Successful Virtual Wards at Royal Stoke and County Hospitals

Royal Stoke Hospital and County Hospital, part of the University Hospitals of North Midlands NHS Trust (UHNM), have implemented a virtual ward to provide acute care for patients in the comfort of their own homes. This is part of a large virtual ward project that spans across a group of trusts, including Midlands Partnership University NHS Trust and covers much of the North Midlands.

The hospitals are using the Docobo Remote Monitoring virtual ward capability across the patch. This is consultant-led and enables clinicians to review patients while they are in the comfort of their own home, reducing hospital stays, promoting quicker recovery and minimising disruption to patients' lives. The virtual ward now provides 228 virtual beds across the region and is receiving fantastic clinician and patient feedback.

How does the virtual ward work?

The virtual ward process begins with a referral from a clinician who has seen the patient at the hospital. Once they have received a referral, a Virtual Ward clinician assesses the patient either clinically or digitally. If accepted onto the scheme, the patient’s care is managed by a designated ‘Consultant of the Week’, supported by a Virtual Ward Matron, and virtual ward nursing staff. The solution has been designed for patients who are stable but require ongoing treatment, monitoring and clinical reviews that can be effectively managed remotely.

Patients are assessed on an individual basis and the length of stay on the virtual ward is tailored to the patient’s clinical needs, with care managed remotely or through face-to-face interactions as necessary.

Patients on the virtual ward are monitored using Docobo Remote Monitoring functionality, enabling patients to independently record and submit data on their vital signs and other health metrics.

Once the patient’s condition improves sufficiently, responsibility for their care is transferred back to their GP.

Sarah Yates, Virtual Ward Matron at Stoke Hospital says:

Since using the virtual wards here we have seen improved patient outcomes and improved patient experience.  We have also found that it’s not only the younger people who are able to thrive with remote monitoring. We recently had a 101-year-old on the Docobo Remote Monitoring platform who was able to successfully operate the solution – and really enjoyed doing so. Although our cohort are mostly frail, we really believe that age is not a frailty.

We also know very well that spending time in hospital is not good for most people – we try to prevent deconditioning and muscle wastage that happens when people spend a long time in hospital. We’re on a mission not to decondition! Virtual wards do just that. It means people can stay in their home and be cared for there.

The Docobo Remote Monitoring system is very user friendly and self-explanatory. What patients like is that even though they are submitting readings on an iPad, there is still someone on the end of the dashboard to act on if there is any change in the condition.

Dr Zia Din, Consultant Physician and Medical director for the service, says:

The virtual wards programme in Staffordshire has been transformative in supporting our aspirations to deliver care closer to home. The ability to remotely monitor people enables us to safely and efficiently manage our patients. This model of care not only enhances clinical outcomes but also empowers our patients to engage with their health needs from the comfort of their own homes, whilst they are being treated for acute illnesses. The consultants in the hospital can access patient data real-time from the Docobo Remote Monitoring system through our integrated care records.

Kingsley Marshall, Assistant Programme Manager, Midlands Partnership University NHS Trust, Acute Care at Home Service says:

Virtual care can be the best type of care for a patient and saves them having to be in hospital.  We like to get our lower acuity patients onto virtual wards and the more patients we have, the more we depend on it to do the work for us. The bigger picture is that it’s not just about those who are in hospital, it’s admission avoidance too. That is important to us. All of us who work on the project have had relatives through the remote monitoring system and they have all fed back positively. We’ve also had lots of positive patient and clinician feedback too.

Positive patient feedback from UNHM virtual ward – mini case study

A 32-year-old woman with a history of epilepsy and asthma, was admitted to the Royal Stoke University Hospital while 26 weeks pregnant. She lives with her husband and 3-year-old son.

She presented with shortness of breath and a persistent cough. Despite receiving antibiotics and steroids from her GP, her symptoms did not improve. She contacted the 111 service, which advised her to attend the Accident & Emergency department. After a 24-hour admission to the Acute Medical and Respiratory Assessment (AMRA) unit, she was discharged to the virtual ward.

On the virtual ward, her condition was identified as an infective exacerbation of asthma with a high risk of pre-eclampsia. The virtual ward team provided several key interventions:

• Nebuliser loan: She was loaned a nebuliser to help manage her asthma symptoms.
• Daily observations: Her vital signs were monitored daily and reviewed via the Docobo Remote Monitoring platform.
• Medication management: her salbutamol ran out, prompting the issuance of a new prescription, which was collected and delivered to her.
• Peak flow monitoring: Her peak flow was regularly monitored to assess her respiratory status.
• Pathology testing: A sputum sample was collected and tested to guide antibiotic therapy.
• Antibiotic delivery: Antibiotics were prescribed and delivered to her home.
• Nebuliser use reduction: She was supported to gradually decrease and eventually stop the use of the nebuliser.

Her symptoms improved significantly during her time on the virtual ward. The continuous monitoring and timely interventions facilitated her recovery without the need for an extended hospital stay. She was eventually discharged from the virtual ward and her care was transferred back to her GP for ongoing management.

She said:

All the staff were so friendly and willing to help me and acted on all my symptoms. I felt I got better by being at home and didn’t have to worry about my little boy.

This case highlights the virtual ward’s role in improving patient outcomes and enhancing the overall care experience.

The virtual ward demonstrates the benefits of using remote monitoring for patient care. By managing peoples’ conditions remotely, the virtual ward is not only providing effective medical treatment but also supporting their emotional wellbeing, allowing them to recover in the comfort of their home.