Virtual Wards: Lessons Learned and Future Considerations

Virtual wards provide a flexible alternative to traditional inpatient care. Using a combination of tech-enabled care devices, real-time remote monitoring, and coordinated care pathways, virtual wards allow people with acute or long-term conditions to be managed remotely, reducing unnecessary hospital admissions and enabling earlier discharges.

This model has proven particularly effective in helping those in post-operative recovery and people with certain long-term conditions like diabetes, respiratory illnesses and heart failure. A systematic review and meta-analysis published in JAMA Network Open found that some virtual ward transition systems led to a 14% reduction in mortality and a 16% decrease in hospital readmissions for heart failure patients. These findings highlight the potential of virtual wards to improve outcomes for both patients and care providers.

Recognising their success, NHS England (NHSE) has committed to expanding virtual wards throughout the UK. In May 2024, NHSE announced £150 million worth of virtual ward funding to enhance virtual ward capacity, with a target of maintaining virtual ward occupancy levels above 80%.

While there have been no new budget announcements for virtual wards in the NHS’s  2025/26 Operational Planning Guidance or the government’s ‘Road to Recovery’ Mandate released in January, the 10-year plan, due to be published in spring, may outline whether additional financial support will be allocated to further expand virtual wards.

In partnership with The Access Group, North East London NHS Foundation Trust (NELFT) successfully implemented a COPD (Chronic obstructive pulmonary disease) virtual ward model that’s so far shown to have a positive impact on patients, the Trust, and its acute partners.

The digital platform integrated into the virtual ward by sharing real-time data from Whzan’s remote monitoring devices to Access Rio, the Trust’s electronic patient record (EPR), and Access Patient Flow, which monitored the entire virtual ward.

The connection between these systems and the data that fed between them ensured seamless communication between multidisciplinary teams and the BHRUT Acute consultant. This not only improved the coordination of staff and improved each individual’s care but also demonstrated the following benefits:

• 45% reduction in admissions, easing the burden on emergency services and improving capacity in hospitals.
• 97% patient satisfaction rate, with individuals feeling more in control of their care.
• 400-500 bed days saved, optimising resource use whilst improving patient outcomes.

The successful implementation of this model is a clear example of how virtual wards can be scaled to enhance the efficiency of health and social care systems and improve patient experiences across regions. The simple and easy integration with the Trust’s existing clinical systems, coupled with the ability to view real-time insights, proved to be a game changer and enabled care teams to communicate and coordinate effortlessly.

In addition to the positive impact on operations and patient care, the virtual ward model also had significant benefits for staff in their daily roles. It empowered the team to deliver holistic, person-centred care within patients' homes, which they found deeply rewarding. The management of the virtual ward also contributed to improved job satisfaction, with some staff noting the positive impact on their wellbeing and working lives.

Despite the successes with NELFT’s virtual wards pilot, naturally, there are some key lessons to be learned from the programme and from providers that have ran similar initiatives. Understanding these lessons and insights from reports such as the Nuffield Trust will be crucial as virtual ward pathways are expanded and refined to meet the growing demands of health and social care systems.

1.     They’re Not a ‘One-Size-Fits-All' Solution

While virtual wards offer a valuable alternative to traditional hospital care, they are not a replacement for hospitals. Certain medical conditions demand close, immediate intervention that a hospital setting is better equipped to provide. For example, if a patient with sepsis is admitted to a virtual ward to recover but begins to deteriorate quickly, the time it takes for an ambulance to arrive and for a hospital to secure a bed could delay critical treatment.

Sepsis is a time-sensitive condition, and the immediacy of in-hospital care—where life-saving interventions such as antibiotics and fluids can be administered immediately—remains crucial. In contrast, patients on a virtual ward do not have immediate access to such interventions, which may lead to worsened outcomes if the condition escalates without timely intervention.

However, virtual wards remain incredibly valuable in preventing avoidable hospital admissions for conditions that do not always require acute oversight. With real-time monitoring and early warning systems, many deteriorations can be detected and acted upon before they become emergencies. Remote monitoring tools allow care teams to track vital signs continuously, often leading to earlier interventions than what might occur in a hospital, where observations are typically taken at set intervals.

