Virtual wards ‘not a silver bullet’ for NHS as occupancy levels grow

More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity.

However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”.

Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November.

The snapshot was taken on December 21, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital.

Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely.

Teams can also prescribe medications, order blood tests and administer fluids intravenously if needed.

They are recommended by the National Institute for Health and Care Excellence (Nice) to treat those with frailty, acute respiratory infections and, since October, heart failure.

In July, 6,227 patients were on virtual wards, with the figure rising to 6,429 in August, 6,807 in September and 7,317 in October.

Occupancy levels were at 72.7% for December, up from 70.2% in November and an increase of 8.6% from the 64.1% reported in July.

Earlier this year, NHS England set an ambition to roll out 10,000 virtual beds to ease winter pressures. It met the target in September.

Some 10,421 virtual beds were available in September, increasing to 10,737 in October, 11,231 in November and 11,805 in December.

Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”.

He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit.

“Virtual wards are a key part of our urgent and emergency care recovery plan, alongside thousands more core beds in hospital to ensure greater capacity and improved waiting times for patients, all while embracing the latest technology such as remote monitoring, apps, and wearable medical devices.”

However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”.

“Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added.

“But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients.

“If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.”

Miriam Deakin, director of policy and strategy at NHS Providers, added that virtual wards are “not a cure-all”.

“Virtual wards can help patients avoid unnecessary hospital stays by providing care at home, when appropriate,” she said.

“In line with national targets, trusts have been working incredibly hard to deliver more ‘hospitals at home’ to ensure patients receive the right care at the right time.

“However, virtual wards are not a cure-all. They require support from skilled staff while greater investment in the prevention of ill health is central to reducing pressure long term.

“Securing public and staff buy-in for virtual wards is also vital to unlock the full benefits for patients and the NHS.”

Occupancy levels on virtual wards also varied between integrated care boards (ICBs) in England last month.

Buckinghamshire, Oxfordshire and Berkshire West ICB had the highest occupancy level, with 93.0% of its 497 beds full, or 462 patients being treated.

The lowest occupancy level was the NHS Derby and Derbyshire ICB with 36.3% of its 157 beds full.

The latest figures on virtual wards mean there are now 23 virtual beds per 100,000 people over the age of 16 in England who are registered with a GP.

There is a long-term NHS ambition of reaching between 40 and 50 beds per 100,000 people, which would translate to 50,000 admissions a month.

A Department of Health and Social Care spokesperson said: “We have made 10,000 fully-staffed hospital-at-home places available to patients across the country, allowing people to get the specialist care they need in familiar and comfortable surroundings.

“This is in addition to the 5,000 extra hospital beds we created to manage additional winter pressures and £8.1 million to improve discharge.

“There are 50,000 more nurses caring for patients than in 2019 – after we hit our recruitment target six months early – and our Long-Term Workforce Plan will further expand the nursing workforce, with additional training places, improved retention and the introduction of new roles.”