Since then, the Government, and NHSE in turn, have made the rollout and expansion of virtual wards a top priority. The Department of Health and Social Care announced on 30 January 2023 the ambition to support 50,000 people a month through the virtual wards. This represents a mammoth 500% increase in monthly capacity across the board¹. As of March 2023, NHS virtual wards have succeeded in delivering treatment to 100,000 people in the last year through 340 virtual ward programmes across England, supporting 16,000 patients in January alone².

So why is the government pushing such a massive expansion? Because the benefits of virtual wards are significant. It allows clinicians to provide truly patient-centric, safe and effective care in their own home. The Department of Health and Social Care predicts that through holistic community based services, of which virtual wards form an integral part, 20% of emergency hospital admissions could be prevented¹. Fewer avoidable admissions mean safer, better, and faster care for the people who really need hospital-based treatment. In a time where there is great pressure on the NHS on all fronts, programmes like this are invaluable.

However, achieving the expansion and the benefits it promises, is going to mean that providers across England will need to scale up their virtual ward provision and do it at pace. Reviews of existing virtual wards provisions indicate that there is still a lot to learn about how organisations can roll them out effectively³.

With this in mind, we outline five critical success factors that will help you achieve your ambitions, based on our experience supporting the rollout of virtual wards.

1. Put in place the right clinical and operational leadership: The targeted expansion is ambitious. This will mean your organisation will need to nominate the clinical and operational leadership in tandem (with the right governance structures to support them) to match that ambition. Clinical leadership should be driven from a multidisciplinary angle, empowering all professionals including doctors, nurses, physiotherapists, occupational therapists and pharmacists. Operational leaders will need to understand the benefits of virtual wards and have the skills to drive rapid progress in a structured and collaborative way.
2. Make sure you have buy-in from across the organisation, not just the Board: Expanded rollout of virtual wards will lead to a change in the profile of patients you see in your urgent care pathways, and potentially the structure of the people that work in your organisation. To make sure you’re able to achieve your goals and do it sustainably – you’ll need to make sure that staff feel that it’s not ‘being done to them’, but rather that they have a significant role to play. In an ideal world, you would invite staff to co-design the structure and delivery of virtual wards. If there are barriers to this, you’ll need the right engagement across the organisation to ensure that virtual wards deliver care which meets the needs of patients and improves the working lives of staff.  
3. Make the most of learning from across the NHS: Don’t re-invent the wheel – there are lots of virtual wards pilots and provisions in place across England. Access, or set up, shared learning communities to make the most of the great work being done by organisations. Communities of practice – often facilitated by NHS regional teams – not only help teams identify the best solutions, importantly, they also help you from making the same (and sometimes costly) mistakes.
4. Radically rethink staffing models and maximise the opportunity for professional development: Critical to any initiative is having the right people to implement it and see it through. In light of challenging vacancy levels throughout the NHS, you’ll need to think creatively about how you can staff the virtual wards and whether this will require additional recruitment⁴. Furthermore, not all staff will be at the same level of digital literacy, so you’ll need to make sure that you’ve dedicated enough resources to appropriately train staff in the use of, what can be, completely new technologies. Virtual wards present an opportunity for staff to expand their remit and skillsets to operate at the ‘top of their licence’, further their professional capabilities and secure more senior roles.
5. Set up the right digital infrastructure: Virtual wards rely on connecting different technologies to enable patients and clinicians to monitor health and interact. You’ll need to make sure that your organisation can support the relevant digital tools and that you have the right data sharing and information governance structures in place.

While virtual wards hold great promise for our increasingly pressured health ecosystem, their rollout will require careful planning and on-the-ground support to ensure sustainable success.

If you would like more information regarding our experience in rolling out virtual wards please contact Chris Bradley: chris.bradley@thepsc.co.uk.

Authors: Arup Nath and Mikoto Nakajima from the PSC Transformation team, and Dr Stefano Pallazo, Respiratory Medicine Doctor & Associate at The PSC

 Article References:

1. https://www.gov.uk/government/news/nhs-to-expand-services-to-keep-vulnerable-out-of-hospital

2. https://www.england.nhs.uk/2023/03/world-leading-nhs-virtual-wards-treat-100000-patients-in-a-year/

3. https://www.hospitaltimes.co.uk/virtual-wards-failing-patients-clinicans-bridge-gaps-winter/

4. https://www.nursingtimes.net/news/research-and-innovation/analysis-virtual-wards-offer-potential-benefits-but-come-with-risks-02-11-2022/