Virtual wards and hospital at home services
A national programme to support UK virtual wards—also known as ‘hospital at home’ (HaH)—launched in England in 2022.
Virtual wards and hospitals at home allow people to receive treatment and care in their homes, rather than as a hospital inpatient, while maintaining regular contact with health professionals. It is not a substitute for acute inpatient hospital care.
Virtual wards take full responsibility for patient care, delivering medical, nursing and allied health support through a multidisciplinary team (MTD).
Improving urgent and emergency care
In January 2023, NHS England pledged to reduce pressure on hospitals by increasing the use of virtual wards as part of its plan to improve urgent and emergency care. Similar initiatives have been adopted in Scotland, Wales, and Northern Ireland.
Later the same year, the NHS virtual ward expansion was announced. This saw thousands of children being treated at home in every region of England.
Urgent and emergency care delivery plan
The ‘Delivery plan for recovering urgent and emergency care services’ committed to several measures, including:
- increased hospital capacity
- expanded workforce
- faster hospital discharges
- enhanced community care for older adults
- improved access to the right care
- expansion of virtual wards to 10,000 beds, with the aim of monitoring 50,000 patients monthly.
Virtual ward and hospital at home models across across Wales, Scotland and Northern Ireland
In Northern Ireland, all health and social care trusts have established hospital at home services, these MTDs deliver intensive home care for patients experiencing acute illnesses.
In Scotland Hospital at Home provides acute care in patients' homes, offering services equivalent to hospital care. The programme has reduced hospital stays, increased patient numbers and expanded services across Scotland. For more information, visit Healthcare Improvement Scotland’s website.
In 2023, Wales’s Health Minister emphasised the need to prioritise community-based services that support patients living independently at home for as long as possible.
Key benefits
Research has shown that virtual wards can significantly reduce the length of a patient’s stay. A study by the National Institute for Health and Care Excellence (NICE) found they can help save up to £9,081 per patient (PDF).
Additionally, staff who participate in virtual ward programmes gain knowledge and clinical skills when supporting patients with complex chronic diseases, according to a study by the South Eastern Health and Social Care Trust.
In summary, the key benefits of virtual wards include:
- reduction in hospital admissions and demand for beds
- supporting early discharge from hospital and freeing up beds
- reducing the burden of travel for families and improving convenience of care
- enhancing accessibility of care for people with disabilities and individuals with complex health needs
- increasing patient comfort by allowing treatment in familiar environments
- offering faster hospital admission if health deteriorates
- providing quick access and support to health professionals
- alleviating hospital pressures through new uses of technology and enabling the remote monitoring of health.
Development of a framework for staff working in virtual wards
In 2022 NHS England commissioned Skills for Health to create a comprehensive framework. The aim was to provide a clear set of standards for the skills and capabilities required by staff working in virtual wards and urgent community response teams.
The framework is used to inform the education, training, and career progression of these staff. They will also be used to inform the development of local workforce models. The key benefits of this framework include:
- Standardisation: It will create a consistent standard of practice across the NHS for staff working in virtual wards and urgent community response teams.
- Improved quality of care: By ensuring that staff have the necessary skills and capabilities, the framework will help to improve the quality of care provided to patients.
- Enhanced patient experience: The framework will also help improve the patient experience by ensuring that staff can effectively use technology to deliver care.
- Improved workforce planning: The framework will be used to inform the development of local workforce models. This will help to ensure that there are enough staff with the right skills and capabilities to meet the needs of patients.
Overall, the framework is a valuable tool that will help to improve the quality of care provided by virtual wards and urgent community response teams.
Online resources and guidance on virtual wards and hospitals at home
In addition to the framework, NHS England launched an online hub dedicated to virtual wards, providing resources for patients, information on various clinical conditions and support for family members.
Carer’s UK (2024) Unpaid carers: getting it right – a virtual wards system pathway and professionals’ checklist.
Chappell P, Co M, Hardie T, Lloyd T, Tallack C, Gerhold M, Mayers C (2024) What do virtual wards look like in England?
Chicken N (2022) Remote Monitoring and Virtual Wards Resource Series Stage 2: Engage.
Hakim R (2023) Realising the potential of virtual wards.
NHS England (No date) Virtual wards.
NHS England (2024a) Virtual wards operational framework.
NHS England (2024b) GRIFT’s virtual wards guidance updated to reflect new NHSE operational framework.
NHS England (2023a) Supporting clinical leadership in virtual wards – A guide for integrated care system clinical leaders.
NHS England (2023b) NHS virtual ward expansion will see thousands of children treated at home.
Royal College of Physicians (2023) The RCP view: Hospital at home and virtual wards.
Royal College of Physicians, UK Hospital at Home Society ad British Geriatrics Society (2024) Joint statement: ‘Hospital at Home’ not ‘virtual wards’.
Sheasby L (2023) Impact of virtual wards, The Access Group, 14 April.
Skills for Health (2022) Virtual ward and urgent community response capability framework.
Thornton N, Horton T, and Hardie T (2023) How do they public and NHS staff feel about virtual wards?
Wells E (2024) Virtual Wards: benefits, challenges and required skills, Nursing Times, 120(10), pp.18-21.
Southern Health & Social care Trust (2023) Hospital care at home.
Baxter H (2023) Virtual wards will play a key part in the future of healthcare, FutureScot, 23 March.
Healthcare Improvement Scotland (2023) Expanding hospital at home across Scotland.
iIHub (2024) Hospital at Home: Older people/Acute adult (PDF).
iHub (no date) Hospital at Home programme.
iHub (no date) Hospital at Home - Your team.
NHS Education for Scotland (NES) (2023) Hospital at Home knowledge and skills development framework.
Scottish Government (2023) More investment in Hospital at Home.
Scottish Government (2024) Hospital at Home for Older People.
Burgess AJ, Mehta A, Davies EK, Hapgood N, and Davies EA (2024) Patient experience and outcome measures in virtual wards at Swansea Bay university health board, Age and Ageing, 53(Suppl 1).
Grange H, Johns G, Ahuja A, Harper P, Williams E, and Gartner D (2024) Capacity planning of virtual wards for frail and elderly patients, Healthcare, 1(0).
NHS Wales (2022) Virtual wards offer hands-on care closer to home.
NHS Wales (no date) Virtual wards – bringing your care closer to home.
Welsh Government (2023) Funding to increase allied health professionals and access to community-based care.