In addition, for many patient cohorts—such as frailty patients or individuals with long-term conditions like COPD, diabetes, or mild heart failure—the comfort and familiarity of a home environment can contribute to better outcomes, reduced stress, and a faster recovery process.

2.     Costs are Difficult to Quantify (but aren’t the only savings)

One of the biggest challenges of virtual wards is defining and evaluating their cost benefits. The financial debate intensified after a British Medical Journal (BMJ) article published in January 2024 suggested that virtual wards could cost nearly twice as much as traditional hospital care. However, more recent analyses, such as the South East region evaluation, provide a different perspective on virtual ward costing models, highlighting potential savings of up to £10 million and demonstrating that virtual wards are effective in reducing pressure on acute care services.

Much of the scepticism around virtual wards stems from the complexity of cost measurement. Unlike traditional hospital stays, virtual wards involve a mix of direct and indirect expenses, including investment in technology, staffing, remote monitoring tools, and digital infrastructure. In addition, indirect savings—such as reduced hospital readmissions, improved bed availability, and lower long-term care costs—are harder to quantify in strict financial terms. This makes it challenging to capture the full economic picture in simple cost comparisons.

While upfront costs may appear high, however, virtual wards contribute to long-term savings by preventing avoidable hospital admissions, reducing lengths of stay, and enabling earlier interventions that prevent deterioration. A well-run virtual ward can keep patients healthier for longer, reducing their reliance on expensive inpatient care and easing workforce pressures by allowing clinical staff to focus on the most critical cases.

Moreover, the benefits of virtual wards extend beyond cost savings—they also contribute to environmental sustainability. A prime example comes from University Hospitals of Leicester, which shared during an NHS Confed webinar last summer that since launching their virtual ward program in 2020/21, they have saved £635 per admission (for stays of 2-5 days) and prevented 219 hospitalisations—equating to an impressive 8 tons of carbon emissions.

Beyond reducing hospital admissions, virtual wards also minimise the need for patient travel, further lowering carbon footprints. Patients receiving care at home avoid potentially costly taxi fares, reliance on family or friends for transport, or the stress of long commutes to hospital appointments. This not only enhances convenience and accessibility but also reinforces the sustainability benefits of shifting care closer to home.

Lastly, and possibly the most important saving comes in the form of resource optimisation. Shifting suitable patient cohorts to virtual wards enables hospitals to free up beds for those in need of acute care. This not only helps them avoid costly emergency interventions, but it also improves the efficiency of the health and social care system overall.

3.     Digital Integration is Essential

A successful virtual ward depends on a robust digital infrastructure. Digital platforms that integrate with existing health and social care systems mean that not only do care professionals have to go through extensive training to be able to use them, but they also enable everyone to have access to the same up-to-date information. As a result, communication between teams is streamlined, and patient records can be updated quickly and accurately to make it so care remains coordinated and responsive.

To ensure the team at NELFT was well-prepared to manage the virtual ward, the Trust implemented a comprehensive three-month clinical training programme. This initiative upskilled general and non-specialist nurses in managing COPD cases, equipping them with the necessary skills and knowledge to safely care for patients in their homes.

The programme also focused on familiarising staff with the digital tools and processes needed to carry out peoples’ care plans effectively. This hands-on training ensured both the staff and individuals they were caring for could confidently navigate the technology while delivering high-quality care.

The smooth implementation of these processes at NELFT was only made possible by the joined-up approach between providers and systems. If parts of the Trust were still relying on paper records or disconnected systems, patient information and notes that could be crucial to their recovery may have been easily lost or siloed, undermining the effectiveness of the virtual ward.

As such, for these programmes to truly make a difference, the systems they rely on need to be digital and interoperable, and integrated across all levels of care—from acute settings to community providers. It’s even more essential that data flows seamlessly between these different services to ensure care is properly coordinated and outcomes are improved for the better.  

4.     Technology Must Be Aligned with Clinical Workflows

One of the key lessons from working with NELFT has been the importance of mapping out existing workflows before implementing technology. Rather than simply introducing digital tools and hoping they improve processes, successful virtual ward models are built around the needs of clinicians and the way they work.

