CASE STUDY

Virtual Wards Performance Evaluation & Re-Design

Context

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.

Methodology

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.

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 Need​s

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.

Impact

-1 %
to
0 %

Increase in service utilisation from 77% to 90%

0 %
to
0 %

DNA reduction from 8% to 5%

0 %

20% reduction in unnecessary follow-up appointments

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.

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.
Dr Rachel Marsh
Clinical Lead Virtual Wards
University Hospitals of Leicester Trust

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