A recent NHS Confed report, ‘Realising the Potential of Virtual Wards’, cited how a workforce and skills shortage in the NHS is impacting the ability to fully develop, deliver and scale the full ambition of virtual wards.
With nursing teams at the heart of virtual ward delivery, it is paramount that we understand not only what is needed to set teams up for success in terms of implementation and delivery, but also the opportunity this model of care offers the workforce.
To investigate this topic, we partnered with NHS clinicians and Govconnect for ‘New Ways of Nursing’, the first part of ‘The Future of Virtual Wards’ series. The discussion was chaired by Professor Natasha Phillips, former Chief Nursing Information Officer NHS England, and featured Dr Niall Keenan, Consultant Cardiologist in Watford, Clinical Advisory Group Chair for Virtual Wards in the East of England and National Steering Group Member; Jen Tomkinson, Head of Specialist Services, Sirona Care & Health, Bristol North Somerset and South Gloucestershire ICB; and Becky Ashworth, Lead Nurse for Clinical Engagement and Clinical Safety, Doccla.
Here are some key points from the event:
Professor Phillips, building on her experience in leading the ‘Phillip Ives Review’ which examined the digital readiness of nurses and midwives, outlined how ‘person-centred care’ must be at the heart of the nursing revolution. Virtual wards provide an opportunity to deliver this model of place-based care, and she described the importance of embracing these new ways of working with nurses at the helm of shaping this future. She ended her keynote with a rallying cry to the profession: “This is a call to action: reflect on what you’ve heard today and think about how you can take this forward in your roles as nurses.”
Over the past few weeks, Rishi Sunak unequivocally demonstrated his interest in virtual wards following a series of visits to local sites, and inclusion of virtual wards within the government backed NHS Workforce Plan. The national picture looks promising with 10,000 virtual ward beds already being used and staff experience from those delivering them being described by Dr Keenan as ‘‘extremely positive”.
The disparity, however, between NHS ambitions and the numbers needed to adequately staff virtual wards is stark. Dr Keenan outlined how virtual ward staffing needs to be properly planned: staff need to be trained to work on these pathways and, critically, there needs to be enough nurses to deliver the work. The potential for virtual wards to relieve pressure on the system should not be overlooked. In his closing remarks, Dr Keenan stated: “We know there are serious pressures in emergency departments, and we can’t solve these just by bolting on more surgical capacity. We need to look differently at what we’re doing. Virtual wards are a key part of that.”
Jen Tomkinson described the journey the team at Bristol, North Somerset and South Gloucestershire (BNSSG) ICB have undertaken in implementing a virtual ward powered by Doccla. Central to its success is what she describes as a “team of teams”: the importance of finding a digital partner who will work effectively in alignment with clinicians on the ground to develop a collaborative model which places patients and their carers at the centre. This requires a cultural shift for both patients and clinicians, the extent of which should not be underestimated.
For the former, Tomkinson explained how healthcare professionals need to shift from “the experts” to empowering patients to manage their care - and trusting they will escalate when needed. For clinicians, this means supporting staff to lead with, what she describes as, “courage-based healthcare”: to take the risk to remove a patient from hospital and trust they will be managed effectively. For her team, using Doccla’s tech-enabled solution and the additional clinical support provided by Doccla’s remote patient monitoring nurses, has facilitated and empowered her team to deliver this new standard for care, with one BNSSG clinician saying: “I have more information so I have better clinical oversight and can hold more risk”.
Introducing the nurses’ perspective, Ashworth shone a light on the indirect benefits virtual wards can offer both patients and clinicians. For patients, the ability to recover surrounded by home comforts not only prevents the deconditioning often attributed to extended medical stays but also avoids hospital-based infections and has a direct impact on a patient’s immune system, integral to their recovery.
Whilst for the nursing profession, virtual wards enable more time to care for patients (without the interruptions common to a hospital ward) and fine-tunes assessment skills by essentially assessing a patient ‘blindfolded’. A better work/life balance for nurses was also a key take-away. Critically, Ashworth explained how this could also help retain more nurses and expand the workforce as a whole. Doccla's team of remote patient monitoring nurses are not only able to provide additional clinical capacity (through Doccla's CQC accreditation), speaking directly to the workforce shortage issue cited by Dr Keenan, but also offers nurses the opportunity to engage in the workforce in a way that may otherwise not have been possible. Closing, she shared one story from a Doccla nurse who described how: “Working as a remote monitoring nurse has allowed me to continue my nursing career, despite having a long-term health condition/disability.”
Workforce shortages are a strain that is undoubtedly being felt across the system. When attendees were asked at the start of the webinar: “What do you think is the biggest challenge facing the nursing profession in delivering virtual wards?” 48% selected ‘staff shortages’ as the main challenge. But what is clear, is when done right, tech-enabled virtual wards, not only reduce the systemic pressure on hospitals and improve patient outcomes, they also offer a chance to reimagine patient-centred care, in a way that can bolster the nursing profession. As the BNSSG team outlined, integral to this is a cohesive team with nurses at the heart. This was echoed by the event chair, Professor Phillips, who summarised: “Nurses must lead and shape this future.”
For more information on how Doccla can work with your team to integrate hassle-free virtual wards, and provide embedded support with clinical capacity, click here.