Virtual wards: developing business cases to unlock patient and system benefits

Virtual wards offer the promise of providing safe, high-quality care at home. Recently, the Health Innovation Network South London and NHS England (London Region) have collaborated on a number of events and projects to help understand the challenges and opportunities related to virtual wards in London.

In this blog Dr Sanjay Gautama, Chief Clinical Informatics Officer for OneLondon and consultant anaesthetist, discusses how well-developed businesses cases are important to help realise the full benefits of virtual wards for patients.

Virtual wards already appear to be delivering a positive impact to patients across London and are playing an important role in giving patients the choice to receive safe and high-quality care at home.

However, with operational and financial pressures on NHS services perhaps more pronounced than they have ever been, justifying investment into the wider spread and implementation of virtual wards requires the development of sustainable and robust business cases.

Developing the business case for an emerging new model of care can be a significant challenge – with issues such as a paucity of evidence, fractured data sets and a rapidly-evolving technological offering all making it difficult for providers or commissioners to pull together comprehensive benefits assessments.

Given these issues, NHS England (London region) and the Health Innovation Network South London recently brought together key stakeholders from across the capital to understand the most critical considerations for virtual wards business cases and to review the evidence at hand.

Key findings from the subsequent report included reflections on operational priorities, such as the potential for virtual wards to provide admission avoidance rather than only step-down care, and the importance of near-seamless integration into existing services.

The report also summarises evidence from four key areas of benefit identified so far in real-world virtual ward implementations:

The report provides practical, experience-based information about the challenges of optimising virtual wards, as well as guidance on structuring business cases and appropriate measurement and evaluation.

We hope that our newly-published report will prove useful for anyone working in this space across health and social care.

Download the full report

View our full paper for detailed information about the benefits and considerations for virtual wards business cases.

Access the full report

Patients are on board with digital tools in primary care: now it’s time for us to make the most of their potential

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In 2023, NHS England (London) commissioned the Health Innovation Network South London to undertake a significant research project looking at Londoners’ experiences of using digital tools to access primary care services.

Following the publication of a report entitled Patient Perspectives on Digital Access to Primary Care, which summarises the research, we hear from Matthew Nye, Director for the Digital First Programme at NHS England (London), about where the digitisation of primary care stands in 2024.

Through early pilots we identified digital tools have an important role in improving patient experiences and outcomes in primary care; when we expanded the programme across London in 2019, one of our key ambitions for using digital technology was to improve access to the right care at the right time, as well as increase personalisation and efficiency of care.

Nearly five years later, the patient voice captured in our Patient Perspectives report demonstrates that we are realising more of those ambitions across London.

It is very positive to see that three quarters of the Londoners we spoke to are now using digital tools to interact with their GP surgery.

We know from this survey, and other work that has taken place locally and nationally, that digital tools such as consultation forms, the NHS App and GP practice websites can really help patients access the right kind of help more quickly for their specific need.

These tools can often help to triage patients more efficiently than relying on busy telephone lines. For patients, that means less time wasted and faster access to appropriate support – whether that is seeing a GP in person, getting advice from a practice nurse, physiotherapist or pharmacist or being able to complete a task such as ordering a repeat prescription online.

Capturing the patient voice

The unexpected Covid-19 pandemic forced an unprecedented change to how patients could access and interact with health care services, and the implementation of “digital first” was accelerated, resulting in the rapid rollout of many digital technologies into primary care.

Feedback from GP practices suggested that, for some patients, the digital tools  and new processes implemented at a practice or local level worked well, but the pace of change made it difficult for us to get a truly comprehensive view of what patients thought about these digital tools.  A key recommendation from the report included improved communication with patients to build awareness and understanding of the digital tools available in primary care, facilitate signposting and better manage patients’ expectations.

More than 3,000 patients shared their views with the Health Innovation Network South London for this report. This has meant that we’ve been able to get a really good idea of what is and isn’t working for patients. Using the results of the survey and themes captured from the focus groups, we can work with colleagues at every level of primary care across London to continue to improve the use of digital tools and effectively embed this with implementation resource.

The case for investing in change

We know that primary care services across London are very stretched and busy. Finding the time to improve GP websites, optimise online services and integrate the NHS App might seem like a tough ask.

However, the survey and focus groups have demonstrated the value that patients see in using digital tools, as well as highlighting some clear recommendations for improvement.

Patients want to use these channels to manage their own health in a more convenient way, but sometimes they are running into frustrating issues with poorly designed forms and websites, consultation forms only being available for part of the day, or not being able to access a full range of online services via the NHS App.

We are confident now that practices have the right digital tools and the objective is to improve the balance between what patients want and the processes/pathways provided by primary care to achieve improved outcomes, greater efficiency and a good user experience.

This report plays an important role in building the case for primary care to invest in supporting GP practices to improve the use of digital tools, and proactively encourage patients to sign up to and use digital tools where appropriate. If you can enable the majority of patients to quickly and easily complete tasks online, it is likely they will engage. That, in turn, reduces pressure on clinical and administrative staff and frees up time for the interactions that require a face-to-face or a phone call, including supporting digitally excluded patients who might not feel confident or are unable to use digital tools.

One of the key recommendations from the report is driving up quality, standardisation and compliance with usability and accessibility standards, whilst ensuring that there is consistency with digital tools and they are available all day.  A focus on this will have a direct positive impact on addressing digital exclusion, through making sure that more people can make use of digital tools if they choose to.

Patients suggested that GP surgeries build in mechanisms to capture timely feedback to enable continuous improvement of digital tools and pathways. It is clear that the need and use for digital tools in primary care is very much in the present, rather than the future. This is an exciting place to be – and more reason than ever to listen, embrace and deliver in line with the expectations and recommendations of patients.

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Please get in touch for more information on our work to understand patient perspectives on digital tools in primary care.

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