City St George’s experts contribute to major project measuring the impact of NHS Virtual Wards
Academics from City St George’s, University of London have been selected to lead quantitative analysis for the evaluation of a National Health Service (NHS) initiative, which aims to relieve pressure on hospital bed space.
Dr Navid Izady, Reader in Operations & Supply Chain and Dr Jack Fosten, Reader in Data Analytics at Bayes Business School, along with Dr Victoria Serra-Sastre, Reader in Economics in the School of Policy & Global Affairs, have been commissioned by the NHS to work alongside Healthcare Integration Partners (HIP) in exploring the effectiveness of its ‘Virtual wards’ programme.
Inpatient beds are valuable hospital resources, and shortages can adversely affect both patient outcomes and the wellbeing of staff responsible for them. Average utilisation for general and acute beds has consistently exceeded 90 per cent across England in recent years – well above the level many experts regard as safe.
With bed space at such a premium, NHS initiatives to alleviate this pressure include the introduction of virtual wards. Also referred to as a “hospital at home,” virtual wards enable patients to receive hospital-level care in familiar home environments. This approach often speeds up recovery and improves patient outcomes, while freeing hospital beds for those most in need of on-site acute care. Daily patient reviews are conducted by a clinical team, either through home visits or via video technology.
Virtual wards are a key NHS England priority, with more than 12,000 beds currently operating nationwide.
Although an evidence base on virtual wards is developing, the large-scale impact of the national programme has yet to be fully assessed. In response, NHS England has commissioned an “Impact Evaluation of Virtual Wards” to be carried out by a partnership between City St George’s, University of London, Healthcare Integration Partners (HIP) – a healthcare consultancy – and Kaleidoscope, an organisation specialising in information governance.
In line with the Government’s ambitions to reform the NHS, the two-year project aims to provide a quantitative research framework to aid the assessment of strategic development, design, and implementation of Virtual Wards.
The project’s methodology will include econometric modelling to assess patient and hospital-level outcomes, such as readmission rates and length of stay. A simulation model will then estimate how changes at patient and hospital levels can combine to affect system-wide measures, such as overall bed availability and patient flow throughout the healthcare system. In addition, a cost-effectiveness analysis will estimate expenditures associated with virtual wards, per unit of improvement in key outcomes, to take into account costs to the healthcare system and broader social care networks.
Dr Izady, an expert in stochastic modelling of service and manufacturing operations, said:
“Lord Darzi’s independent report into the state of the National Health Service concluded that it must ‘reform or die’, which has put evaluations of key initiatives at the top of the agenda.
“Virtual wards have been well-received by patients and are helping to free up hospital bed space for those most in need.
“They are a necessity to ensure those requiring the most critical care can receive it without having to wait various lengths of time for availability.
“However, their success is dependent on applying a highly efficient operation model, selecting the right set of patients, and having the right staff in place.
Our mission is to provide the necessary research expertise to help evaluate the progress of this initiative, and the impact it is having to improve patient outcomes and support urgent and emergency care pressures.
“We are excited to be working with the NHS and HIP on this important project, and look forward to playing our part in furthering home-patient healthcare.”
Rehan Qureshi, Associate Director at HIP, said:
“The National Virtual Ward Programme is a key priority for NHS England, enabling patients to receive hospital level care at home.
“As the adoption of virtual wards continues to grow, so is the evidence base for their impact. However, the roll-out of the national virtual ward programme has not yet been evaluated at scale.
“HIP will contribute our clinical, operational, and functional expertise of virtual wards, guiding the evaluation process to assess the quantitative impact of virtual wards on patient outcomes and system efficiency. We look forward to working with City, St George’s, and leveraging its academic resources and research capabilities to provide in-depth analysis, using latest evaluation methodologies.”
An NHS spokesperson said:
"The evidence base for virtual wards has grown rapidly over recent years, with evaluations demonstrating positive patient experience and outcomes.
“We are pleased to be working with Health Integration Partners and City St George’s University to develop this evidence further through a national quantitative evaluation. This evaluation will be the first of its kind and will consider the impact of virtual wards on patient experience and outcomes and the wider system, as well as what characteristics of virtual wards are most effective.”
