Virtual Ward Team

There are many different jobs within a virtual ward. A large number of these revolve around the nursing staff who perform the core day-to-day functions, but there are several other specialist and senior roles required for the clinical team (like in a typical hospital ward) to ensure high standards of care. 

The following are advertised virtual ward positions on the NHS Jobs website:

• Consultant 
  The consultant is the doctor, GP, or senior nurse responsible for your medical treatment whilst on the Virtual Ward. They are a core part of establishing the care and treatment plan for a patient.
  
  According to Northumbria NHS, “Consultants will retain clinical oversight for their patients on the virtual ward to support the team across each specialist areas including respiratory, frailty, heart failure and surgery.” In some cases, they can also be required to go out to perform patient visits and evaluate nursing assessments.
  
  
• General Practitioner (GP)
  Some virtual wards will utilise a GP alongside a consultant role, but the functions are similar. They can assess via remote consultations or in person, triage, prescribe, and develop care plans.
  
  
• Advanced Clinical Practitioner
  This is a clinical practitioner who is educated to a masters level. They do not have to be a doctor. Their combination of education and clinical experience makes them ideal for moving into team management and leadership, to lead by example and guide colleagues, and this is a step to reaching consultant level. The role still performs patient assessments in the community and manages patient care.
   
• Nurse Practitioner
  A nurse practitioner is more senior to typical nurses. They are university educated to enhance their clinical expertise and insight and as such can prescribe to patients. They perform virtual ward home visits in conjunction with the Healthcare Support Worker to perform a full health assessment.
  
  
• Clinical Team Leader (aka Assertive Case Manager, Community Matron)
  The day-to-day clinical work of the ward is led by a senior nurse, with three varying job titles depending on the trust hiring. 
  
  
• Virtual Ward Coordinator
  The coordinator is an experienced administrator who works with the wider team (and especially with the consultant) to progress the patient investigations and treatment, so that decisions can be made on care delivery. This involves coordinating the daily patient reviews and typing up the outcomes of appointments, as well as organising future care appointments or sessions. Operational leadership is a big part of the position; staff management (shifts and visits), supervision, and development fall under this remit. 
  
  
• Virtual Ward Manager
  A virtual ward manager is responsible for development and budget. The role sounds similar to the VW coordinator, but it more of a ‘big picture’ position to ensure efficiency, financial sustainability, and appropriate development. 
  
  
• Assistant Practitioner
  According to NHS Health Careers, “Assistant practitioners (sometime known as associate practitioners) have skills and experience in a particular area of clinical practice. Although they are not registered healthcare professionals they develop a high level of knowledge and skill through their experience and training.” 
  
  
• Occupational Therapist 
  
  
• Independent Living Officer 
  
  
• Rehab Support Worker 
  
  
• Nurse
  There are several different Bands of nurses that are used within virtual wards. Please scroll down for our virtual ward nurse section for more details. 
  
  
• Healthcare Support Worker
  The HSW is the first dispatch in many ‘Hospital at Home’ cases. Whilst performing patient visits their duties include performing a cardiograph, taking bloods, and completing the National Early Warning Score (NEWS) assessment. 
  
  
• Physiotherapist
  
  
• Pharmacists (inc. Senior + Technician)
  The duties of a pharmacist involve providing prescriptions of medication and other drugs, and virtual wards will typically work with one or more pharmacists depending on needs. In some cases they may opt to recruit a Pharmacy Medicines Management Technician for medicine reviews, though a Senior Pharmacist is the primary on such review processes. 
  
  
• Ward Administrator (Ward Clerk)
  The ward administrator is an information handler. They have dedicated contact details and act as a relay between the virtual ward team, patients and their families, and outside clinicians such as a GP or their staff, as well as with emergency services where necessary. They provide what the NHS calls ‘receipt and resolution’, which is the collation of enquiries from patients, visitors, and staff so that they can be addressed in an orderly fashion by the virtual ward. 
   
• NHS@Home Pathway Coordinator
  The pathway coordinator position is responsible for orchestrating the patient flow as a step-down into a soft discharge; identifying eligible patients and getting them into the virtual ward for a gradual wind-down in care. 
   
• Social Worker
  A social worker is a community role to engage with patients and their families to highlight concerns, problems, and vulnerabilities, and how best these can be resolved – with the help of the virtual ward or broader community care. 
   
• Health Visitor (inc. Community Nurse)
  According to the NHS, “Health visitors are specialist community public health nurses, (SCPHN) registered midwives or nurses.” 
   
• Patients 
  Without the active engagement of patients, there is no virtual ward, but going further than that is the clinical humility to recognise that patients with long-term conditions often know how to manage their condition better than a doctor due to their lived experience. Including patients in their own care, engaging with them, and learning from them is an integral part to the growth of virtual wards and the cementing of them as a natural part of the NHS. 
   

Please note that virtual wards, like hospital wards, aim to be a multidisciplinary team and as such some roles will see crossover between both the physical and remote care realms. This list also doesn’t account for behind-the-scenes positions, such as a CEO, Transformation Leads, and Clinical Directors. 

Not all virtual wards need every type of personnel however. As discussed in our other virtual ward content, there are five main types of virtual ward at present: 

1. Covid 
2. Respiratory 
3. Frailty 
4. Heart failure 
5. Diabetes 

A specialist in frailty, one of the most common virtual wards at present, wouldn’t be a hiring target for a diabetes ward, and likewise a specialist practitioner in heart conditions wouldn’t be the appropriate hire for a respiratory ward.  

