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Feature Secondary Care

The virtual wards aiming to ease hospital pressures

BMJ 2022; 378 doi: (Published 06 July 2022) Cite this as: BMJ 2022;378:o1603
  1. Jo Best, freelance writer and doctor
  1. London, UK

Health services in England have been tasked with treating more patients at home, to cope with growing demand for beds—Jo Best asks how this will work

In Norfolk and Norwich University Hospital every specialty is being encouraged to create its own virtual ward, a system whereby a patient can avoid time in hospital by being monitored or cared for at home.

“The model for our [virtual] ward here was that this was to be an extension of the hospital,” says Mark Pasteur, the trust’s medical lead of virtual wards. “The aim was to completely mirror a hospital ward as much as possible, with a view to—now and in the future—it becoming a part of hospital life.”

The number of virtual wards is set to grow. In April NHS England published guidance tasking all integrated care systems (ICSs) with creating between 40 and 50 virtual ward beds per 100 000 of the population by December 20231—around 25 000 across England2—although NHS internal figures suggest that this deadline is likely to be missed. Those figures indicate that there are around 80 virtual wards across 51 trusts, though information on which specialties are covered is lacking.3 Frailty and acute respiratory infection virtual wards should take priority, says the guidance (though it doesn’t say why).

Pasteur’s respiratory virtual ward has its own nurses available 24 hours a day, its own junior doctors, consultants, ward clerks, and pharmacists (no virtual physiotherapy or occupational therapy yet, but perhaps in the future), and patients remain on the same IT systems, much the same as patients in a bricks and mortar ward.

Norfolk and Norwich has a standard operating procedure that each specialty can use; any specialty that thinks a virtual ward will work for it can use this framework to develop its own. …

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