Walsall Virtual Wards success for patients and clinicians with remote monitoring

Walsall Healthcare NHS Trust has been at the forefront of integrating virtual care technology to support patients remotely, especially those in vulnerable groups such as nursing home residents, older adults and those with complex medical conditions. Its successful Virtual Wards (VW) initiative, using the Docobo Remote Monitoring platform from Graphnet, is a collaboration with the Walsall Together partnership.

Background and introduction

Virtual Wards in Walsall were introduced as part of the wider ‘Walsall Together’ initiative, which aims to integrate health and social care services for the benefit of the community. Initially launched in June 2022 with the Acute Respiratory Infection (ARI) virtual ward, the programme has since expanded to five pathways: Hospital at Home (H@H), Palliative Fast Track, Frailty, and Discharge to Assess (D2A). The virtual wards provide remote, continuous monitoring of patients who might otherwise require hospital admission. Since its launch, the team at Walsall has seen a reduction in readmission rates from nursing homes, which previously had high occupancy and frequent patient transfers to the hospital.

Virtual Wards in Action

Walsall's Virtual Wards programme is built on the integration of technology and clinical collaboration. The wards allow patients to receive hospital-level care in their own homes, reducing unnecessary hospital stays and admissions. The service focuses on vulnerable patients, including those with acute respiratory infections, frailty, and those in need of palliative care.

Key Features of Walsall Virtual Wards:

• Docobo Remote Monitoring Platform: This is used to track patients' vital signs and wellbeing. The technology provides patients with devices that measure clinical observations like heart rate, oxygen saturation and temperature. In ARI virtual wards, for example, patients' clinical observations are monitored twice daily to ensure that any changes in their condition are detected promptly.
• Tailored care for different patient needs: In the Frailty Virtual Ward, which primarily serves older patients, remote monitoring is used more for monitoring social and care needs, rather than just clinical observations. The team captures patients' responses to specific questions to guide multidisciplinary discussions, ensuring patients can cope at home and receive the care they need. This approach ensures care is tailored to each patient’s unique circumstances.
• Collaborative multidisciplinary (MDT) approach: Each virtual ward operates under a specialist consultant who works closely with the acute trusts, GPs and community nurses. Teams are small but efficient, with just four community nurses handling a caseload of virtual patients. The collaboration ensures continuity of care as patients transition from hospital to home, or from care homes into a virtual setting. This is further supported by the integrated ‘Front Door’ service, which triages patients and streams them into the appropriate virtual ward.
• Discharge to Assess (D2A): This pathway, introduced in November 2023, focuses on patients discharged from hospital but still needing assessments and care in the community. The team ensure that patients at risk of readmission are identified early and monitored closely, significantly reducing readmission rates.

James Wheatley, paramedic and VW team member says:

"We’ve reduced readmission rates from nursing homes since the virtual ward has been in place. We’re seeing the benefits for patients and clinicians every day."

Features such as quick notes ensure that all team members are up to date with patient status, reducing delays in care and ensuring continuity, even if a member is not on shift. The system's ease of use and expanding functionality have improved efficiency and team satisfaction.

Fiona Micheli, Lead Nurse for Virtual Wards, said:

“Virtual wards provide the reassurance that people need without them having to leave the comfort of their own home as we would all prefer to avoid hospital if possible. The other pathways have been set up more recently but are showing similar encouraging results and feedback from patients has been positive.”

Outcomes and Impact

Since the launch of Walsall Virtual Wards, there have been notable improvements across several key metrics:

• Reduced readmissions: The team has seen a significant drop in readmission rates from nursing homes and other care settings. This reduction is attributed to proactive monitoring and early intervention facilitated by virtual care.
• Improved patient occupancy: The virtual wards have helped to ease hospital pressures by reducing bed occupancy and allowing more patients to be treated at home. This is particularly beneficial during times of high demand, such as winter months or during viral outbreaks.
• Shortened length of stay: Patients in virtual wards have a shorter length of stay in the healthcare system overall, as they can be discharged sooner from hospital into virtual care.
• Enhanced MDT Collaboration: The virtual ward model has enabled stronger collaboration between healthcare professionals across different settings, including acute trusts, GPs, and community services. This multidisciplinary approach ensures holistic care for each patient, addressing not only their medical needs but also their social and emotional well-being.

The introduction of Virtual Wards in Walsall, supported by the Docobo Remote Monitoring platform, has transformed the way care is delivered to some of the most vulnerable patients. The combination of technology, multidisciplinary collaboration and proactive patient management has resulted in a reduction in readmissions and improved patient outcomes, demonstrating the potential of virtual care to revolutionise healthcare delivery.

Walsall’s Virtual Wards serve as a model for other regions looking to implement similar programs, particularly in managing patient flow, reducing hospital admissions and providing effective care at home.