With NHS England and NHS Improvement asking all Integrated Care Systems (ICSs) to extend or introduce the virtual ward model, the publication of ‘Supporting information for ICS leads: Enablers for success: virtual wards including hospital at home,’  is a welcome document. We talk to Adrian Flowerday, MD at Docobo about the report and the virtual ward model, and explore the guidance which kicks off a two-year funded transformation programme to support the development of virtual wards operating to standardised clinical models, across every area of England.

What are the benefits of Virtual Wards?

The report defines a virtual ward as: ‘a safe and efficient alternative to NHS bedded care that is enabled by technology. Virtual wards support patients who would otherwise be in hospital to receive the acute care, monitoring and treatment they need in their own home. This includes either preventing avoidable admissions into hospital or supporting early discharge out of hospital.’

The report also states: ‘Virtual wards present an opportunity to develop flexible and new ways of working that may attract new staff, retain existing staff, improve staff satisfaction, and enhance health and social care integrated multidisciplinary team working.’ I’d totally agree with this sentiment. Virtual Wards have been gradually rolling out since the Covid pandemic started, we’ve been at the forefront of developments and assisted our clients in this area ever since. We’ve seen real benefits in this method, and the uptake of remote patient monitoring as well.

What’s the ambition of the report?

The ambition is to share information and details on what is expected from ICSs over the next few years with regards to Virtual Wards. ICSs are being asked to deliver 40 – 50 virtual ward ‘beds’ per 100,000 people by the end of 2023. They are also being asked to implement two pathways (acute respiratory infection and frailty), with an ambition to expand upon these pathways.

There’s a lot of collaboration being encouraged, for example: ‘Virtual ward services should be developed across systems and provider collaboratives, rather than individual institutions. Services can be based on partnership between secondary, community, primary, social care and mental health services and in many cases partnerships with the independent sector.’ So there’s lots of room for working across systems and services.

What sort of funding is available for ICSs? What about technology – where’s the funding for this?
£200 million of funding is available from the Service Development Fund (SDF) in 2022/23. A further contribution of £250m, on a match-funded basis, will be available in 2023/24. With regards to technology support – NHSX is providing up to £6.3 million available nationally in the form of Regional Scale Programme funding, which will support ICSs with IG and project management etc.

The recommendation is that this funding is spent on platform, software and licensing costs and, really importantly, ‘ensuring interoperability between chosen systems to enable effective data sharing, aligned to the ICS’s digital, data and technology strategy.’

Will this work across boundaries of care?
Absolutely, there’s a huge focus on health and social care working together, in fact, the report sets out some strong ambitions for this:
Ensure integrated working with established teams as appropriate. For example, matrix working with urgent care response teams, primary care, community nursing teams, rehabilitation and enablement teams and trusted assessors for care homes.
• Build on existing and emerging integrated health and social care models that reflects the diversity and care needs of the population served for example, enable capacity in existing out-of-hours services, including community night nursing team services or general practitioner out of hours service where appropriate.
• Consider collaborative models with the voluntary community social enterprise sector to enable people to be cared for at home with support for provision of meals, social and wellbeing, companionship, and advocacy.

What about the technology? I know Docobo is a pioneer in the Virtual Ward space?
Very much so – there’s lots of guidance in how to set up Virtual Wards from a technological point of view – take a look at this for more details on the ‘hows and whys’.

The report also says: ‘The independent sector also comprises important innovators and suppliers of technology. Ensuring virtual ward services are enabled by technology may also mean building on existing and new relationships with independent sector technology suppliers (ISTSs).’

We’ve been working with lots of our clients in this field, and we’re able to set up Virtual Wards really quickly and efficiently, for example in Coventry and Warwickshire, and in Liverpool, too.

We have the documentation and example operational procedures and logistics flow charts available to get Virtual Wards up and running rapidly, as well as the questions set already proven for ARI and other areas such as Frailty, Paediatrics, and Heart Failure, to name but a few.

What about the interoperability element? In November last year you joined the System C & Graphnet Care Alliance, this must be a real help for interoperability both for Virtual Wards and other key areas?
Yes, absolutely! We’re working with our four Care Alliance partners in order to enable full integration across health and social care settings, which fits in perfectly with all the work going on with Virtual Wards. As all the other members of the Care Alliance are innovative and experienced providers of integrated IT solutions across the health and social care market, we’re really excited for the work we are doing together – including exciting EPR integrations! Watch this space!