'Virtual ward' in Wolverhampton praised by NHS executives
A "virtual" ward in Wolverhampton which has helped more than 400 Covid-19 patients and others has been praised by leading NHS chiefs for the innovation.
NHS England and NHS Improvement executives were shown the facility at Wolverhampton Science Park and met with Royal Wolverhampton NHS Trust staff.
And they met with Professor David Loughton CBE, chief executive of the trust, watched a video of how the model works and had a round-table discussion on it.
The virtual ward started as the Oximetry at Home service in December 2020 in response to the pandemic, linking in with patients at home rather than them attending hospital.
It evolved into the Covid virtual ward, an early supported discharge ward supported by the community's Hospital at Home nursing team – with with support from medical staff on a multi-disciplinary team basis.
And with the support of technology and NHSX funding, the Chronic Obstructive Pulmonary Disease (COPD) virtual ward started in June 2021. The virtual ward currently has 12 staff – made up of eight registered nurses and four healthcare support workers – with each nurse responsible for 25-30 patients, including other patients in the community.
It also has medical support from different consultants, depending on the pathway. And from its opening in January 2021 to January this year, 462 Covid-19 patients and 117 patients with COPD were seen.
Dr Jonathan Odum, chief medical officer at the Royal Wolverhampton NHS Trust which runs New Cross Hospital, said: "We were delighted to welcome executives from NHS England and NHS Improvement and proud that the work being undertaken at Wolverhampton has attracted regional and national attention.
"The national team was very impressed with the work that’s being done. This is a really exciting opportunity and is part of a national development as part of the ‘out of hospital’ programme. It’s one we’re very keen to develop within Wolverhampton.
"When you consider these patients would potentially be admitted to a hospital bed, it leads to a real shift in the care we’re able to provide in the community. We look forward to seeing this progress over the next few months and years."
NHS England and NHS Improvement chiefs including Tim Ferris, national director of transformation, and Dr Vin Diwakar, regional medical director for the London region, were shown the facility at Wolverhampton Science Park.
Dr Diwakar said: “It was great to see the innovation and commitment of the team in Wolverhampton who are caring for more and more patients in their home using technology, when previously they would have been in hospital.”
Rather than being re-admitted to hospital, patients are monitored at home via a digital system called LUSCII, accessed via an app allowing them to submit readings. These appear on a clinical dashboard, alerting the Virtual Ward of any deterioration and enables the team to act quickly, via a home visit or referral back to hospital.
The aim of the virtual ward is to identify COPD patients discharged from Emergency Department (ED) and therefore not necessarily seen by a respiratory specialist, to ensure their COPD discharge bundle – which includes a pulmonary rehab inhaler technique and medication review – is managed correctly, preventing re-admission.
Rebecca Currie, matron for the virtual ward and Hospital at Home team, said: “Most patients find the LUSCII app very user-friendly so we monitor them from here, but there are patients who can’t use that, so we upload observations manually.”
Dr Odum revealed ambitious plans were underway to expand the service from its current 50 daily patients to between 250 and 300 patients. Plans to expand the virtual ward will be incremental, so patients with other respiratory conditions and those not requiring acute care needs but still needing ongoing management can be accommodated.
Pathways for asthma and supportive / palliative went live on March 7 and April this year, and the plans are for other pathways to be introduced – including pneumonia and upper respiratory infection – soon.
Data from the COPD Virtual Ward is currently being analysed to confirm that the ED and the hospital admissions for these patients has been reduced.
"Ultimately, we’ll be looking to provide as much out-of-hospital care as we can through the virtual ward, thereby preventing as many patients as possible utilising secondary care services when there isn’t a need for them to do so,” added Dr Odum.
"We’re also looking to expand the clinical team with the introduction of clinical pharmacists and others, and expand the virtual ward technology into care homes in Wolverhampton, so all care home residents potentially have the opportunity to receive enhanced care support when they need it, rather than being admitted to hospital."
