Virtual wards plan at risk from staff shortages

Systems have been set a national target of increasing virtual ward beds to above 10,000 ahead of next winter, relieving pressure on hospitals. The service has already rapidly increased its virtual capacity from nearly 4,500 in May 2022 to more than 7,600 in March this year. And there is a longer term ambition to provide 40 to 50 virtual wards per 100,000 people handling more than 50,000 admissions a month.

A briefing from the NHS Confederation – Realising the potential of virtual wards – said there was considerable enthusiasm for virtual ward expansion among healthcare leaders. When done well it can keep people out of hospital, facilitate early discharge and reduce clinical time. But it warned that the ‘severe workforce and skills shortage’ in the NHS – there was an 11% vacancy rate in December 2022 - is impacting on systems’ ability to deliver the virtual ward programme.

There is an assumption that digital care models require fewer NHS staff, as face-to-face contacts are reduced. But there are still significant staffing requirements within multi-disciplinary teams and clinicians are needed to drive the programme.

‘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,’ said Matthew Taylor (pictured), the confederation’s chief executive. ‘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.’

The briefing stresses the importance of planning for virtual ward staffing. Long-term establishments should be set and regularly reviewed and this needs to be supported by long-term investment. Short-term funding models are hindering recruitment, planning and impact assessment of virtual wards, the confederation said.

It also called for greater flexibility for systems about the conditions supported by virtual wards.  The ‘overwhelming focus on respiratory infection and frailty pathways’ was too limiting with systems keen to explore areas outside of acute care such as mental health, primary and community care. And adequate social care support is also essential to deliver successful virtual wards – with insufficient funding ‘preventing systems from fully addressing the holistic and wrap-around needs of patients away from only clinical virtual ward support’.

In a further move to cut waiting lists, the Department of Health and Social Care this week said that patients would be given greater choice over where they receive care. Patients will be given up to five options for where they are treated, with the choices selectable via the NHS app or online. The Department said that just one in 10 patients currently exercise their right to choose, but research had shown that giving patients choice can cut up to three months off their waiting time by selecting a different hospital in the same region.