Virtual Wards
““Virtual wards should be technology-enabled to maximise the opportunity they offer for both patients, carers and staff. Technology-enablement means the management of patients via a digital platform.”
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Virtual wards are being introduced at pace into the NHS in England as a way to enhance patient care and improve efficiency within the healthcare system.
A virtual ward is a model of care that aims to provide hospital-level support and monitoring to patients in their own homes or in community settings, thereby reducing the need for hospital admissions or facilitating earlier discharges.
MCO and Virtual Wards
MCO was introduced at University Hospitals Sussex in oncology as part of an Enhanced Supportive Care (ESC) service since late 2020.
An initial review of the impact of the new service was published in the British Medical Journal of Supportive and Palliative Care was in July 2022, and showed:
400 patients across 23 clinicians had benefited to date, across 10 cancer types and 8 hospital sites.
5% fewer unplanned admissions,
Length of stay 1.43 days shorter.
Return on investment of £1.40 for every £1 invested in the new service.
My Clinical Outcomes has since been adopted by Sussex Integrated Care Board (ICB), known as NHS Sussex, to integrate and form part of the roll-out of the regional ‘Our Care Connected’ project and integrated into the regional ‘Plexus’ Care Record.
The first clinical priority is to configure MCO to support initial Respiratory, Heart Failure, Frailty and General Medical Virtual Wards. In parallel work streams are developing around:
NHS App integration to allow patients to access MCO through the NHS app.
Expansion out to all trusts across the Sussex region including Sussex Community Foundation Trust (SCFT), Surrey and Sussex Healthcare NHS Trust (SaSH) & East Sussex Healthcare NHS Trust (ESHT).
Enhancing the tumour and treatment specifity of Patient-Reported Outcome Measures (PROMs) pathways already live in oncology.
Building out additional pathways e.g. to support orthopaedic elective backlog waitlist priortitisation & introduce Patient Initiated Follow Up (PIFU), as well as supporting mental health services.
Read more about MCO work at NHS University Hospital Sussex.
Further Context
The introduction of virtual wards the NHS has driven by several priorities:
Capacity Management: Virtual wards can help alleviate the strain on hospitals by reducing the number of unnecessary hospital admissions and enabling timely discharges, freeing up beds for patients who require short-term acute care while still ensuring appropriate support for those who can be managed in a community or home-based setting.
Cost Efficiency: By avoiding hospital admissions and reducing the length of stay for patients, virtual wards can help reduce costs such that resources can be redirected to other patients and areas of need in the system.
Patient-Centred Care: Virtual wards prioritise delivering care in the comfort of patients' homes, which is often preferred by individuals and can contribute to their overall well-being. Patients often report improved convenience, reduced disruption to their daily lives, and enhanced engagement in their own care.
The implementation of virtual wards involves several key components:
Remote Monitoring: Virtual wards typically utilise technology such as remote monitoring devices and digital health platforms like MCO to enable healthcare professionals to monitor patients' observations, symptoms, and overall health status from a distance. Devices and platforms can also include wearable sensors, smart devices, and mobile applications that collect and transmit data securely to healthcare providers with data being integrated for remote review by skilled clinical teams.
Care Coordination: A multidisciplinary team, that may include doctors, nurses, pharmacists, and social workers, collaborate to provide coordinated care for patients in virtual wards. These professionals work together to assess patients' needs, develop personalised care plans, and ensure appropriate interventions are in place. Communication and information sharing are facilitated by bringing together devices and data collected from platforms like MCO into the local electronic health record.
Early Intervention and Prevention: By closely monitoring patients' health status, virtual wards aim to identify early signs of deterioration or exacerbation of chronic conditions. Healthcare professionals can intervene promptly, providing necessary treatment and support to prevent complications and avoid hospital admissions. Additionally, virtual wards emphasise proactive strategies, such as health education, self-management techniques, and preventive measures, to empower patients and promote better health outcomes.
Enhanced Support and Follow-up: Patients enrolled in virtual wards receive regular check-ins and support from healthcare professionals. These interactions can take place through video consultations, phone calls, or secure messaging platforms. The virtual ward team ensures that patients have access to the necessary medications, therapies, and support services required for their recovery or management of chronic conditions.
The utilisation of virtual wards within ICBs/ICSs is likely to continue to evolve and expand in the future. Introducing remote, digital PROMs through the use of MCO can support the implementation of virtual wards and ensure their success by:
Patient Engagement: Remote, digital PROMs empower patients to actively participate in their own care. By providing patients with a user-friendly digital platforms or mobile applications, they can conveniently report their symptoms, functional status, and quality of life from the comfort of their homes. This engagement fosters a sense of ownership and involvement in their care, promoting better adherence to treatment plans and self-management strategies.
Real-Time Monitoring: MCO allows healthcare providers to receive timely updates on patients' health status. By monitoring PROM data, healthcare professionals can monitor changes in symptoms, identify potential issues, and detect early signs of deterioration. This real-time monitoring enables prompt interventions, reducing the need for hospital admissions and facilitating early interventions to prevent complications.
Personalised Care Plans: The data collected through MCO can inform the development of personalised care plans for patients in virtual wards. Healthcare providers can use the information provided by patients to tailor interventions, medications, and support services to meet individual needs. This personalised approach can help improve both patient satisfaction and outcomes.
Outcome Measurement and Evaluation: Digital PROMs provide a standardised and systematic approach to measuring patient outcomes in virtual wards. By using validated questionnaires and assessments, healthcare providers can track and evaluate changes in patients' health over time. This data is invaluable for assessing the effectiveness of interventions, identifying trends, and making data-driven decisions to improve care delivery.
Research and Population Health Management: Aggregated and anonymised data from MCO can contribute to research and population health management efforts. Analysing PROM data at a population level can help identify trends, disparities, and opportunities for targeted interventions. It can also inform policy-making decisions and improve the overall quality of care provided in virtual wards.
Get in touch if you would like to know more about how MCO can support your virtual wards.
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