As many as one in three patients in some hospitals are unable to be discharged despite being medically fit due to a lack of social care provision.
But so-called ‘virtual wards’ have been introduced as part of the NHS plan to tackle the problem, exacerbated by the usual winter pressures on the service.
Sky’s health correspondent Ashish Joshi spoke to a man who is in one of the first virtual wards and is using the new app.
Brian Fairfax dumps the contents of the box onto the table.
He puts a thermometer, blood pressure monitor, and oximeter on the table.
Brian is recovering from surgery. A few weeks ago, he had knee replacement surgery after spending a year on the waiting list.
But waiting for the operation wasn’t the only thing causing him some anxiety.
“I don’t know anyone who likes to be in the hospital, so the sooner you get in and out, the better,” he says.
Brian was worried about how long he would be in the hospital after the operation.
“My wife is sick. Even though she has carers who come to her, I am her main carer, so I have to take care of her,” he explained.
While we were talking, his wife, Pam, was lying in bed in a back room in a bungalow outside Stevenage in Hertfordshire.
“Although I still can’t go shopping and things like that right now, my daughter does, but I generally wanted to be home with my wife.”
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Brian, a retired electrician, is otherwise medically fit, but recovery time after a routine operation like a knee replacement can mean spending up to a week on a hospital ward.
But the simple tools in his box mean he can be monitored at home by entering basic readings into a healthcare app on his smartphone.
In doing so, Brian is a patient on a virtual ward. His readings, taken three times a day, are analyzed remotely.
If they issue any warnings, he will be contacted or even visited by a health worker.
This is the kind of technology that we hope will prevent some people from calling an ambulance or taking a hospital bed.
It also means that Brian does not need to see a community nurse unless absolutely necessary. This frees the nurse to other potentially more vulnerable patients.
Virtual suites are monitored in control centers that are just like regular offices. Clusters of offices with employees on phones, all staring at their computer screens.
The Stevenage center that cares for Brian monitors up to 90 patients at home at any one time.
Dr Elizabeth Kendrick, Medical Director at the Hertfordshire Community NHS Trust, explains what her teams are doing as we tour the virtual hospital.
“You can see on this screen that we have several of our patients in our virtual ward who are going through a variety of their observations,” she says, pointing to a computer in front of us.
“Here we have doctors who are part of the team, we have general practitioners that we’ve hired, and they go through the whole ward.”
As many as one in three patients in some hospitals is medically fit to be discharged, but that cannot be due to a lack of adequate social care.
Delays in unloading put an enormous strain on emergency departments and ambulances.
Reduce emergency admissions by a third
This is why the NHS has made virtual wards part of its plan to tackle the stress of winter and wants 25,000 beds available by the end of next year.
Dr Greg Edwards is the Chief Medical Officer of Doccla, the healthcare technology company that works with the Hertfordshire Community NHS Trust.
He says hospitals using this technology are seeing benefits.
“We’re working with over 20 hospitals, and we’ve found that you can reduce the chances of emergency admissions by about a third, which is really important for hospitals that are under tremendous pressure right now, especially in the winter.
“The flip side of this is that we can help patients get out of the hospital more quickly.”
Virtual wards pose their own workforce challenges, and will not, on their own, solve all the problems facing the health service.
For patients like Brian, the ward may be virtual – but the impact it’s having is real.
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