Virtual wards are set to become a reality for more patients in the UK with the National Institute for Health and Care Excellence (NICE) confirming that technical guidelines are expected to be published by September 2023. The recommendations will help NHS England meet its winter deadline to uplift bed capacity through digital transformation.
In a blog post for the independent organisation, NICE explained that it had three ‘strands of work’ contributing to NHS England’s targets to deliver 40 to 50 virtual ward beds per 100,000 population by December – equivalent to 24,000 beds. The national health service for England has said that it expects each Integrated Care System (ICS) to implement virtual ward models for acute respiratory infection and frailty.
The organisation was founded by the UK government in 1999 to provide national guidelines for care and rid citizens of being victims to postcode lotteries. It assesses evidence of different models of care to provide guidance and advice for health and social care professionals and encourages the uptake of best practices to improve outcomes for patients. NICE says it also develops recommendations to “drive innovation” for health and social care.
Technical assessment guidelines are being created to enable NHS patient remote monitoring
Mark Salmon, programme director, NICE’s science, evidence and analytics team, wrote that for the implementation to be successful, several requirements were needed. These included only using virtual ward beds for patients that would be normally admitted to an NHS acute hospital bed or facilitating early discharge, maintaining efficient, safe staffing and caseload management, and ‘fully exploiting’ remote monitoring technologies and digital platforms to deliver effective and efficient care.
A TEC Action Alliance’s report from February showed that ambulance trips to A&E reduced to 68% when technology-enabled care responder teams handled emergency calls. It also enabled 85% of people to remain at home. However, the report also found that only 18% of respondents used telecare or telehealth services and that the alliance hadn’t seen evidence of “large-scale implementation” of digital care solutions.
According to NICE, clinical and technical assessment guidelines are being created to support NHS workers in deciding where to refer patients over the age of 16 with suspected acute respiratory infections and what key conditions digital platforms require to meet the demands of the health service. The technical assessment guidelines will be published in September and the clinical guidelines will follow in October.
In the technical assessment guidelines project summary, NICE says that the NHS’ ambition is to create more virtual wards to give acute ‘safe and more convenient’ care to patients from their homes using remote monitoring. By doing this, the health service believes it can help prevent “avoidable admissions into hospital”, freeing up hospital beds for other urgent cases.
Virtual wards could mean patients could be treated at home and not live in hospitals
In March, the NHS said that 19 out of 20 hospital beds were taken. Of the total number, 14,000 beds were occupied by a patient who was clinically ready to leave, but unable to be discharged due to a social care package not being ready for them. The NHS hopes that virtual wards will also enable these people to leave the hospital and continue to receive treatment while they await care.
“Different models of virtual wards exist depending on whether the service is mostly remote or mostly face-to-face,” the summary says. “Some of those models such as the mostly face-to-face delivered hospital at home are not new having been utilised in the UK and internationally in different pathways successfully. What is new is the innovation of new digital health technologies to enable the mostly remote model.”
The project is being assessed as part of the Health Technology Assessment Innovation Laboratory (HTA Lab) programme at NICE and is being led by Liz Islam, who has worked in the public sector for over 20 years.
The third stream of work is NICE’s development of economic evaluations and implementation of support tools for NHS, expected between June and November 2023. NHS sites that are already using virtual wards will be contributing real-world data to NICE to support economic business case development.
To support its ambitious targets, NHS England launched a new procurement framework to run until 2024 to accelerate the uptake of virtual wards. It covers alarm receiving centre platforms, digital alarms, personalised healthcare records and intelligence activity monitoring.
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