Virtual Ward Programme Evaluation
Context
Akeso was commissioned by the North West London Integrated Care Board (NWL ICB) to evaluate its Virtual Ward programme across four acute providers and 34 pathways, as well as the NWL Virtual Hospital. The aim was to assess the programme’s impact on patient care quality and outcomes, and determine its cost-effectiveness compared to traditional inpatient care.
Virtual Wards represent a strategic shift in care delivery—supporting patients at home with clinical oversight, thereby reducing hospital admissions and enabling earlier discharge. With increasing pressure on acute services and a growing need for integrated, patient-centred models, NWL ICB sought a robust evaluation to inform future investment and scaling decisions.
Methodology
Our evaluation is based on three principles: evidence, inclusivity, and collaboration. We used a mixed-method approach across four domains—Patient & Carer, Staff, Quality, and Finance—to assess overall programme performance. This framework gave NWL ICB a robust way to evaluate Virtual Wards using both quantitative (financial, clinical outcomes) and qualitative (experience, satisfaction) data.
Listening First: What Patients and Staff Told Us
We conducted staff satisfaction surveys and interviews, analysed patient and carer feedback and conducted carer focus groups to understand lived experience. Insights revealed high levels of satisfaction with the personalised care model, but also highlighted areas for improvement in communication and pathway consistency.
Real-time Performance Driven Design
Using Virtual Ward and Non-elective inpatient data, we developed interactive dashboards to visualise key metrics and trends. These tools enabled real-time feedback loops and supported decision-making across Providers and the system.
Comparator Modelling
We built a Machine Learning-based comparator model to identify Non-elective Inpatients with similar characteristics to Virtual Ward patients. This allowed for robust outcome comparisons across metrics such as Reduction in Length of Stay (LoS), Admission avoidance and Readmission Rates.
Cost effectiveness
We assessed the cost-effectiveness of Virtual Wards by comparing the cost of delivery against savings from avoided admissions and early discharges. This analysis was Provider and pathway-specific and informed targeted recommendations.
Impact
The evaluation culminated in a comprehensive Programme-wide economic report. Key recommendations included:
Substantial opportunity for standardisation and scaling: High-performing pathways—such as those for heart failure, diabetes, and atrial fibrillation—should be extended across Providers and throughout the Programme through increased utilisation of the Virtual Ward Hospital model.
Expansion of admission avoidance pathways: Enhanced collaboration with community services and Accident & Emergency departments will maximise referrals to the virtual ward and optimise patient outcomes.
Early and proactive patient identification: Improvements in onboarding processes, enhanced awareness, and increased use of data-driven insights will help identify suitable patients efficiently.
To implement these recommendations at scale, a centralised hub-and-spoke framework was proposed to facilitate system-wide coordination and address broader population health needs. This model extends beyond the effectiveness of conventional acute care nursing, incorporating specialist nursing, independent pharmacy prescribing support, and stronger integration with Urgent and Emergency Care (UEC) and community teams. The anticipated impact of these enhancements is an estimated net cost benefit of £3–4 million for the Programme
Contact Our Experts
Olivia Jeffery
Manager
olivia.jeffery@akeso.co.uk