Liverpool University Hospitals NHS Foundation Trust’s award-winning Heart Failure Virtual Ward

Liverpool University Hospitals NHS Foundation Trust’s (LUHFT) award winning Heart Failure Virtual Ward is enabling heart failure patients to receive the care and treatment they need in the comfort and convenience of their own home while reducing their need for visits to hospital.  Patients are monitored at home by heart failure specialists from LUHFT and clinicians at Mersey Care NHS Foundation Trust using remote monitoring digital technology.

Using virtual care remote monitoring to reduce hospital stay for Heart Failure patients. 

The North West’s first acute heart failure ‘virtual ward’ was established in May 2022 and is run by a team at LUHFT and Mersey Care. It sees the two trusts working together with remote monitoring technology providers, Graphnet, to ensure that patients with acute heart failure (new or known diagnosis with decompensation) can receive the care and treatment they need while living in the comfort and convenience of their own homes. The team has recently won an HSJ Patient Safety award. 

The heart failure virtual ward specialist team has since treated over 1,000 people at home and reported back that using virtual wards not only improves their outcomes, but also helps with their recovery.

With new guidance from NHS England, supporting the implementation of virtual wards as an additional, complementary service model for people with heart failure, the work at LUFHT is pioneering. https://www.england.nhs.uk/publication/guidance-note-virtual-ward-care-for-people-with-heart-failure/ 

The problem

With over 900,000 people in the UK living with heart failure and heart failure patients accounting for 5% of hospital admissions, the team at LUHFT  led by Dr Rajiv Sankaranarayanan, Consultant Cardiologist, wanted to find a way to look after more heart failure patients in the comfort of their own homes rather than being admitted to hospital. 

The solution

Rajiv and the team at LUHFT worked in partnership with Mersey Care’s Telehealth Service and their remote monitoring technology partner Graphnet, to set up the acute heart failure virtual ward which is now enabling the NHS to intervene early when signs of deterioration are observed.

The Docobo remote monitoring solution from Graphnet has been trusted in out-of-hospital care since 2001. Now part of the Graphnet product suite, Docobo Remote Monitoring enables market-leading remote patient monitoring and virtual care across the UK and internationally.

How does the heart failure virtual ward work?

• Heart failure specialist nurses visit patient homes to assess them and to deliver intravenous diuretics
• Heart failure patients record daily observations and symptoms onto the Docobo Remote Monitoring system, including temperate checks, blood pressure, oxygen levels, step count and an ECG taken at home, three times a day
• Patients fill in a daily symptoms’ questionnaire for clinical assessment 
• All information entered is automatically presented for the nurses at Mersey Care’s telehealth hub
• Anomalies in the readings are observed by the nurses at the hub, who will usually, then contact the patient.  This pro-active caring is re-assuring for patients and the support of a hospital consultant is at hand
• Nurses at the Mersey Care’s Telehealth hub triage the alert and will respond
• Heart failure specialists, such as Dr Rajiv, review the patients’ observations and take the action required for the care of the patient
• Heart failure nurses can also see patients at home on the same day as and when required
• Electronic prescribing is performed to optimise medications and the VW team benefits from a specialist pharmacist input
• Heart failure patients also undergo home cardiac rehabilitation

Benefits and excellent results of the heart failure virtual ward

So far, since its launch in May 2022, the services has treated over 1,200 patients across Cheshire and Merseyside. 

The virtual ward: 

•    Avoids the need for hospitalisation or reduces length of hospital stay
•    People can be monitored in the comfort of their own home 

Dr Rajiv Sankaranarayanan, Consultant Cardiologist and Heart Failure Lead at Cheshire and Merseyside ICB, said: “It’s a great honour to lead this project. With an estimated 900,000 people living in the UK with heart failure,  and people with heart failure accounting for 5% of hospital admissions, it is great to be able to monitor people in their own homes by heart failure specialists through the aid of remote monitoring digital technology, thus avoiding the need for hospitalisation. Health care professionals can refer patients into the service from A&E departments, primary care, outpatient clinics, heart failure ambulatory care units, acute medical units and hospital wards at LUHFT (Aintree Hospital, Royal Liverpool) and we have also received referrals from Liverpool Heart and Chest Hospital."

Peter Almond, Telehealth Head of Service, Community Care Division at Mersey Care says: “Coupling the Telehealth clinical hub and digital technology to support this pathway has really benefitted patient care by helping to avoid admissions where they aren’t necessary and supporting the patient to recovery in the comfort of their own home. Mersey Care are proud to work alongside Rajiv and his colleagues over at LUHFT and this virtual ward is an excellent example of how services can work together to support patient care.”

Colette, a patient, says: ‘It gives you your life back”.