Will virtual wards save the NHS?

Virtual wards, thousands more hospital beds and hundreds more ambulances were promised today by Rishi Sunak as he unveiled his crisis plan to tackle the country’s worst-ever A&E waiting times.

During a visit to Country Durham, the PM promised to deliver “the largest and fastest-ever improvement in emergency waiting times in the NHS’s history”, insisting that his two-year recovery plan – which will be introduced from April – is both “ambitious and credible.”

Backed by a dedicated fund of £1bn, the government will roll out 5,000 new hospital beds this year – boosting capacity by 5% – and 800 new vehicles, increasing the ambulance fleet by 10%. 

Another key element of Sunak’s strategy is to expand urgent care in the community, with the creation of so-called “virtual wards”.

In order to relieve pressure on A&E departments, patients will be treated from their own homes while monitored by medics via daily visits or video calls. Some 3,000 “hospital at home” beds will be created before next winter, with the aim of about 50,000 patients eventually being cared for at home each month. The plan will see the use of urgent community response teams scaled up with the hope that frail and elderly patients can be better supported to continue living independently or recover at home.

Measures to slash NHS England waiting times are desperately needed. At present, less than 70% of patients in A&E are being treated or admitted within four hours – the worst waits on record. And last month, the average ambulance wait time for emergency calls such as heart attack and stroke victims was 90 minutes. 

Sunak will no doubt hope that the much-needed strategy unveiled today will distract from the Zahawi affair and help him to regain some authority. But will his proposed measures work? 

The “virtual ward” policy appears largely sensible. Indeed, as Dr Chris Hobson, Chief Medical Officer at Orion Health, has argued convincingly on Reaction, if we wish to relieve pressure on existing health workers and solve backlogs, then we must embrace the digital health transition, not resist it.

In fact, as Hobson notes, in some remote parts of the US, entire ICU wards are being run digitally, with doctors in remote offices monitoring patients on ventilators. And emerging research indicates that the “tele-ICU” approach has been associated with reductions in mortality and less time spent in ICU. 

Yet the glaring problem with Sunak’s new strategy is the scant detail on how he plans to address critical gaps in the NHS workforce. At present, one in ten posts in the NHS is vacant, with over 150,000 vacancies in total. And, as Noah Keate wrote previously on Reaction, a record 40,000 nurses left the NHS workforce in the year to June 2022 – roughly one in nine nurses – with many citing burnout, poor working conditions and growing frustration over pay. 

Investing in new beds and ambulances is a good idea in itself, but it won’t achieve much without the workforce to staff them. 

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