Rosie Kate Lindsay, Paige Cunnington, Mary Dixon-Woods, Why is implementing remote monitoring in virtual wards (Hospital at Home) for people living with frailty so hard? Qualitative interview study, Age and Ageing, Volume 54, Issue 1, January 2025, afaf003, https://doi.org/10.1093/ageing/afaf003
Why is implementing remote monitoring in virtual wards (Hospital at Home) for people living with frailty so hard?
Why it matters
England is likely to need between 23,000 and 39,000 more hospital beds by 2030/31. Providing hospital care in people’s homes could be a practical alternative to building more NHS facilities, helping to reduce risks and improve efficiency.
There have been high expectations of remote monitoring as a key element of NHS England’s virtual ward (otherwise known as “Hospital at Home”) programme. But its use on virtual wards caring for people with frailty has been low compared with other virtual wards. The reasons why remote tech monitoring hasn’t had such high uptake on frailty wards aren’t clear – so THIS Institute set out to find out.
This study looks at the views and experiences of people involved in virtual wards – for example as health professionals, managers, policymakers, or evaluators. The project was guided by a patient and public involvement group.
What we found
We found four main challenges with using remote monitoring in virtual wards for frailty care:
- Healthcare professionals weren’t sure about the benefits of remote monitoring for people with frailty.
- Some people said that that remote monitoring would require significant changes in how patients, carers, and staff worked.
- The right tools and technology weren’t always available, and products needed to be improved to give frail patients and virtual wards better support.
- Virtual wards differed greatly in operation and use of remote monitoring, making comparison difficult. Standardisation efforts were sometimes viewed as unhelpful, and the balance between standardisation and local flexibility wasn’t always right.
Although using remote monitoring has been a major goal of the NHS virtual wards programme, this study highlights several of the key challenges in making it work for frail patients. If technology is going to work, the solutions will need to be co-designed with input from patients, carers, and staff who care for patients with frailty across different health and social care sectors.