‘We’ve cut out the middleman’: How NHS virtual wards mean acute patients are now being treated at home
Elizabeth Simpson is recovering from a nasty bout of pneumonia.
Her oxygen levels dropped so low that she could have been taken to hospital.
That made her feel anxious because at 80 years old she didn’t want to be separated from her family.
She also knew she would be at greater risk of a hospital-acquired infection.
That was a valid concern as the latest NHS data shows COVID infections caught in hospitals are rising.
“If you go into hospital at my age you might catch something else. It’s much more relaxing at your own home because you can go to bed, have a cup of coffee or whatever you want. And the side effect of it all is people having to visit you in hospital – the stress,” Mrs Simpson said.
Luckily for Mrs Simpson she was referred to the virtual wards team at Frimley Park Hospital in Surrey.
This unit, one of the first in the country to set up a remote hospital service, is tasked with treating acute patients at home.
This has benefits for the hospital and the patient.
Gemma Cash has seen an improvement in the treatment of patients using virtual wards
Firstly, it stops unnecessary patient admissions and also helps with the discharge of patients who can continue their treatment at home.
This eases pressure on hospital capacity, improving the flow of patients through the system.
Secondly, patient recovery times are known to improve when treated at home.
One of the nurses visiting Mrs Simpson at home is Gemma Cash, an advanced clinical practitioner with Frimley Health NHS Foundation Trust.
Mrs Cash says she has seen an improvement in the treatment of patients like Mrs Simpson.
“We didn’t have to wait for her to get into an ambulance to go to A&E, to wait in the queue in A&E to be assessed. From 111 we’ve cut out that middleman and we come straight here and do that assessment directly,” she said.
The virtual ward is run by a team at Frimley Park Hospital
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Virtual wards, remote monitoring and rapid discharge teams are all part of the wider government effort to ease pressure on the NHS.
Trusts that have been able to employ these specialist consultant-led teams report some success with the easing of pressure on acute services.
It is a model that the NHS is likely to pivot towards in the future as more emphasis is placed on preventing patients needing to attend hospital and stay for ongoing treatment.
But the success of this programme is dependent on the recruitment and retention of trained staff.
There is already a shortage of nurses and the workforce crisis extends right across the NHS.
It also does not address the long-term crisis in social care which is driving the pressure on hospitals who are unable to discharge medically-fit patients. This number has grown again to almost 14,000 across England.
This and the recruitment and retention of trained staff is an ongoing problem for doctors like Lucy Abbott, consultant geriatrician and chief of service for community services and older peoples’ medicine, who established Frimley’s virtual ward team.
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Dr Abbott told me: “Clearly workforce is our biggest, biggest challenge, and we need to have highly-skilled professionals looking after people with frailty and as you say, that care, that support from social services as well.”
I asked Dr Abbott if her service could be a substitute for a lack of social care.
“No, no,” she replied. “We have to work together.”
The pressure on the NHS is easing slightly. But it would be a dangerous mistake to think the NHS winter crisis is over.
The workforce shortages, compounded by ongoing industrial action by nurses and ambulance workers and the need to address the serious problems in social care, mean the pressure is likely to continue for some time.
Counter-terrorism police are investigating after an incident involving a crossbow and a firearm left two women injured in Leeds.
Police were called to Otley Road at 2.47pm on Saturday to reports of a “serious incident involving a man seen with weapons”, West Yorkshire Police said.
Officers arrived at the scene to find two women injured – and a 38-year-old man with a self-inflicted injury. All three were taken to hospital, with the man held under arrest, but their injuries are not believed to be life-threatening.
“Two weapons have been recovered from the scene, which were a crossbow and a firearm,” Counter Terrorism Policing North East said in a statement.
The incident happened on the ‘Otley Run’ pub crawl, with one venue saying it was closed for the evening due to “unforeseen circumstances”.
Officers guard one of the crime scenes
Officers inside the cordon in Leeds
Counter Terrorism Policing’s statement added: “Due to the circumstances surrounding the incident, Counter Terrorism Policing North East have taken responsibility for leading the investigation with the support of West Yorkshire Police.
“Extensive enquiries continue to establish the full circumstances and explore any potential motivation.”
Home Secretary Yvette Cooper described it as a “serious violent incident” and said she was being kept updated by police.
“Thank you to the police and emergency services for their swift response,” she said. “My thoughts are with the victims and all those affected by this attack.”
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Wrexham AFC have been promoted for the third season in a row.
The North Wales-based side has gone from the National League to the Championship in just three seasons, under its Hollywood owners Ryan Reynolds and Rob McElhenney.
Wrexham were second in the table and had a run of eight games unbeaten ahead of their match against Charlton Athletic on Saturday, which they won 3-0.