This also impacts how many jobs there are, depending on the scope of the virtual ward care being provided and the size – and needs – of the local population.

Nurses are the primary workforce of the NHS, so it makes sense they would also be pivotal in virtual wards, but what is a virtual ward nurse? 

There are several skill and pay bands within which all clinicians fall, and it’s the same for nurses. Typically virtual wards utilise band 5, 6, and 7 nurses for their operations, but in some cases – depending on the purpose of the ward – they will extend that to include bands 4 and 8.

• Band 4 – Assistant Practitioner (inc. Virtual Ward nursing associate)
  This is the lowest band of nursing expertise in the virtual ward. The position is to support individuals receiving care, and to provide monitoring. Senior nurses will provide guidance and instruction for delivering care as per the patients care plan.
  
  
• Band 5 – Newly-qualified Nurse (inc. Community Nurse)
  This is the entry level for nursing, and these nurses are to use their knowledge to make care judgements. They are responsible for patients on the ward and accountable when assessing them and implementing a care plan.
  
  
• Band 6 – Specialist or Senior Nurse (inc. District Nurse)
  The senior nurses will have an oversight role for Bands 5 and 4, though they still perform a mix of remote and office duties for the virtual ward. They work in-hand with the consultant or GP to enact a patient care plan and manage patients properly. They perform initial admission assessments as well as daily reviews of patients and act based on the evidence and testimony of virtual ward staff. 
  
  
• Band 7 – Nurse Practitioner and Advanced Nurse Practitioner
  Nurses with enough expertise can step up to Band 7. These nurses have a more direct involvement in clinical decision making, akin to the consultant role. They can be overridden, but they are qualified enough to be trusted and to take the initiative in care.  
  
  
• Band 8 – Matron or Chief Nurse 
  This is the top rank for a nurse, short of becoming a consultant. The roles entail “advanced assessment and visible clinical leadership skills” with how the virtual ward handles case management, the virtual ward pathway, and inter-departmental relationships for the purpose of cooperation and coordination. 

Modern day nursing already requires a degree of technological expertise, and that is only increasing with the advent of the virtual ward. Nurses must be confident, not just competent, with the software and hardware used to handle remote check-ups and to take patient vitals. 

Like a hospital, virtual wards need a round. What does a virtual round entail though? 

“Patients are reviewed daily by the clinical team and the ‘ward round’ may involve a home visit or take place through video technology. Many virtual wards use technology like apps, wearables and other medical devices enabling clinical staff to easily check in and monitor their recovery.” 

NHS England 

Daily meetings between staff are important. They are an opportunity to discuss everything from specific patients, overall performance, to query any care decisions, and to provide guidance for the care they will be giving. They are a forum for sharing knowledge and handing patients over from one shift to the next. 

Each virtual ward will have a different approach to patient priority, but whether it’s a number system or a traffic light colour code, the patients most in need or more dependent will be treated as the highest priority for observation, assessment, and contact. As per their duties, virtual ward nurses will then use their knowledge and the assessment (virtual or otherwise) to determine whether a patient stays the same priority or goes higher or lower. 

Some of the virtual ward team are office-based, and some are remote. Modern technology means meetings between the two groups are very easy to organise with things like Microsoft Teams or Zoom.

It’s not a secret that the NHS has a staff shortage. Even the House of Lords has published information on the NHS and care staff shortage. As such, this makes the launch of virtual wards tricky and can be considered one of the virtual wards challenges. There are four options available to help establish this new avenue of healthcare: 

1. Cope with the shortage 
2. Take staff from other departments 
3. Hire staff to handle a dual workload 
4. Recruit externally 

Option 1 is the least acceptable, as you can’t offer healthcare that won’t be properly delivered. There are protocols in place to ensure safety to both patients and staff, and simply these wouldn’t be met. 

Option 2 happens quite regularly in the NHS, so this isn’t a bad option. It has the benefit of bringing in people who have at least some experience, and who are used to how the NHS works. It does then put a burden of fresh recruitment on the previous departments, but all employers have to deal with recruitment. 

Option 3 is also something in progress, and inevitable whether or not a department finds plenty of internal or external candidates. The virtual ward is not a replacement for the hospital ward. It is an alternative recovery setting with the same duty of care and same level of dedication to the patient’s wellbeing. The virtual ward will still require people from a multitude of disciplines, so it makes sense that some specialist staff members would cover both hospital and remote care. 

Option 4 is the most desirable, or at least in conjunction with Option 2. The NHS needed more people before virtual wards and needs further still. The notion of a virtual ward though, and limited face-to-face time (especially in more senior roles) might appeal to some who previously left the NHS and would benefit from this remote monitoring style of healthcare and interaction. 

Regardless of which options are pursued, the NHS is already in some cases offering a ‘Golden Hello’ payment across a 2-3 year period to tempt in new staff from outside the recruiting trust. Such financial incentives are successful, so it makes sense for the NHS to utilise them and encourage people to join new virtual wards. Once established, these wards and their success will convince and attract future talent, but for now there needs to be a little jumpstart in a few areas of the UK to get the ball rolling.

At Access, we’re keen to help NHS trusts and partner organisations deliver virtual wards – something we believe to be the next step in the evolution of modern healthcare. Our virtual wards software solutions support virtual ward teams to provide safe, quality care. We offer home monitoring, electronic patient records, and care commissioning, all of which are interoperable meaning we can help you realise truly joined-up care.