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ICSs asked to set up Covid virtual wards to reduce demand on hospital beds


By Awil Mohamoud
Reporter
14 January 2021

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NHS England has recommended that integrated care systems (ICSs) set up Covid virtual wards (CVWs) ‘immediately’ so coronavirus patients in hospitals can be discharged sooner. 

In a letter to ICS CEOs yesterday (13 January), NHS England urged action to establish CVWs in light of ‘the intense pressure on hospital beds’ at the moment, and said this approach has already been implemented in parts of the country. 

The virtual wards – normally operated by secondary care – are a ‘step-down’ measure, allowing ‘earlier and safe discharge of patients with a higher level of clinical support than offered through the COVID Oximetry @home model’, according to the letter. 

In addition to a pulse oximeter, discharged patients are supported with agreed remote monitoring arrangements and additional care and support when needed, it added. 

NHS England said CVWs have been proven to reduce admissions and bed occupancy, as well as reducing the length of stay in hospital – mitigating pressure on beds. 

With a record 32,689 Covid patients in hospital yesterday, Boris Johnson, prime minister warned of a ‘very substantial’ risk that ICU capacity could be ‘overtopped’ – but said he could not give a prediction for when that is due to happen. 

Yesterday’s letter from NHS England said: ‘ICSs are responsible for overseeing implementation working with acute trusts, CCGs and other system partners to determine how CVW(s) are best organised across hospitals within their system.’

It added that ICSs will be asked to provide NHS Digital with routine information on caseload, length of stay, and details of discharge medication and oxygen therapy where relevant.

CCGs will already have access to the national supply of oximeters and trusts can request oximeters directly for use in their CVW, NHS England said, while it is also arranging a further distribution to each acute trust.  

The letter also mentioned support and guidance available to ICSs in setting up CVWs, and details of when they should be used.

It said: ‘The CVW model should be an option available to clinicians for adults in hospital with a primary diagnosis of Covid-19 who have an improving clinical trajectory (symptoms, function, oxygen saturation) and have no fever for 48 hours consecutively (without medication to reduce fever). 

‘Consideration may also be given to patients who are seen in secondary care or by ambulance clinicians where emergency admission is not warranted, but urgent oximetry follow-up is required.’

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