead of the game with software that is interoperable and can cooperate with other solutions, and we’re proud to say that we have launched a new integrated care solution that links patient flow and virtual wards for a big picture solution to patient admission, treatment, discharge and aftercare.