Wrexham’s James McClean lifts the League One trophy. Pic: PA
Wrexham’s Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Championship. Pic: PA
It is the first time any club has been promoted for three consecutive seasons within the top five tiers of English football.
The third oldest association football club in the world, Wrexham AFC was bought by Reynolds and McElhenney in 2020, and has since been the subject of a Disney+ documentary, Welcome To Wrexham.
Reynolds, wearing a Wrexham sweatshirt, and McElhenney were pictured celebrating each goal, and after the game, as the fans came onto the pitch at the SToK Cae Ras (Racecourse Ground) to celebrate the victory with the players.
Wrexham co-owners Rob McElhenney (L) and Ryan Reynolds and Ryan’s wife Blake Lively, before the match. Pic: PA
Both stars came onto the pitch after the supporters returned to the stands.
Speaking to Sky Sports, McElhenney praised those behind the scenes, referring to “so many that don’t get the credit they deserve, people who aren’t talked about”.
Reynolds said bringing success back to the club “seemed like an impossible dream” when they arrived in North Wales in 2020.
Wrexham’s Sam Smith celebrates in front of the fans after Wrexham won promotion to the Championship. Pic: PA
He put the three promotions down to “the coaching staff, the greatest dressing room” and an “all for one, one for all” attitude throughout the club, adding he was “speechless with their commitment and their emotion”.
As for the mouth-watering prospect of another promotion to the promised land of the Premier League, the pair agreed it was “for tomorrow”, before ending the interview with a joint mic-drop.
Veteran striker Steven Fletcher said, “as soon as I came to this club, I knew it was something special. We want to go again. We’ll reset in the summer, take a break and go again”.
“It has been a success.”
Just Stop Oil (JSO) insists it’s been “successful” – as its members ceremoniously hang up their orange high-vis vests during a march in central London.
Since the group formed three years ago, it’s drawn attention and criticism for its colourful, controversial protests, which ranged from disrupting sporting events to throwing soup on Vincent van Gogh’s Sunflowers, and climbing on gantries over the M25. It sprayed orange paint over Stonehenge, and cost police forces tens of millions of pounds.
Those days are now behind it; to the relief of many.
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As a few hundred activists marched through London on Saturday, blocking roads as they went; taxi drivers blared their horns and football fans shouted abuse from the pavement.
The PA News Agency filmed the moment a white minivan seemed to drive towards a group of protesters blocking the road.
Protesters shouted “I’m being pushed back!” to police, while the driver could be heard shouting “What about my right to get home?” to the officers gathered.
But JSO never set out to be popular. And it believes its tactics – though hated – have been successful; thanks to the new Labour government’s commitment to not issue new oil or gas exploration licences.
That’s why, it says, its ceasing direct action.
JSO hangs up its high-vis jackets in central London on Saturday
A washing line of high-vis jackets signifies JSO’s disbanding
“This moment marks the success of the JSO campaign – our demand was to end new oil and gas licences and that is now government policy.
“As a result of which four billion barrels of oil are being kept under the North Sea. The campaign has reached a natural end.”
Dr Oscar Berglund, senior lecturer in international public and social policy, disagrees that JSO is disappearing because it’s been “successful”.
He told Sky News policing strength and public perception might have more to do with it.
“They have very low levels of popularity. About 17% of the British population are kind of broadly supportive of what Just Stop Oil do. And that’s too low to recruit.
“It’s difficult to recruit members to something that is that unpopular, and then that a lot of people for good reason I think have kind of stopped believing in that kind of disruption as a means to achieve meaningful change.”
Group triggers specific new protest laws
One thing it did change is the law.
Policing commentator Graham Wettone tells us: “Obstruction of the highway, obstruction of rail networks for example, these are specific offences now.
“It’s given the police more tactics, more methods, more offences they can consider, even stopping and searching somebody who may have something to either lock themselves on or glue themselves to something.”
A JSO activist holds a picture of an imprisoned colleague
Emma Smart was held in prison for her activism with both Insulate Britain and Just Stop Oil.
“The high-vis might be going away,” she tells me, “but we aren’t.”
“These people aren’t going anywhere, we are still committed, dedicated, terrified by the failings of this government and governments around the world.”
JSO activists throw orange paint at van Gogh’s sunflowers
Orange smoke set off by JSO protesters at Stonehenge
She hopes for a time of reflection before it returns in a new form but says the need for climate activism is stronger than ever.
She also believes that while most people dislike JSO tactics, it still raises awareness of the cause and might even push people to more moderate campaign groups.
Just Stop Oil came behind other, similarly controversial climate campaign groups like Insulate Britain and Extinction Rebellion, and as it says goodbye, its disruptive methods have been seized upon by other organisations like the Pro-Palestinian Youth Justice.
The infamous Just Stop Oil orange vests might be going away, but the individual activists, their cause and campaign tactics feel here to stay.
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