The NHS is being urged to relieve the pressure on hard-pressed hospitals by treating thousands of patients in "virtual wards" – at home, with regular visits from health staff replacing long stays on wards.
The service could create 5,800 "virtual beds" in people's homes to help hospitals cope with bed shortages and overcrowded A&E units deal with patients arriving as emergencies, a new report says.
A few hospitals have begun treating certain types of patients this way in an effort to provide a patient-friendly response to growing demand at a time when NHS budgets are tight. In some places up to 35 patients a week, whom doctors agree do not need to be kept in hospital, are being cared for this way.
Patients who agree to have their treatment in a virtual ward can avoid anything more than a few hours of treatment at hospital before being discharged to such care.
Advocates of virtual wards claim that patient satisfaction with such arrangements is very high and recovery is hastened by being at home. Hospitals save money as virtual wards are cheaper to provide than the typical £250-a-night cost to the NHS of an overnight stay.
The new report is by NHS specialist consultant Alex Kafetz of ZPB Associates in conjunction with the NHS Confederation and some trusts which already operate virtual wards on behalf of private healthcare firm Healthcare at Home. It urges NHS chiefs to dramatically expand the currently patchy provision of such care.
University Hospital Southampton NHS Foundation Trust began looking after small numbers of patients who had undergone surgery such as a hip or knee replacements in virtual wards in 2010. Around 120 mainly elderly patients every month now stay at home, where they receive up to three visits a day from a nurse to change a dressing, give them an injection or check their blood pressure and up to several visits a week from a physiotherapist who helps them regain their mobility through intensive mobilisation.
Jane Hayward, the trust's chief operating officer, said: "Only 2% of patients on the scheme end up back in hospital again compared to the average, which is 7%.
"We started this because we are a big, busy trust and didn't have anywhere else physically to expand into and so needed to think how to do differently."
So far the trust has looked after 2,366 patients this way and saved 14,228 bed days through what it calls "enhanced supported discharge" or "healthcare at home". In a survey 98% of such patients said being at home had benefitted their wellbeing, while 90% were very satisfied with the home care they received.
The Royal Free London NHS Foundation Trust offers a similar service but plans to add video consultations – where the patient can speak directly to their consultant while at home – to the package of care they offer. "Patients absolutely love this service. It's optional. They can choose to stay in or go home, but pretty much all of them go home", said Katie Donlevy, the trusts's director of integrated care. "Medically the care is better than being in hospital because the patient cane recover more quickly at home, especially complex elderly patients, who may otherwise be stuck in a bed in hospital."
A spokeswoman for NHS England said virtual wards were an excellent idea which typified the sort of innovation the NHS needed to embrace in order to meet the growing challenges it is facing.
Denis Campbell Guardian
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