How the NHS is using 'virtual wards' and smartphones to clear beds at hospitals operating at near capacity

December 08, 2022

"We're looking for patients," Jodie Storrow tells me as we walk along a long corridor on the third floor of University Hospital Coventry.

We are heading towards Ward 31. This is where the hospital's respiratory patients are treated.

Jodie, the hospital's clinical operation manager for integrated care, has a very specific type of patient that she wants.

"One with COPD, who is on the upward trajectory and does not need any additional support at home," she says.

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What she means is a patient with a chest, lung or respiratory condition, who is getting better and can be discharged safely without worrying about a package of care.

These are the sort of patients that fit the profile for the hospital's "virtual wards".

The hospital is operating at near capacity. There are patients waiting in its emergency department who have been admitted but cannot come up to a ward because there are no beds available.

So Jodie must find patients whose care can continue remotely at home.

"Hospitals are very busy," she explains. "There's no secret. So if we free up beds on our wards then we free up another bed for someone that needs it."

On Ward 31, Jodie finds her patient, Richard Hall, a retired 56-year-old from Coventry.

Richard was rushed to hospital last week after he almost fainted after inhaling paint fumes. He has a long history of chronic lung disease.

Richard has jumped at the chance of being discharged early. He was not expecting to go home until next week.

He tells me he is anxious about staying in hospital and needs to get back to his flat as quickly as possible.

"It's coming up to Christmas," he says.

"All my heating and everything is on in my flat as well so I'm burning electricity at the minute. I need to get home and sort things out for Christmas really, so yeah it means everything to me."

Richard will be given a smartphone and asked to take his oxygen and blood pressure readings and his temperature up to three times a day.

The recordings are entered by him into a phone app that relays the information to a computer in the hospital.

The data is closely monitored and any warnings that signal a deterioration in his health are flagged to supervisors who can then take action.

Identifying patients like Richard who benefit from care at home eases pressure on the hospital.

It is a strategy developed during the pandemic and forms a key plank of the care-at-home measures that senior health leaders are pushing as part of their winter crisis plans.

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The shortage of beds puts pressure on every part of the hospital including its emergency department. If beds cannot be found then ambulances cannot hand over sick patients.

In the hospital's new minor injuries unit Dr Ed Hartley, its clinical director for emergency medicine, points to some graphs displayed on an iPad-sized monitor fixed to the wall.

He explains there are four ambulances waiting at the hospital ready to discharge patients and attend the next emergency, but cannot as there is nowhere to put them.

I had been told earlier by the hospital's chief medical officer Professor Kiran Patel that 56 patients had been admitted across the hospital and were waiting for beds.

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This hospital, like many across England, has too many patients that are ready to go home but cannot be discharged because there is no social care package in place for them.

Dr Hartley says: "Five years ago, you wouldn't come to emergency departments, be seen, need a bed and then wait several hours for that bed.

"That wouldn't happen, we would have considered that to be unacceptable. And that's now a daily occurrence."

It was here at Coventry hospital exactly two years ago that the world's first COVID vaccine was given to Margaret Keenan.

That vaccine changed the course of the pandemic.

That health crisis forced change and innovation in the NHS, like the virtual ward that will now let Richard go home early.

The health service will need more of the same if it's to cope with the winter that is well on the way.

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