By Prof Hamde Nazar, NIHR Newcastle PSRC
At the PSRC PhD SafetyNet event in March 2024, it became clear that were individual researchers and doctoral students investigating various safety aspects of a model of care known as virtual wards, currently gaining a lot of traction. Virtual wards, or hospital at home is not a new concept, but there has been increased drive to better manage patients in their home to avoid hospital admission and/or facilitate early discharge. Virtual wards allow patients of all ages to safely and conveniently receive acute care at their usual place of residence, including care homes.
After some corridor discussion, Prof Beth Fylan (Yorkshire and Humber PSRC) and Prof Hamde Nazar (Newcastle PSRC) decided to organise a collaborative Virtual Wards PSRC Safety Event.
In September, guest speakers, researchers, doctoral and pre-doctoral students across NIHR infrastructure were welcomed to the cross-PSRC Virtual Wards event in Newcastle University. The aim was to facilitate discussions to identify and develop research priorities and foster partnerships in this area of research.
The day was opened with an informative update by the virtual ward programme lead at NHS England, Charlotte Lynch. Charlotte provided an overview of the current evidence base and newly published Virtual Wards operational framework. It was recognised that there have been priority areas such as frailty, respiratory and heart failure and an increasing focus on children and young people. The national virtual wards team are keen to hear more evidence about what features of virtual wards are associated with positive outcomes and for which patients. There is interest to understand the longer-term impact on patients and establish how patient safety can be measured in this context.
Sophie McGlen then delivered interim findings on the barriers and enablers to implementation of virtual wards across the Midlands integrated care system. Sophie described the many factors across the system, organisation and practitioner levels that are important to consider around virtual ward implementation.
Maggie Westby provided an update on a realist review on virtual wards for patients with frailty. The key take home messages were around having more proactive care, keeping people safe and stable to prevent deterioration and potential crisis.
Representatives from four of the PSRCs (Newcastle, Yorkshire and Humber, Greater Manchester and North West London) showcased patient safety in virtual wards research projects.
Three round table discussions then focussed on:
- Research priorities for patient safety in virtual wards
- Potential methods and strategies to researching patient safety in virtual wards
- How to embed patient and public involvement and engagement and equality, diversity and inclusion into research
Attendees agreed on some key areas that required further evidence. namely:
- Establishing shared definitions and standards for virtual wards
- Investigating data availability, integration, sharing and governance for virtual wards
- Investigating patient safety in virtual wards – understanding appropriate metrics and strategies
- Investigating safe and appropriate patient assessment for and monitoring within virtual wards
- Understanding the need for and nature of workforce training, preparedness and competence
There was an appreciation that evaluations of virtual wards to date have been mainly single-site and observational in nature. There was a consensus that multi-site studies employing robust research designs, experimental where possible, are needed to improve the quality of the evidence base.
All attendees discussed the need for sustainable, well-resourced and diverse patient and public involvement to feed into all stages of the research process.
The final discussions of the day were to establish the next steps for this group given the shared interests and endeavours. There is an intention to set up a community of practice around patient safety in virtual wards where researchers can share, disseminate and signpost evidence and findings. The group are interested to explore the potential for collaboration for research and funding applications.
Researchers interested in joining the mailing list for the community of practice can contact Hamde Nazar from the Newcastle PSRC hamde.nazar@newcastle.ac.uk
Following on from this event, Prof Hamde Nazar has been invited to share the directions of research as identified by the PSRCs at a Virtual Wards sand pit event in October 2025 that is supported by the Advanced Care Research Centre based at the University of Edinburgh, the NIHR Applied Research Collaboration (ARC) North East and North Cumbria and Newcastle University.