Context
Changes in society, population, technology, and policy are reshaping the healthcare landscape. As part of this transformation, the boundaries between medical facilities and people’s homes have become more diffuse. In 2005, the NHS piloted a new service called a "virtual ward," which brings hospital-level care into patients' homes.
During the COVID-19 pandemic, these services were rapidly expanded to meet the urgent need for more and better care while minimising risk.
Care-at-home initiatives offer significant potential benefits: they help prevent harm and provide care in environments that are more familiar, comfortable, and personalised. The NHS also viewed virtual wards as a means to increase staff satisfaction, free up hospital beds, and reduce costs.
Due to these advantages, the service was prioritised and expanded swiftly. However, because it scaled so quickly, the design of these services lacked comprehensive guidance and frameworks. As virtual ward services have not been clearly or consistently defined from the top down, their implementation and understanding have varied across different settings. This has resulted in confusion that affects referring clinicians, patients, carers, and service providers.
Confusion among clinicians leads to fewer referrals, incorrect referrals, and incomplete or inaccurate explanations to patients.
The lack of clarity for patients and their carers generates anxiety due to uncertainty about the service, early discharges, and, in some cases, behaviours that are not in the best interest of their health.
Moreover, among organisations developing virtual ward services, there is a consensus that this shift in the context of care presents an opportunity to rethink how care is delivered and to evolve practices in a more patient-centric manner. However, to achieve this, they need to identify best practices through shared learning and the development of generalised insights.
