Supportive, spiritual or secluded – what is the actual experience of receiving virtual care?

October 17, 2023

Imagine being unwell and having the comfort of your own home as your healthcare setting—an idea that is becoming a reality with the concept of virtual wards. NHS England London Region and the Health Innovation Network South London (HIN) recently held a patient and people involvement group to delve into the experiences of individuals who have been a part of this innovative healthcare approach. Here Amanda Begley, Director of Digital Transformation, and Joe Barker, project manager in digital transformation at the HIN describe the benefits, challenges and improvements highlighted by patients and carers.

Patients’ views and experiences are central to any new models of care, and so we were keen to hear how it feels being cared for on a virtual ward, and to share these insights with those leading the planning and operational delivery of virtual wards.

During the discussion patients and carers highlighted a range of benefits they had experienced by being able to be stay in a home environment. Three key themes that came up in the discussions were around:

  1. Emotional wellbeing: One of the most heartening takeaways from the discussion was the profound impact of emotional support. Participants emphasised that having loved ones around during their illness made them more determined to heal. As one patient aptly put it, "It's like you want to give up more when you're in a hospital bed." The familiar surroundings of one's own home, with the comfort of your own bed and the freedom to watch your favourite TV shows, contributed significantly to emotional well-being.
  2. Self-perception and quality of life: One carer highlighted how being in a familiar environment helped their loved one feel less like a "very ill" person. It allowed them to maintain a sense of normalcy in their life during their illness, which positively influenced their self-perception and overall quality of life.
  3. Praying and spiritual support: Another important benefit was the importance of spiritual support. One person spoke about how being at home allowed them to receive visits from people who could pray for them, and they could continue openly practicing their faith, like reading the Bible, which isn't always possible in a hospital setting.
"Having [friends and family] around you makes you want to recover more quickly. It's like you want to give up more when you're in a hospital bed."Participant

However, it was also clear that peoples’ individual circumstances meant that virtual care presented challenges. The three main challenges highlighted were:

  1. Isolation and mental health: Some people expressed concerns about isolation when recovering at home. They recognised the potential impact on mental health, as being alone for extended periods during illness can lead to feelings of loneliness and isolation.
  2. Carer commitments: Carers in the group shared their experiences, revealing how work commitments sometimes limited their ability to provide continuous care. This issue highlights the importance of integration with social and domiciliary care.
  3. Suitability and accessibility assessments: Accessibility concerns were raised as well, particularly for individuals living in multi-storey buildings with access challenges. The need for proper suitability assessments and emergency response planning was raised.
"If you're at home by yourself, that can be very isolating and could have an impact on your mental health."Participant

Practically there were some suggestions for improvements that resonated with the group as a way to ensure the model is as effective as possible:

  1. Patient choice: Participants stressed the importance of including patients in the decision-making process, particularly the decision to admit and discharge. They emphasised that patient views should be considered during multidisciplinary team (MDT) discussions. One specific issue that was raised was around the number of staff that would be visiting the patient’s home.
  2. Service branding and communication: Some patients found the term "virtual" off-putting, associating it with technology and not seeing anyone in person. They suggested a shift in branding, proposing that the term "NHS Care at Home" better reflects the essence of the service.
  3. Time to connect: Patients valued the personal connection with healthcare staff, continuity of care givers and highlighted the need for staff to have time for meaningful interactions. This human touch was felt to be particularly important for older individuals.
“If [the staff] don’t have time to interact, you don’t get that connection, and older people particularly like that connection, they like that same face.”Participant

In conclusion, our patient focus group shed light on the nuanced experiences of those involved in virtual wards. While the benefits are significant, addressing challenges and incorporating patient and carer views can further enhance the effectiveness of this evolving healthcare model. By continuously improving and adapting, we can ensure that virtual wards provide the best possible care while supporting compassionate and meaningful relationships.

The discussions and ideas from this focus group will contribute to the development of virtual wards in the London region, improving them and making them sustainable.

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