Blog

In this blog, Gemma Wright, Head of Portfolio for Patient Safety, Virtual Wards, Transforming Wound Care and Polypharmacy, reflects on the invaluable lessons she and her team have gathered over the past two years while actively engaged in the Remote Monitoring and Virtual Wards project.

Like every person who worked in or near the NHS at the start of the pandemic, the future was very uncertain but what we all knew was that we needed to work together to find new and innovative ways of caring for some of our most vulnerable patients remotely. This inevitably meant to rely more on digital technology challenging our ways of working that, in some cases, went back decades.

We were ideally placed to support our colleagues across the NHS system with the rapid roll-out of remote monitoring technology as, as a Health Innovation, our focus is on transforming lives by driving the spread and adoption of health innovation and services that can improve patient care outcomes and service delivery. Working with commissioners at what at the time was NHSX, NHS England and our three Integrated Care Systems (ICSs), we identified three technology companies to work with and started the process of identifying which patient cohorts and clinical settings would benefit most from a rapidly redesigned pathway and where we had energy across the NHS.

During the following two years we worked in settings spanning paediatrics to elderly care homes. We supported over 4,289 patients, and achieved the following:

• GP visits: 134
• A&E visits: 30
• AAU admissions avoided: 58
• Outpatient appointments: 44
• Home visits: 91
• Ambulances: 36
• Community Nurse visits: 73
• Total potential monetary saving of above avoided visits: £71,290

Our role was to work with sites to adopt and spread the use of the technologies and then to conduct a robust benefits realisation exercise. We worked with colleagues within the NIHR to fully evaluate the programme and reported our findings back to NHS England.

Whilst we were in the midst of the programme, virtual wards as a more defined concept were emerging, with NHS England keen to create a more sustainable future for the model. Many of our projects operated in the tech-enabled virtual wards space, therefore we were keen to keep abreast of developments and identify where we could support our system colleagues with their implementation at the end of our NHS England commission.

Explore our suite of resources

To that end we created a suite of resources, compiling the learning and outcomes of our recent programmes, developing template resources for our NHS colleagues to utilise and creating a space to hold all the vast amounts of virtual ward and remote monitoring information in one useful place. We also produced guest blogs featuring clinicians who had been at the centre of our projects, hearing their insight and hopes for the future.

• A blog including background information to the NHSx programme, infographics on benefits seen and an intro to our 2022/2023 programme;
• A video with Sheffield Children’s Hospital showing their journey to implement remote monitoring technology;
• Stage 1 ‘Start’ including a video on the end-to-end implementation process (Implementation Wheel) and a guide to writing an initial business case and identifying a digital solution;
• Stage 2 ‘Engage’ including a video on benefits measurement and a guide to setting up an evaluation;
• Stage 3 ‘Deliver’ including infographic guides to training, testing and IT set up;
• Stage 4 ‘Embed’ including an infographic overview of post go-live activities and considerations;
• Stage 5 ‘Sustain’ including an infographic on ensuring sustainability for business as usual;
• A library of existing Virtual Wards/Remote Monitoring guidance and resources from other sources (published in the ‘Sustain’ stage blog);
• Guest blog from Amjid Mohammed, Emergency Department Consultant from Calderdale and Huddersfield NHS Foundation Trust, discussing their approach to setting up their Emergency Department remote monitoring project;
• Guest blog from Andrew Noble, GP with Extended Role at City Health Care Partnership Hull (CHCP), discussing their remote monitoring programme and transition into a virtual ward

Conclusion

By using our expertise and keeping our finger on the pulse of an ever changing subject matter, we have secured projects with West Yorkshire Integrated Care Board (ICB) supporting three Primary Care Networks (PCNs) evaluate the implementation of remote monitoring technology, linking with innovators across the region to bid for the ICB virtual ward tenders, working with partners to bid for the Health Foundation’s tech-enabled care programme, supporting colleagues in South Yorkshire ICB to develop their virtual Emergency Department project and partnering with Sheffield Centre for Health and Related Research to bid for NIHR research projects looking at the adoption of technology within domiciliary care settings. Lots of exciting projects on the horizon which we feel would not have come to fruition had we stopped at the end of our NHS England remote monitoring commission and lost the energy we had created.

What I have learnt through this process is the importance of capturing knowledge, reflecting on achievements and challenges, and thinking about what can be learnt from these to benefit our colleagues across the NHS. Sometimes we get caught up in the hamster wheel of commissioning, moving from one thing to another without ample time to reflect and evaluate THEN share what we learn. Perhaps something to consider when we are building our work programmes and discussions with commissioners. A perfect world, right?