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Blog posted by: Mark Salmon, programme director within our science, evidence and analytics team, 30 May 2023.

An early introduction to NICE’s ongoing activity in virtual wards

Why do we need virtual wards?

The ambition for virtual wards is to expand the capacity of the acute care sector by managing patients, who would otherwise be in hospital, remotely in their homes, creating potential staffing efficiencies and providing safe and more convenient care for patients.

NHS priorities and operational planning guidance sets an ambition for systems to deliver 40-50 virtual ward beds safely and sustainably per 100,000 population by December 2023. This is equal to the delivery of up to 24,000 virtual ward beds and £450m additional funding over two years has been made available to systems to support this transformation. At a minimum, NHS England state that they expect each ICS to implement virtual ward models for two pathways: acute respiratory infection and frailty.

Successful implementation will require systems to:

• maximise their overall bed capacity to include virtual wards
• only use virtual wards for patients who would otherwise be admitted to an NHS acute hospital bed or facilitate early discharge
• maintain the most efficient safe staffing and caseload model
• manage length of stay in virtual wards through establishing clear criteria to admit and reside
• fully exploit remote monitoring technology and wider digital platforms to deliver effective and efficient care.

How NICE is contributing to this effort

NICE has 3 streams of work that are actively contributing to support these ambitions:

• Development of a NICE clinical guideline on acute respiratory infection in over 16s: initial assessment and management. This guideline will aid healthcare professionals in deciding where to refer people aged 16 and over with suspected acute respiratory infections, including referrals to Virtual Wards and acute respiratory infection Hubs. Expected publication October 2023.
• Development of technology assessment guidance on technologies that enable virtual wards for acute respiratory infections. The aim of this guidance is to outline key considerations and characteristics of the digital platforms that help to materialise the value and benefits of virtual wards for patients, healthcare professionals and the system. This will include guidance and advice on future priorities for data collection. Expected publication September 2023.
• Development of economic evaluations and implementation support tools
  • NICE plans to publish an update of the economics evidence that supports its clinical guideline (NG94) on emergency and acute medical care (for over 16s). This guideline aims to reduce hospital admissions through training and community alternatives. Expected publication late June 2023.
  • NICE is accessing and reviewing real-world economics data from NHS sites that have implemented virtual wards to provide general advice to support economic business case development. NICE will develop case studies and implementation support tools highlighting benefits and barriers. Expected publication phased July – November 2023.

Use these links to our guidance development pages to register as a stakeholder and keep up to date with the progress of this work.