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New virtual wards operational framework

The ‘virtual ward’ or ‘hospital at home’ model has broad clinical support, including endorsement from professional bodies with a growing evidence base demonstrating patient, system and staff benefits when all components are delivered at scale, says NHS England’s new framework.

Virtual wards allow patients of all ages to receive acute care safely and conveniently at their usual place of residence, including care homes. In appropriate cases, it can be a substitute for acute inpatient care.

The virtual ward model is now available in all 42 integrated care systems (ICSs) although there is variation in the models and pathways they deliver. This is mainly due to pre-existing service arrangements reflecting local need and because national policy to date has supported a range of approaches to support expansion. While some local variation will remain, recent evaluation indicates that a greater consistency nationally in the components of virtual wards would maximise benefits for patients and the wider system.

The newly published virtual wards operational framework is designed to support consistency across the NHS and maintain virtual ward capacity and optimise occupancy so it is consistently above 80%.

The framework also clarifies the expectations of virtual wards and how they should be developed over time to maximise benefits for patients. It is intended to be used by those involved in the planning, implementation, delivery and/or monitoring and evaluations of virtual wards, including providers and integrated care boards.

This framework updates previously published guidance which has been withdrawn. Additional guidance has been published for acute respiratory, illness, frailty, and heart failure pathways, with other local virtual ward pathways to be developed at a local level to meet the needs of children and young people, for example.

Several case studies are included in the framework demonstrating the range of virtual ward pathways across various ICSs together with clarity on what good looks like in terms of functions, core components and key outcomes.

If your integrated care board is looking to implement virtual wards or evolve your current model contact our team to understand more about the legal considerations.

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Sophie Burton-Jones

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