Deep Dive Report - Avoiding Hospital Admissions (all you need to know)

Healthwatch Staffordshire undertook a deep dive to evaluate in some detail at admission avoidance services in Staffordshire that focus on reducing unnecessary admissions to hospital and relieving some of the pressures on the ambulance and secondary services. They focussed their research on virtual wards.  The initial intelligence gathered through feedback from the public suggests that there is limited understanding of what a ‘virtual ward’ is and what this means in practice for them as a potential patient. The aim of this Deep Dive therefore is to educate and inform the public about admission avoidance in a way that enables them to feel involved in their care at treatment and understand the impetus behind and benefits of Admission Avoidance.

People being referred to a virtual ward from the hospital depends upon good communication between community or hospital staff, talking to patients about virtual wards and involving them in the decision making and informing them of what the service would be and how it would be delivered so that the patient and their family could be fully aware of and signed up to the process. Again, for patients in hospital, it was found that hospital ward staff were not as aware of exactly how a virtual ward operated in the patient’s own home, so patients were often in the dark about what to expect and having any choice in the decision. 

In some parts of the county, a nurse from the virtual ward team visits Royal Stoke hospital to see which patients are eligible, and this is an initiative that may well be of value to patients in Queens Hospital Burton and County Hospital Stafford in terms of engaging patients and family members in the process. Communication between providers and the public would potentially lead to greater confidence in the service and more patients and family members accepting of the service.

Although Healthwatch has been told that virtual ward staff are trying to increase public awareness of the service, from our research this does not seem to be having an impact. Healthwatch felt that increasing public awareness by more publicity, for example, screens in GPs surgeries explaining what virtual wards are and promoting the Home Care is Best Care Campaign.

If virtual wards are to be the preferred place of treatment, the other forms of support individuals living alone might require when they are unwell, such as meal delivery, care needs, isolation assistance, and medication management, need to be considered. This could include working with the VCSE sector.

National Guidance (NHS England – Virtual wards operational framework) states that the service can be referred to as ‘Virtual Ward’ or ‘Hospital at Home’. Healthwatch felt that the latter term is used as it better describes the service being provided. T

Many of the people Healthwatch spoke with mentioned poor communication often between services, e.g., hospital and community, statutory and non-statutory as being a barrier on occasions, including staff providing services on the front line. The comment “it could always be better“ was used several times. There are a whole range of wrap around type services aimed at supporting admission avoidance and improved communication between these services would benefit both the service and patients significantly.