Virtual wards target in jeopardy without urgent action on staffing crisis
Healthcare leaders are warning that a key national target to roll out thousands more virtual ward patient beds in NHS organisations across the country by next Christmas, and help avert another terrible winter crisis, is being severely hampered by the dearth of clinical staff available to run them.
They are concerned that the national target for integrated care systems to have established and ensured that NHS organisations in their patch are actively running up to 50 virtual wards per every 100,000 patients - the equivalent to 24,000 beds - across England by December 2023 is in jeopardy. They are also sounding the alarm that the target to scale up capacity to above 10,000 beds by autumn is also at risk.
These remote wards, staffed and run in a similar way to a real-life hospital ward, crucially help to ensure patients can remain and be cared for in the comfort of their own home or in other residential accommodation.
New NHS Confederation analysis on the levers needed to put in place a successful national roll out of virtual wards also highlights healthcare leaders fears that the continued lack of a long-term workforce plan from the government means systems are being set up to fail to meet the target set by NHS England last year.
Yet despite the barriers, in the past twelve months the NHS has successfully managed to treat more than 100,000 patients in these so-called ‘hospital-at-home’ wards with more than 340 virtual ward programmes now running across England, totalling over 7,500 virtual beds.
It warns that “while we await both the national workforce plan and the digital, data and technology workforce plan it cannot be underestimated how this steady lack of available workforce over the years continues to affect the feasibility of delivering virtual wards at scale.”
Commenting on the report Matthew Taylor, chief executive of the NHS Confederation said:
“It is very concerning to note that vital new models of innovative care like virtual wards, which could go a long way to help in shoring up the health service’s defences and head off another winter crisis this year, are being jeopardised because of a lack of staff to run them.
“There is now a real and urgent need to address staffing in the NHS and we know that this is having a significant impact on all aspects of care.
“Support from NHS England for virtual wards has been very welcome and there is a need to get them rolled out far and wide to help address winter demand more effectively.
“However, it is also important that those setting them up are allowed more flexibility so that their use is not limited solely to frail patients or those with respiratory illnesses.”
Other recommendations include the need for staffing to be “properly planned” with opportunities for clinical staff from acute, social, community and primary care to work in these wards, both permanently and on secondment, to ensure they are seen as a lasting service that can offer real career development.
Leaders also want both the government and NHS England to set out a larger-scale digital project for virtual wards and for it to be made much easier for systems to access local data so they can make informed and bespoke local healthcare decisions that address the needs of their local populations.
The analysis warns that at present the potential for increasing effective use of virtual wards is undermined by lack of access to good data on local population needs and demands.
Elsewhere, the report suggests NHS England should be less prescriptive about specific virtual ward pathways and that the current overwhelming focus on respiratory infection and frailty virtual ward pathways is undermining the NHS’ ability to use virtual wards in other areas of the NHS beyond acute care, including mental health, primary and community care.
Leaders say that to achieve the target and continue to successfully roll out virtual wards for the longer-term, ongoing investment as well as adequate social care support is also vital.
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