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Rise in patients cared for at home on ‘virtual’ wards

More than 40 Addenbrooke’s patients have swapped a stay in hospital in the last month, for care at home - provided by a new virtual ward with 24hr, 7 days a week remote medical monitoring and supported by a dedicated nursing team.

Using smart phone apps, technology platforms and wearable medical devices, such as temperature readers and pulse oximeters, patients on a virtual ward can be monitored constantly, with their vital signs recorded throughout the day and night.

At the same time, a team of senior nurses check in with patients up to four times a day by phone or video call, with care also available face-to-face from a multi-disciplinary teams based in the community.

If patients need further care, such as blood tests, scans or IV therapy, they can come in to hospital for regular appointments.

So far most patients have stayed on the virtual ward for around 3-5 days, freeing up around 150 bed days in hospital.

Patricia Trigg, virtual ward patient
Patricia checking her blood pressure and wearing an oximeter, at home with husband Brian.

Being looked after by the virtual ward team in my own home, with Brian by my side, makes an enormous difference to both of us.

Patricia Trigg, CUH virtual ward patient

Patricia Trigg, 67 years old from Quendon in Essex, is a cancer patient. She recently had intensive chemotherapy and is recuperating while she waits for a stem cell transplant.

In the past she may have spent weeks in hospital, being monitored in case her condition deteriorates. Instead, she and husband Brian were able to celebrate their golden wedding anniversary at home last week. She said:

“I can sit in my own lounge, sleep in my own bed and I’ve not once felt worried about whether I should be in hospital. I still go in for regular appointments and if I have any concerns while I’m at home, I just give Gemma and the team a call.”

Brian Trigg added:

“After looking after me for 50 years, it’s now my turn to look after her, with the help, care and support of the virtual ward team. I’m thrilled that she’s home and we could celebrate our wedding anniversary where we both belong.”

By freeing up hospital beds and creating more capacity, virtual wards improve the flow of patients through CUH, easing pressure on the emergency department and helping to reduce waiting times for both planned and emergency care.

By early next year it's hoped the virtual ward will have expanded to look after around 100 patients at any one time.

WATCH: Gemma Czech lead nurse for the CUH virtual ward.

Link: https://youtu.be/GspCxFCTQNc

Video transcript

00:00:03:02 - 00:00:04:08

When the patient’s on the virtual ward,

00:00:04:08 - 00:00:06:15

we are able to do their observations,

00:00:06:15 - 00:00:08:13

either continuously or intermittently,

00:00:08:13 - 00:00:09:22

depending on their care pathway,

00:00:09:22 - 00:00:11:06

which we create with their doctors.

00:00:11:06 - 00:00:12:02

We’re able

00:00:12:02 - 00:00:13:09

to monitor their blood pressure,

00:00:13:09 - 00:00:15:03

their saturations, their respiratory rate

00:00:15:03 - 00:00:16:02

and their temperature.

00:00:16:02 - 00:00:17:06

This all goes through

00:00:17:06 - 00:00:19:02

onto our Masimo dashboard,

00:00:19:02 - 00:00:20:13

which means that we are alerted

00:00:20:13 - 00:00:21:12

if there's any issues

00:00:21:12 - 00:00:23:11

with the patient's vital signs.

00:00:23:11 - 00:00:24:08

The patients have access

00:00:24:08 - 00:00:26:01

to the Ward twenty-four seven.

00:00:26:01 - 00:00:26:21

The patients have had

00:00:26:21 - 00:00:28:02

really good experiences with this

00:00:28:02 - 00:00:29:13

and they enjoy being able to contact

00:00:29:13 - 00:00:30:11

a nurse straight away.

If any of our patients has any concerns, or just needs some reassurance, we are always available to talk to on the phone.

Gemma Czech, lead nurse for the CUH virtual ward.

For patients, virtual wards mean they can leave hospital days or even weeks earlier, while still getting the expert care they need.

They can benefit from the comfort of their own surroundings, sleeping in their own bed, eating their own food and being in the company of their family, friends and pets.

This often speeds up their recovery and reduces the risk of hospital acquired infections, with patients able to return to daily routines and avoid deconditioning.

A wrap-around approach also promotes better self-care for patients and the confidence to safely recuperate at home.

Senior Sister Gemma Czech is the lead nurse for the CUH virtual ward. She said:

“Our team includes a range of expertise including senior nurses and physiotherapists and links directly with consultants and specialist clinics from across the hospital as well as services in the community. We are there for patients 24 hrs a day, 7 days a week, ensuring they get the best care, in the best place for them."

At Cambridge University Hospitals NHS Foundation Trust (CUH), a wide variety of patients can be looked after on the virtual ward, including respiratory, gastro and frailty conditions, and those recovery from cancer treatment, neurosurgery and organ transplants.

All patients are carefully selected to make sure their needs can be safely managed remotely.

With the NHS under so much pressure, we have to embrace new ways of working and adopt strategies and technology that enable us to deliver care differently, in a way that liberates patients and maintains quality.

Dr Iain Goodhart, leads the virtual ward programme at CUH

Dr Iain Goodhart is an anaesthetist and leading the virtual ward programme at CUH. He said:

“Being able to remotely monitor patients at home is an important development but it must be combined with round the clock access to human contact, whether on the phone, on a video call or in person.

"That is why the CUH virtual ward is staffed by a dedicated and experienced team, to maintain that vital personal contact and the best quality of care.”

Patricia and Brian virtual wards
Patricia and Brian at home, celebrating their golden wedding anniversary.

Dr Ewen Cameron, Director of Improvement and Transformation at CUH said:

“The virtual ward is part of a raft of measures CUH is putting in place to ease pressures on capacity. These include innovations in our day surgery unit, enabling more patients to return home within 24hrs, working more closely with partners in primary care and across the local health system and a renewed focus on recognition, retention and support for staff.

“In addition in emergency care, more walk-in patients can now be treated on the day, helping to ease demand on emergency inpatient beds.”

NHS winter plans

NHS England is working with local areas in implementing out of hospital home-based pathways, including virtual wards, to improve flow by reducing hospital attendances.

In community care, NHS England is working with local areas to increase the number of virtual wards; creating an additional 2,500 virtual ward beds.

For winter, NHS England has laid out plans to reduce hospital occupancy by increasing capacity by the equivalent of at least 7,000 general and acute beds, through a mix of new physical beds, virtual wards, and improvements elsewhere in the patient pathway.

A new campaign has been launched to give our local people the information they need to stay Well Together This Winter.

For top tips and tools to stay well during the colder months, please visit www.cpics.org.uk/well-together (opens in a new tab)

https://www.england.nhs.uk/virtual-wards/ (opens in a new tab)