Virtual wards

Guidance and resources to support implementation of virtual wards

Virtual wards, often known as Hospital at Home, are a safe and efficient alternative to bedded care. Using technology and face-to-face care, they offer patients who would otherwise be in hospital the choice of receiving the treatment they need in their own home, either preventing them from being admitted to hospital or allowing them to be discharged from hospital sooner.

GIRFT is working with NHS England’s Virtual Ward programme to help NHS teams establish new models of virtual wards, in more clinical areas, and for patients with a broader range of conditions.

An increase in the use of virtual wards was identified as a key ambition in NHS England’s Delivery plan for recovering urgent and emergency care services (January 2023).

On this page, you can find links to useful resources focusing on the key benefits and principles of virtual wards, as well as the practicalities for implementation.

The guidance focuses in particular on frailty services – where Hospital at Home has been used to provide a safe alternative to hospital for patients living with frailty through community-based acute health and care delivery – and on services for those with acute respiratory infections.

Data relating to Hospital at Home suggests that patients are five times less likely to acquire an infection when treated on a virtual ward compared to an acute setting, and eight times less likely to experience functional decline. Virtual wards also serve to free up physical beds for other patients who require an in-patient admission.

Dr Shelagh O'Riordan

Joint virtual wards clinical lead

Shelagh is a consultant geriatrician. She was a consultant at East Kent Hospitals NHS Trust for 14 years before leaving in 2016 to join Kent Community NHS Trust as a community geriatrician.

Shelagh has developed a community frailty team in East Kent, supporting seven community hospitals providing the medical cover and undertaking frailty proactive care as part of the MDT based with integrated neighbourhood teams. In March 2020, as the pandemic struck, the team urgently set up a Frailty Hospital at Home to provide an alternative offer for people living with frailty to hospital admission. This service has grown and is now permanently commissioned.

Shelagh is the professional advisor (geriatrician) to NHS England’s Community and Discharge Cell. She is the lead clinician for the GIRFT virtual wards programme.

Dr Rajiv Sankaranarayanan

Joint virtual wards clinical lead

Rajiv is a consultant cardiologist at Liverpool University Hospitals and heart failure pathway clinical lead at Cheshire and Merseyside ICB.

He graduated from Bangalore Medical College and Research Institute in India in 2002 and moved to the UK to undertake his residency and cardiology fellowship training in Manchester (Wythenshawe Hospital, Manchester Royal Infirmary). He also undertook a British Heart Foundation funded PhD research project into heart failure and arrhythmogenesis.

Rajiv has won several national awards for innovations such as creating the UK’s first NHS heart failure mobile app for patients, and HSJ and BMJ award nominations for creating the world’s first multi-speciality virtual heart failure MDT and developing the Liverpool acute heart failure virtual ward.

He and his team have been involved in integrating artificial intelligence in heart scans to help detect early signs of heart failure, as well as conducting ongoing public screening events in collaboration with Liverpool City Council, the Department of Public Health, Everton Football Club and the Pumping Marvellous Foundation.

He is a board member of the British Society for Heart Failure, British Cardiovascular Society digital and IT committee and clinical advisory board member of the Pumping Marvellous Foundation. He has been part of NHSE England expert committees for HF Virtual Ward, PIFU and diagnostics for virtual ward. He also has an active research role as NIHR advanced research scholar, is an honorary senior clinical lecturer at the University of Liverpool and is the principal investigator of several multicentre research trials. He has more than 50 peer reviewed publications.

Dr Sarah Mercer

Joint virtual wards clinical lead

Sarah is a consultant practitioner for frailty, and an occupational therapist by professional background. She clinically leads an Urgent Community Response and Frailty Hospital at Home Virtual Ward in Hampshire.

Sarah is also a mixed methods researcher with interests in the overlap between physical markers of frailty, mental wellbeing and occupational performance.

Maria Parsonage

Joint virtual wards clinical lead

Maria is the pleural clinical lead and virtual ward clinical lead for North Cumbria. She qualified in 1995 and worked across respiratory medicine and critical care in her early career. With a strong interest in advanced practice, she became an ANP in 2002, completing her MSc in clinical nursing and non-medical prescribing qualification 2005/2006. Maria has worked across boundaries as a respiratory consultant nurse and pleural disease specialist since 2016, and is currently the pleural clinical lead and virtual ward clinical lead for North Cumbria.

Dr Towhid Imam

Joint virtual wards clinical lead

Towhid is a consultant geriatrician and leads the Front Door Frailty service at Croydon Hospital, part of the Croydon Health Services NHS Trust.

He advises on policy around older people and frailty for NHS England, and is a clinical lead for the NHS South West London Integrated Care Board (ICB).

Making the most of virtual wards

GIRFT and the Virtual Ward programme have produced this guide, which outlines how the NHS can make better use of virtual wards, allowing more patients to get the care they need at home, safely and conveniently, rather than being in hospital.

Aimed at clinicians and operational teams, this guide draws on the existing guidance and resources and highlights key advice and steps to get the most out of virtual wards, and in doing so, deliver better care for more of our patients.

Click above to view the pdf document

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