Case Study: Northampton General Hospital Trust rolls out virtual wards for asthma patients
In the past few months there has been a ‘ground shaking’ shift in the adoption of virtual wards in the NHS. It has been a vital and valuable tool for delivering safe, effective healthcare during the COVID-19 pandemic. It’s set in motion an altering of how hospitals deliver care and moves it from the hospital to the home.
The use of virtual wards, also referred to as remote patient monitoring services, allow suitable patients to receive the care they need at home, in a safe and convenient manner. It also offers up a significant opportunity for NHS trusts to narrow the gap between demand and capacity for hospital beds and staffing, by providing an alternative to admission and/or early discharge.
While newspapers and magazines have been awash with news about how virtual wards are being boosted to accommodate the influx of patients in this latest wave of coronavirus, these innovative services are much further reaching. They have the ability to extend treatment for chronic, persistent conditions, like heart or respiratory, and help overcome the lengthy pre-and post-elective surgical waiting times we’re seeing in the health service.
Dag Larsson, CEO of virtual ward company, Doccla, said: “We have seen a huge interest in tech-led virtual wards and the service we offer as hospitals look for alternative, innovative ways to approach patient care. The focus on integrated care that works to the benefit of patients and clinicians is the driving force. What virtual wards can do is rapidly scale capacity to serve patients and expand the breadth of care available to them, without putting extra pressure on the hospitals themselves.”
Its use beyond the pandemic is illustrated by Northampton General Hospital NHS Trust’s (NGH) decision to utilise virtual wards in the treatment of asthma patients, made possible with the support of Doccla.
The success of NGH’s responsive home monitoring service for patients recovering from COVID-19 led to the trust exploring how similar hospital-at-home services could benefit other patient groups. In one of these patient groups were chronic asthma sufferers, after it was noted there was a gap in services for patients experiencing acute exacerbation in the community.
Advancements in remote and Internet-of-Things technology provide an opportunity to improve how healthcare is delivered. Tech-led virtual wards are put in place to optimise care of patients, support communication and enable the effective management of a patient’s condition.
Northampton General Hospital is a 700-bed hospital with one Asthma Specialist Nurse working closely with a Respiratory Consultant to provide a service for patients with asthma. The impetus for the implementation of the Asthma home monitoring service (HMS) came from the need to better support patients in the community and keep them out of the hospital setting during the pandemic.
The Asthma HMS was introduced to support patients in managing the exacerbation of their asthma symptoms safely at home. By providing one point of call for patients and earlier intervention in the community, NGH was looking to reduce the need for intensive medical treatment, reduce admissions, and support early discharge from hospital.
Implementing virtual wards
Effective management of asthma requires patients to self-manage their condition with the support of clinicians.
Patients with Asthma (PWA) are given an individual plan to manage their condition, which can be actioned when symptoms begin – with the hope of preventing acute exacerbation. However, if symptoms persist, timely specialist support is essential but COVID-19 protocols caused additional headaches as providing access to such services when patients need it has become increasingly difficult. This can lead to further deterioration requiring intensive medical intervention and hospital admission.
The design of the Asthma HMS pathway was developed through very close collaboration between the NGH team and Doccla. Patients are equipped with wearable medical technology and a mobile to use to submit their readings from home, which are then reviewed on the tailored Doccla Dashboard by an Asthma Specialist Nurse (ASN) who is trained to use the virtual ward service.
Positive outcomes for hospitals and patients
The results exceeded the trust’s expectations. The HMS provides a previously unavailable service for patients who experience acute exacerbation of their asthma. It demonstrates that, with additional support, patients can self-manage asthmatic-episodes safely at home, rather than attending A&E and face the possibility of hospital admission.
The effective self-management of chronic conditions, like asthma, can improve quality of life by allowing patients to manage symptoms and recover comfortably at home when symptoms become more severe. It also promotes the capacity to live as normal a life as possible, such as attending to responsibilities like work and families.
As one asthma clinic patient explained: “The home monitoring system has been a fantastic tool that has enabled me to be monitored and to monitor the state of my asthma first hand without having to be admitted into hospital. As a full-time employee and a mother with childcare issues, being admitted was unfortunately not a viable option when needed.
“Doccla’s home monitoring system [from NGH] gave me the freedom to be able to maintain my home and working life without throwing everything into turmoil… I have been able to see how the medications have been improving my condition – it has also enabled me to have treatments that would otherwise not have been available from the comfort of my own home. I feel these tools and this asthma service have been invaluable… it can save so many people having to be admitted into hospital which, given the current climate with the coronavirus, is a very welcome bonus.”
To date, 166 patients have been admitted onto the service, with the average patient spending 11.5 days on a virtual ward.
In the first six months of the HMS programme (May-October 2021), NGH was found to have;
- Reduced patient admission – HMS saw 76 per cent of Asthma patients avoid the need to be admitted to hospital as a result of earlier intervention, allowing for treatment at home.
- Early discharge – HMS was able to help 24 per cent of patients to be discharged early from hospital.
- Increased clinical capacity – remote patient monitoring services like this one from NGH allow for a much higher ratio of nurse to patient care, compared to nurse:inpatient.
- Improved patient care – the service provides patients with one point of contact for all asthma-related needs, with timely access, giving them continuity of care.
Sharing experiences and sowing the seeds for future virtual wards
With the positive experience of Asthma HMS, as well as with COVID and respiratory patients, clinicians at NGH are working with Doccla to speak directly with other clinicians in the country to further raise awareness of how RPM can be used to improve practice and increase patient satisfaction.
For further information on virtual wards and to find out how Doccla’s virtual wards can help your hospital, please visit www.doccla.com