Virtual wards

The Hospital at Home Team covers a range of services including chronic respiratory illnesses, outpatient antibiotic therapy service, frailty, and everything in between which requires hospital-level interventions but can be done at the patient’s own home. The service went live on 1 August 2008 and has a capacity of 40 beds, which is being expanded further. To date, there have been more than 1,500 patients through our service.

Find out more about virtual wards on the Dartford and Gravesham NHS Foundation Trust website.

Medway and Swale Health and Care Partnership (H&CP) clinical teams have been working in collaboration to provide virtual wards within Medway and Swale, based on the provision of 40 beds per 100,000 population. 

This is a large complex programme, phased to work towards delivering 155 beds by March 2024.  Clinical teams across the Medway and Swale system work together to codesign and coproduce clinical pathways to safely care for patients in a virtual ward, who would normally be managed in a hospital environment.  Ensuring patients meet the appropriate clinical criteria for safe care and positive clinical and patient outcomes, they are managed in the community by integrated teams of hospital and community teams. 

The first pathways we have concentrated on include:

• Hospital at Home - Focuses on patients being discharged early from Medway NHS Foundation Trust to continue treatment and remote monitoring (using devices to record patients’ oxygen saturations, pulse and blood pressure), with virtual care delivered by the Hospital’s SMART team.  This service was in place before the virtual ward programme was launched. It has been the foundation to the start of other pathways within the programme.  Care is provided seven days a week and the pathway can manage up to 50 patients at a time.
• Acute Respiratory Illness – Medway Community Healthcare respiratory team has developed a virtual ward model to manage patients in the community virtual ward environment. The team engages with the hospital respiratory team to manage and monitor patients’ respiratory condition. These patients would otherwise have been admitted to hospital (Admission Avoidance).  The team manages patients with a range of chronic obstructive pulmonary disease (COPD) conditions and acute respiratory illness. They have the capacity for up to 15 patients.
• IV therapy – This is provided in the community by Medway Community Healthcare’s OPAT service, receiving referrals directly from Medway NHS Foundation Trust and providing IV therapies in the community to help patients to have their treatment at home.  Without the community IV team, patients would remain in the hospital longer.  The community team links directly to the acute Hospital at Home service, Consultant Microbiologist, and Medical Consultant. They have the capacity for up to 10 patients.
• Heart Valve pathways – A pathway developed in collaboration between the Hospital at Home team and the Cardiology team for patients waiting to be transferred to a different hospital for their heart valve procedure.  Normally the patients would remain at Medway NHS Foundation Trust until transfer. Instead, this pathway enables patients to be discharged home whilst continuously being monitored with a remote monitoring device. Arrangements for their admission to hospital for their procedure can be made from the patient’s home.  This pathway enables patients to be discharged earlier and spend time in their own homes.  The capacity is up to 5 patients.
• Frailty – This is a new pathway, focussing on seeing frail patients in their own homes to avoid admission into hospital or to enable an earlier discharge, if they are admitted to hospital.  With community teams engaging directly with the Frailty Consultant and Frailty Specialist Teams; pathways are currently being finalised to support admission avoidance. Patients are referred to be seen directly in a ‘Frailty Hot Clinic’ then discharged home for ongoing community treatment and monitoring; or admitted directly to a frailty unit, should the patient’s condition indicate that this is the best environment for them.  Alternatively, when the patient is suitable for discharge through the joint working between the hospital Frailty Team and the community teams, patients are discharged sooner with their ongoing treatment plan, and monitoring, continuing in their homes.

Plans are in place to scope exciting new pathways to develop into virtual wards, to include:

• Emergency Department to virtual ward directly (pilot of the pathway already completed in December 2022)
• Paediatric pathway
• Other cardiology pathways for admission avoidance or early supported discharge.

You can also find more information on the Medway NHS Foundation Trust and Medway Community Healthcare websites.

We'll have more information on virtual wards in east Kent soon, please check back.

We'll have more information on virtual wards in west Kent soon, please check back.