Introduction

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As part of our “Enhancing Acute Capacity in the NHS” series, we previously explored the ripple effect of acute capacity constraints. Evaluating current NHS solutions shows that hybrid healthcare is the future, blending human-led care with tech innovations. Let’s dive into how tech-enabled virtual wards can help tackle NHS acute capacity challenges.

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Healthcare technology has come a long way since the early 19th century, from clinical thermometers to oxygen saturation probes and beyond. These advancements have revolutionised patient care, improving outcomes and managing chronic conditions more effectively. While our tools have advanced, the need for vital trend data to guide clinical decisions remains critical. When patients are discharged, and monitoring diminishes, flaws in the healthcare system become apparent.

Virtual wards bridge this gap by providing continuous observation. The increasing availability of affordable, user-friendly devices empowers patients to monitor their health at home, track vital signs, and provide clinicians with valuable trend data during routine consultations.

Tech-enabled virtual wards and remote monitoring

The distinction between home care, virtual wards, and tech-enabled virtual wards is subtle but significant, with each offering unique benefits. Real-time communication with clinicians is key to truly hybrid healthcare, enhancing capacity through remote monitoring. Current non-tech-enabled virtual ward systems are excellent for patients who need significant support and can't manage their own care. Conversely, tech-enabled virtual wards empower clinicians to confidently discharge patients who are improving and only need remote monitoring or minimal care, like taking daily medication. This approach frees up hospital beds for those who need them most. For suitable cases, tech-enabled virtual wards offer better solutions for clinician management, condition management, and health equity.

Improving clinician-to-patient ratios

By leveraging technology, fewer clinicians are needed to oversee a larger number of patients. Previously, clinicians or healthcare assistants had to travel to take observations, limiting the number of patients they could see in a day. The challenge is the already disproportionate ratio of clinicians to potential patients for home monitoring within the NHS. If you consider patients with chronic conditions like diabetes, heart disease, COPD, and other long-term conditions, as well as post-operative patients who could benefit from home monitoring, this could be a significant portion of the population. Assuming around 10% of the UK's population could be candidates for home monitoring, this gives us approximately 6.7 million potential patients.

Based on these conservative figures, there are about 22-23 patients needing home monitoring for every clinician. The number of clinicians relative to potential patients for home monitoring is disproportionately low. Now, with tech-enabled virtual wards, each patient has their own set of devices that automatically transmit data to clinicians. This automation reduces the manual workload, allowing a smaller team of clinicians to monitor trends in more patients effectively.

Transforming condition management 

Tech-enabled wards not only give clinicians the confidence to discharge suitable patients early but are also great for reducing further hospital admissions and increasing capacity.

Chronic conditions affect a significant portion of the population. Current data shows that approximately 30% of the UK population - over 20 million people - live with one or more long-term conditions such as diabetes, heart disease, COPD, and other chronic illnesses. The sheer volume of the population affected demonstrates the significant potential benefits of home monitoring​.

During the winter months, they are more likely to get sicker due to greater exposure to weather changes and seasonal flu. By pre-empting this with longer-term patient monitoring, clinicians can act ahead of illness, intervening with antibiotics or other necessary treatments before the patient deteriorates. This might then require a clinician to visit the patient's home or a hospital visit, but overall, the care required is minimal compared to how it would be if the deterioration went undetected.

Bridging the gap on health equity

When we say we "empower patients," we mean making sure they can monitor and report to clinicians effectively. The quality of care depends on the quality of data reported. Higher-functioning patients, or those with more time—generally older folks—typically handle manual monitoring well. But what about time-poor younger professionals? Or patients with conditions like ADHD that make it challenging to follow a manual process? With 2.6 million people in the UK living with ADHD, many patients can't self-report accurately but don't need to be in the hospital for monitoring. This is where tech-enabled virtual wards fill the gap.

By automating as many steps as possible in the home monitoring process, clinicians can capture more accurate data from more patients in real-time. This lets clinicians make better decisions, improving care quality and reducing the time needed per patient. The NHS's push to be more inclusive and consider different patient demographics is crucial. Implementing technologies that help catch, empower, and enable more patients will combat the health disparities that arise from socioeconomic factors and other medical conditions, resulting in greater health equity.

Key success factors for effective virtual wards

A recent PPL study analysed 29 virtual wards to understand their impact on admissions in the South East. As of February 26, 2024, 64% of all virtual ward admissions in this region were included in their evaluation. The findings reveal that these virtual wards can avoid approximately 22,794 admissions annually. This translates to an estimated 9,165 non-elective admissions avoided each year. Here are the key takeaways:

• Operational impact: Virtual wards have significantly reduced non-elective hospital admissions. For every 2.5 virtual ward admissions, one non-elective hospital admission is avoided. Some mature wards even achieve a 1:1 ratio.
• Financial benefits: The evaluation highlights a net annual benefit of £10.4 million across the region. The total annualised gross benefit is estimated at £24.5 million, with gross costs at £14.2 million.
• Capacity growth: Virtual ward bed capacity in the region has grown by 20% over the past six months, with a 10% increase in technologically enabled beds. This expansion supports the ongoing creation and integration of new virtual ward services.
• Resource efficiency: Virtual wards enable the redistribution of clinical resources, reducing the strain on hospital beds and ensuring they are available for critical cases. This leads to improved patient flow and overall capacity management.

For more detailed insights, you can read the full PPL report or the NHS summary review.

Increasing acute capacity for the NHS

Tech-enabled virtual wards will not eliminate the gap between demand and capacity for hospital beds, but they can play a substantial role in the solution. By preventing avoidable attendances and admissions and reducing the length of stay through early discharge, virtual wards help optimise resource use and improve patient flow. This innovation supports the NHS in meeting increasing healthcare demands while maintaining high-quality care standards.

Next, as part of our “Enhancing acute capacity in the NHS” series, we'll delve into how Doccla is currently transforming acute capacity in the NHS. If you'd like to learn more about how tech-enabled virtual wards can help improve your operations, feel free to get in touch today.