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The Health Innovation Network South London and NHS England (London Region) have worked with London’s Integrated Care Boards (ICBs) to co-develop a health economic cost model for virtual wards.

In this blog NHS England Regional Director of Digital Transformation Luke Readman and HIN Executive Director of Digital and Transformation Amanda Begley introduce the tool and highlight its importance.

Our previous work on the business case for virtual wards and national surveys (Thorton, et. al. 2023) demonstrate that patients and clinical staff want care to be provided in people’s homes. These sentiments are echoed by the national drive to go further and faster on improving out-of-hospital access to urgent care services, highlighted in both the Department of Health and Social Care’s Road to recovery mandate and NHS England’s 2025/26 priorities and operational planning guidance.

Virtual wards are designed to do just this, preventing avoidable admissions and safely reducing inpatient lengths of stay. However, are virtual wards a wise investment of taxpayers’ money?

Emerging research shows a range of economic benefits, including reducing hospital admissions, length of stay, and transportation costs. Potential efficiency gains from using remote monitoring and telemedicine also appear encouraging.

This is all very promising, but two key questions remain for decision makers considering whether the theoretical business case stacks up against their real-world budget pressures:

•  Is the virtual ward that I am commissioning or delivering economically viable, given local or service-specific considerations?

•  What variables would make it more or less economically viable?

This is why we’ve worked with London ICBs and virtual wards colleagues to co-develop an economic cost model for virtual wards.

Feedback so far on the tool is that:

•   The model and outputs are easy to use and interpret;

•   The tool can be used for retrospective evaluation and prospective planning across various virtual ward pathways;

•   Results can be used to understand the cost implications of clinical and operational decisions around the deployment of virtual wards.

When we ran real-world data through the model, we also identified opportunities for cost savings within services by:

•    Identifying efficiencies such as reducing the time taken to identify, refer and onboard patients, reducing the number of home visits and reviewing the grade of staff needed for different tasks;

•    Improving outcomes such as reducing length of stay and readmission rates.

As is often the case with economic models, there are some limitations – which are detailed in the report – and there is more work we’d like to do, particularly the inclusion of acuity data.

But for now, we hope this practical model will help you determine whether (or how) your virtual ward can become a sustainable and cost saving staple for patients in need of urgent and emergency care services.