NELFT took the time to engage with frontline staff, understand how care was being delivered, and identify areas where digital solutions could enhance, rather than complicate, their workflows. This collaborative approach ensured that technology was seamlessly integrated, making it easier for staff to deliver care rather than adding administrative burdens. As a result, adoption was higher, processes were more efficient, and patient outcomes improved.

This approach mirrors the experience of other health and social care organisations that have successfully implemented virtual wards, where aligning digital tools with real-world clinical workflows has helped them avoid common pitfalls such as resistance to change, inefficient processes, and underutilisation of technology. Instead, the focus remains on ensuring that virtual wards truly enhance patient care while being practical and intuitive for the teams delivering it.

5.    Patient Engagement Plays a Major Factor

Effective engagement with patients and their caregivers is key to the success of virtual wards. Not only is it imperative that patients have clear guidance on how to use virtual ward technology, such as the devices used to monitor their vital signs and follow certain protocols, but they also need to know how to seek support and escalate an issue where necessary. This not only ensures the technology is being used effectively but also empowers patients to actively participate in their care.

As far as feedback goes, the positive impact on the people being cared for at NEFLT was evident: 86% of those surveyed reported feeling less anxiety and more comfortable being treated at home compared to traditional hospital wards, while 57% reported that being monitored continuously gave them reassurance and peace of mind.

Many patients expressed that being in a hospital environment, often distant from home and familiar surroundings, left them feeling anxious and disconnected. One patient noted, "I felt like just another number in the ward," emphasising the lack of personalised care. Others mentioned how hospital wards often felt isolating, with long waits for attention and a sense of disempowerment.

In contrast, the virtual ward experience was notably more comfortable. Patients appreciated the ability to recover at home, where they felt more in control of their care. One patient shared, “I sleep better at home, am more comfortable, and have my regular support from carers, family and friends.”

Moreover, NHS England and multiple Trusts including, Hampshire and Isle of Wight Healthcare NHS Foundation Trust, Liverpool University Hospitals NHS Foundation Trust and University Hospitals Plymouth NHS Trust, all noted that patient satisfaction was much higher from being continuously monitored on a virtual ward, which contributed to a faster recovery.

6.     Always Be Prepared to Adapt

Ongoing evaluation will always be needed to ensure that virtual wards continue to meet the evolving needs of patients and care providers. This should be the case with anything related to care if we are to ensure it remains scalable, cost-effective and makes a genuine difference to patients and providers.

By integrating data analytics and establishing robust feedback mechanisms, NELFT were able to carry out regular assessments of the effectiveness of its virtual ward model, identify areas for improvement, and make adjustments in real-time where necessary.

These insights continue to enable the Trust to refine its processes, improve patient safety, and enhance the overall quality of care delivered remotely. For instance, patient satisfaction surveys, real-time monitoring data and clinician feedback can highlight pain points or opportunities to streamline workflows, ensuring that care delivery remains both efficient and effective.

Continuous evaluation is not just about tracking performance metrics; it’s about adapting to the challenges of real-world implementation. Virtual care models must evolve as technology advances, patient needs change, and new care protocols are developed. This commitment to flexibility and innovation ensures that virtual wards are not only sustainable in the short term but also poised to thrive in the long term.

As health and social care systems continue to integrate digital solutions, the ability to continuously evaluate and adapt will be essential for maintaining the success and scalability of virtual wards while ensuring that patient outcomes are improved and care delivery remains efficient.

Virtual wards may not be a silver bullet, but they represent a significant step toward a better future,; blending technological innovation with patient-centred care. The experiences of health and social care organisations, including our work with NELFT, highlight the importance of digital integration, collaboration and continuous improvement in ensuring virtual wards achieve their full potential.

As more health and social care systems adopt virtual wards, the focus should remain on ensuring they are well-integrated, sustainable and responsive to patient and provider needs. Being prepared to learn from past implementations, refine processes and adapt accordingly will set the stage for virtual wards to continue enhancing care delivery and improving patient outcomes at scale.