High Intensity Virtual Ward

Project overview

Compton Care has a rapid response community palliative care service, which provides patients and carers with 24-7 support. However, the hospice identified that patients with more complex needs required a greater level of support from the entire multidisciplinary team.

In April 2023, Compton launched a High Intensity Virtual Ward to support these patients (and their carers) at home.

Patients on the virtual ward receive:

• daily phone calls
• face-to-face visits if required
• consultant ward rounds twice a week (with consultant cover all day)
• support from a multidisciplinary team that meets once a week
• access to wider hospice services such as chaplaincy, social workers and complementary therapy
• links to other primary care providers as necessary.

The key aim of the virtual ward service is to avoid admissions to hospital, enable patients to be discharged from hospital more quickly, and support as many people as possible to die in their preferred place.

Outcomes

In the first six months of the service, the hospice admitted 371 patients to the virtual ward, with an average stay of 4-5 days.

36 of these patients were admitted to the hospice in-patient unit (IPU) as this was their preferred place of death.

The virtual ward supported 302 patients who would otherwise have been admitted to hospital.

Key facilitators

The hospice decided not to limit the number of patients on the virtual ward. This means the team can support whoever needs the service. However the team have developed clear criteria about who will benefit from being admitted to the virtual ward.

Because Compton already had a rapid response team, they had a lot of the processes and resources that were needed for the virtual ward were in place.

Much of the community support work is carried out by the rapid response team, but three extra posts were recruited:

• a Patient Flow Assistant (who has a Healthcare Assistant background)
• a Nurse Associate (the hospice’s first in a community role)
• a Project Lead.

Challenges

It took time to build up the number of referrals to the virtual ward. The rapid response team needed training to help them understand the virtual ward and recognise patients who might benefit from its support.

The hospice also works closely with the local Acute Trust to improve referrals from hospitals.

The virtual ward will continue to grow as awareness of the service improves. This is likely to lead to further recruitment to support the increased number of patients.

The team is also reviewing admissions to hospital from the virtual ward, to make sure they are appropriate.