Healthcare delivery home environment.
l Keeps patients in a place where they would prefer to be cared for.
l Development of Virtual Wards offers opportunities to address healthcare inequalities in target areas, including COPD and frailty.
l Two and a half times fewer patients treated on a Virtual Ward are readmitted to frailty beds than the national acute benchmark.
l Frees up physical beds for other patients who require an in-patient admission.
l Improves integration between hospital and community services.
l Enabled by technology including remote monitoring.
There is a national policy push by NHS England for ICBs to develop Virtual Wards for a range of conditions, focusing at a minimum on two pathways – acute respiratory infection and frailty – but with the aim of expanding to other conditions and pathways, including surgical recovery. Importantly, the push is for these Virtual Wards to be developed across systems and provider collaboratives and not by individual institutions. In the short-term, the latest plan for supporting Urgent and Emergency Care
Recovery3 set out an ambition to roll out 10,000
Virtual Ward ‘beds’ by the end of September 2023 with a target of maintaining an average occupancy of 80 percent over winter to help speed up recovery, reduce waiting lists and free up hospital beds for those who need them most. The longer-term ambition, outlined in the 2022/23 priorities and operational guidance4 is for each ICB to deliver a capacity of up to 40 to 50 Virtual Ward ‘beds’ per 100,000 registered GP population – a total of 24,000 beds able to manage the acute care for up to 16,000 patients in these ‘beds’ at any one time by the end of
2023/24. Funding of £200m was made available from the Service Development Fund in 2022/23 with a further contribution of £250m, on a matched-funded basis, available in 2023/24 to support the development of Virtual Wards. But there is no recurrent funding. ICBs will need to ensure future funding, for sustaining the infrastructure already created, and as further expansion and uptake is built into their financial plans.
Table 1. Virtual Ward Capacity – By NHS England Region.
Where are we now? The NHS England Virtual Ward programme is well underway with different systems at different levels of maturity. Responsibility and funding for developing the infrastructure sits with the ICBs. Progress is reported to NHS England via monthly Virtual Ward SitRep data submissions. Analysis of this data provides a helpful picture of the progress made in developing and embedding Virtual Ward capacity at national, regional, and local level. Analysis of the latest data shows that, as at the end of November 2023, there were 11,231 Virtual Wards ‘beds’ available, an average of 21.9 per 100k population. A total of 7,886 patients across England were being cared for in these Virtual Ward beds at the end of November, with an average bed occupancy of 70 percent across England. Between July and November 2023, there was
a 16 percent increase in Virtual Ward capacity from 9,713 beds (equivalent to 18.9 beds per 100,000) to 11,231 beds (21.9 per 100,000). Although the short-term target of 10,000 Virtual Ward beds has been achieved, which is good news, much more work and investment is needed to almost double the capacity nationally and achieve the stated ambition of 40 to 50 virtual beds per 100,000 Table 1 shows that the development of Virtual
Table 2. Virtual Ward Beds per 100k GP population – No. of ICBs by Bed Range, Nov 2023 36
www.clinicalservicesjournal.com I March 2024
Ward capacity varies widely across the country. The two best-performing regions - East of England (26.2 beds per 100k) and Midlands (23.4 per 100k) – are well above the national average
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