Helping the NHS tackle health inequalities cost effectively and sustainably

The challenge​

NHS England have identified Virtual Wards as a means of improving patient and carer experience, patient outcomes, and deploying resources, particularly staff time, in the most efficient way possible primarily by reducing hospital activity. ​

National policy has moved from piloting Virtual Wards to targeting a full roll out of 40-50 beds per 100,000 people across England. We are working with our partners to drive implementation of Virtual Wards whilst ensuring a rigorous approach to measuring benefits, learning from experience to improve delivery, and evaluating efficacy is taken, particularly in the context of a still-limited evidence base for the impact of Virtual Wards. ​

Our approach ​

We have helped manage the implementation of Virtual Wards with Integrated Care Board’s (ICB) since September 2021. Capacity has grown to 580 beds as of October 2023, and we have also supported the implementation of new technologies and the articulation of benefits as part of the strategic planning process.​

In other ICBs, we have modelled a suite of interventions to assess their potential to create financial sustainability and reduce population health inequalities for the urgent and emergency care (UEC) pathway. This includes the cost of one additional hospital avoidance for five types of Virtual Ward, and differences in impact associated with ethnicity or deprivation. ​

We subsequently worked to build analysis with a new linked patient-level dataset that provided averages for avoided bed days per Virtual Ward admission for individual pathways and cohorts based on real data, representing a significant improvement on evaluation approaches in other areas to date. ​

Our impact​

In just one of the ICBs we’ve been working with, the live capacity has grown to almost six hundred virtual beds already, a significant increase in twelve months and a major support to their local hospital sector and to patients and carers themselves as we head into another difficult winter.​

We are working with NHS England to deliver a comprehensive evaluation of Virtual Wards in the South East Region, quantifying and articulating the outcomes associated with a diverse array of approaches will allow us to draw even more robust conclusions on what works.  Our recommendations are already helping systems and individual decision-makers focus resources on the most cost-effective interventions, and those which deliver the biggest benefits to patients and those who care for them.​