An independent NICE committee has recommended the use of these technology platforms used in “virtual wards”, sometimes known as “hospital at home”. Virtual ward platform technologies comprise 3 key parts: a patient-facing app or website, associated medical devices and a digital platform for healthcare professionals.
A patient’s temperature, heart rate, oxygen saturation, blood pressure, and respiratory rate could all be monitored and fed back to healthcare professionals, often automatically. Some platforms also include patient questionnaires which are fed back to clinicians.
The platforms will be used more widely to monitor people over the age of 16 with an ARI in their usual place of residence, allowing people to be discharged from hospital earlier or monitored from home without being admitted to hospital and in turn freeing up hospital beds. Virtual wards could also potentially reduce pressure on other aspects of the care system, including primary care appointments and emergency hospital attendance, the draft guidance said.
Admittance to a virtual ward takes place after shared decision-making conversations between the patient, their carers and the clinical team. Patients and/or their carers would also need training and the confidence, motivation and skills to be able to use a virtual ward platform and the associated medical devices while they are at home.
A telephone number is provided to patients to call for advice or support between 8am and 8pm, seven days a week. Instructions are also supplied on who to contact outside these hours.
NICE has been asked to provide guidance on virtual ward technologies for treating ARI as a significant proportion of people needing urgent care from their GPs or in hospital are because of these illnesses.
Mark Chapman, interim director of medical technology and digital evaluation at NICE, said: “The NHS is under pressure and giving people with an acute respiratory infection the chance to be monitored from the safety of their own home or care home can help manage capacity in hospitals.
“Evidence shows virtual wards are safe and can be an option for those who are comfortable using technology to have their condition monitored away from a hospital ward.
“Using these innovative new technology platforms within a carefully managed NHS environment will enable us to generate the evidence to understand the benefits to patients and the wider health system of using virtual wards.”
Health Minister Helen Whately said: “Virtual wards are already allowing thousands of patients to recover in the comfort of their own homes. Expanding them to support people with acute respiratory infections will give more patients the option of recovering at home. At the same time this frees up beds for people who need to be in hospital.
“This draft guidance shows that patients can be monitored at home as if they were being treated in hospital.
“As part of our Urgent and Emergency Care Recovery Plan the NHS will create an extra 10,000 virtual ward beds by winter, alongside 5,000 hospital beds.”
Evidence presented to the independent committee showed there were similar outcomes for those who were treated in hospital compared with those on a virtual ward. Other evidence showed that people admitted to virtual wards were comfortable using the technology, after training given by a healthcare professional.
The evidence also showed that virtual ward platform technologies are potentially cost saving to the NHS. Analysis by NICE's external assessment group estimated the technologies saved an around £872 per person compared with inpatient care, and £115 per person compared with care at home without a technology enabled virtual ward. However there is still some uncertainty over how much the NHS will save using virtual wards, so further evidence will be generated over the next four years to establish the benefits in practice.
A consultation on the recommendations have now begun via nice.org.uk and comments must be submitted by Friday 1 September 2023.