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Views And Reviews Acute Perspective

David Oliver: When visitors return to the wards

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n832 (Published 31 March 2021) Cite this as: BMJ 2021;372:n832

Rapid Response:

The Virtual Ward: There’s No Going Back Now!

Dear Editor

I have read your article ‘When visitors return to the wards’ with great interest, and would like to respond with reference to our experiences in Wales, UK.

COVID-19 conveyed its fair share of tragedies and sadness on many as it took hold of the world and pressed ‘pause’ on the everyday lives we had become accustomed to, and in many ways, took for granted. One thing we, in the UK in particular, took for granted pre-COVID was the freedom to ‘access’ services and the people within these services (professionals and patients) as and when we ‘wanted’ or ‘needed’ them. Don’t get us wrong, there were of course rules and regulations that were correctly followed by us law abiding, socially acceptable citizens, in that we were well aware that there were specific waiting times and opening hours to attend these services. But the freedom to be ‘there’ in person was rarely questioned. And in all fairness, nobody ever really dreamt they’d ever ‘want’ or ‘need’ it any other way. Well of course, until COVID took over and changed the way this traditional function operated.

But, it’s not all doom and gloom. The pandemic made us stop! It made us reflect! And thankfully, it made us weigh up what we ‘want’ and what we actually ‘need’. It is this distinction between the ‘want’ and ‘need’ that is the most prominent turning point within the NHS. And it is essentially this change that the NHS most needed.

Looking back to one year ago – in March 2020 - when the unexpected NHS change occurred, in that much of it went ‘virtual’ out of necessity (not by choice). Across the country video and telephone calls rapidly replaced in-person contact. At first, this was perceived by many as a temporary measure to aid the pandemic gap.

However, in Secondary Care, particularly hospital-based NHS services for in-patients and out-patients, the virtual world has surpassed expectation for both patients and professionals. The temporary measures of virtual hospitals in the UK are no more – virtual is here to stay! In one (very difficult, yet very progressive) year, the initial use of video calls for one-to-one consultations has now extended into joint appointments, multidisciplinary calls, and now even virtual group therapies. There has also been a new service introduced in Wales that provides ‘Virtual Visiting’ to wards – which allows patients to link up with their families whilst in hospital to prevent the need for in-person visits, and to provide easier discharge planning. This Virtual Visiting has proven to be exceptionally beneficial to the patients on the wards for reducing loneliness, stress and anxiety and is reported to have increased communication. This initiative is supported by the Royal College of Psychiatrists in Wales to combat loneliness and isolation. Virtual Visiting families have also reported it “as an excellent service” which provides more reassurance, privacy, and improved family support and involvement, and is more convenient by way of saving time, travel and parking. This type of innovation and creativity cannot be perceived as a pandemic temporary measure – these are moments in history that need to be recognised as ‘change’.

Any type of digital service, be it video consultations, virtual group therapies or even the new Virtual Visitation service now in Wales, it is important to ensure that moving forward we don’t lose sight of what has been achieved, and that everything that ‘works’ is future proofed, and is fully embedded into everyday practice. To return to traditional times would not just be a great shame and a waste of efforts, but would make us all question – what was it all about then? Why tip the world upside down and cause so much mayhem, loss and sorrow to so many, if there’s no positive outcome at the very end of it?

Let the positive outcome be the ‘change’ that happened out of necessity rather than choice. Let the pandemic be a contributor to a better NHS for our future, rather than a historical tragedy.

Competing interests: No competing interests

07 April 2021
Gemma Johns
Research and Evaluation Lead
Sara Khalil, Mike Ogonovsky, Scott Kuperus, Oliver John and Alka S Ahuja
Technology Enabled Care, Aneurin Bevan University Health Board, Informatics, Brecon House, Mamhilad Park Estate, Mamhilad, NP4 0HZ