Akeso conducted an in-depth evaluation for a major Acute Trust, assessing the operational, clinical and financial benefits of their Specialist Virtual Wards programme and opportunities for optimisation and improvement. Using insights gained from our tested evaluation methodology and Population Health Management tool, we designed a target operating model for a Generalised Virtual Ward that would ensure equitable access to meet the diverse needs of the population.
Insight
The Trust had been successful in the mobilisation and expansion of their specialist Virtual Ward pathways. However, with the new Virtual Ward operating framework and ambitious expansion targets set by the ICB and NHS England, they needed support in identifying and communicating the impact for operational and financial planning.
Some of the key challenges with identifying the benefits historically had been due to the disparate data, the disconnected specialty services and the lack of awareness of Virtual Wards across the Trust. To carry out the evaluation we used a quantitative methodology utilising performance and financial data and engaged closely with Virtual Ward Leads and specialist pathway teams to carry out qualitative process mapping and deep-dive analysis to draw further insight into the current operating model of Virtual Wards.
Action
There were three key areas of focus in our evaluation and re-design methodology:
- Benefits and Return on Investment: We conducted a diagnostic performance review of Virtual Wards against non-Virtual Ward pathways and benchmarking against national targets. This was followed by a performance deep-dive and cost-benefit and effectiveness analysis to ascertain value for money in relation to outcomes.
- Population Needs: We used our Population Health Management Clustering tool to understand how effective Virtual Wards are in meeting current needs and to support the design of a future model to target future population health needs. We identified key drivers of health inequality and designed a future scaled-up general Virtual Ward model that both ensured equity of access and supported the wider ambition of progressing digital transformation within care delivery.
- Future General Model: We conducted process mapping to understand the current operating model and identify areas of best practice and opportunities for improvement. Working alongside Virtual Ward Leads, we collated our findings to redefine the visions and goals for Virtual Wards and shape a generalised future model and roadmap.
Results
- Virtual Wards reduced inpatient Length of Stay by up to 5 days which equates to 2,314 bed days saved annually.
- For every 2 Virtual Wards admissions, 1 Inpatient Admission is released.
- Short-term pathway re-design for current specialist model, identifying opportunities for efficiencies including clear workforce planning linked to capacity; increased education, awareness and collaboration cross-site and departments; and standardised Virtual Ward data collections.
- Future Generalised Virtual Ward with Target Operating Model, at Trust and system level to grow Virtual Ward capacity by 150% to meet national targets looking at system-wide working, centralised hub function and ICB demand and capacity planning.
This performance evaluation and re-design demonstrated the cost-benefit of Virtual Wards and the role Virtual Wards can play in both digitally transforming the NHS and clinical ways of working, as well as being able to meet the growing needs of our populations and ensuring equity of access.
Client Testimonial – Dr Rachel Marsh, Clinical Lead Virtual Wards, University Hospitals of Leicester Trust
“Unlike traditional Population Health Management in the UK, which uses risk stratification to focus solely on those already using healthcare services, this novel approach proactively identifies all communities, including those not currently engaging with services, to address inequalities and prevent future health demands across Leicester, Leicestershire, and Rutland, pinpointing where Virtual Wards can provide the greatest benefit for our population”