The Testing and Results of an Integrated Nurse-led Community Virtual Ward Proof-of-Concept

A Community Virtual Ward (CVW) is a flexible and integrated model working across community and hospital settings, receiving admissions from both areas. It is termed a CVW as the care is delivered in the community in the person’s home and beds are not physical beds but virtual beds. The CVW operates similarly to a ward, in that a team of nurses provide care for the duration of the admission. The CVW has been adopted and adapted internationally to meet the needs of various populations, including chronic disease management, older persons care and in response to COVID-19, all with positive outcomes. This included improvements in quality of life, better symptom control and management, reduced emergency department presentations and a reduction in unplanned hospital care.

As nursing and midwifery roles develop and integrate across acute hospital and community settings, the CVW has the potential to provide the necessary framework to support the delivery of integrated care, to maximise the use of technology and to improve access and choice for patients and service users.

This report details the Testing and Results of an Integrated Nurse-Led Community Virtual Ward Proof of Concept, including the governance structure required and the level of integrated of care required, as well as how remote technology was leveraged to support patients at home. These were informed by patient related outcome measures and the individual patient experiences. Additionally, the experiences of nurses and medical colleagues operating within a CVW is presented, including the use of technology and the impact of information sharing across the hospital and community setting.

The CVW provides a generic model that can be scaled up to provide acute care in areas such as chronic disease (for example respiratory, heart failure, diabetes), and older persons care (inclusive of residential care settings). This can be delivered under real world conditions in the community by applying the principles of the model to reach a greater proportion of the population, whilst retaining effectiveness and efficiency. This is achieved by tailoring the use of digital health care, remote monitoring, governance arrangements and the level of integration required depending on regional and local healthcare needs.