Virtual Wards funding and costs

A functional virtual ward means acute beds can be better utilised and, by moving people back to an environment that is more familiar and less stressful, improving a person’s recovery and their overall healthcare experience. 

As of May 2022, NHS England is asking integrated care systems (ICS) across the country to hit a target of 24,000 virtual ward ‘beds’ (40-50 per 100k population) by the end of 2023. These will provide a safe return home for remote care and monitoring for those suffering with frailty or recovering from an acute respiratory infection.

Service Development Fund

Virtual wards need funding though, and that financial support has to be earned through bidding. NHS England (NHSE) published a guide to virtual ward costs and funding in April 2022, which includes information on the availability of funds and how to work with independent suppliers. 

The Service Development Fund (SDF) is provided by NHSE’s Primary Care Group. This arm of the NHS has made £200 million available for the financial year 2022/23 to help establish and develop virtual wards. For FY 2023/24, an additional £250 million pool is available on a match-funded basis (they match what you put in). Beyond that however there is no funding currently ringfenced, meaning NHS trusts will have to account for the continuation of these virtual wards out of their own budgets.

Other funds are also available for technology improvements in the NHS and social care, while they don’t specifically mention virtual wards as a purpose for the funding, implementing virtual wards can help to meet some of the key objectives these funds set out.  

The Better Care fund is a key fund across Health and Social Care aimed at “to join up health and care services, so that people can manage their own health and wellbeing and live independently in their communities for as long as possible.” This includes the adult social care discharge fund, aimed at supporting “timely and safe discharge from hospital into the community by reducing the number of people delayed in hospital awaiting social care.” 

The aims of these funds relate closely to the aims of implementing virtual wards and may be able to be used to support virtual ward projects.

Hospital at Home funding 

With devolution, Scotland, Wales and Northern Ireland have their own prerogatives for care provision, but Scottish health boards are required to provide virtual wards – better known as ‘Hospital at Home’. 

Scotland has invested £3.6 million for the Hospital at Home provision to double its capacity by the end of 2022 and an overall £8.1 million since 2020 and the beginning of the Covid-19 pandemic, with more likely in 2023 and beyond.

Costs to consider when setting up a virtual ward 

Setting up a virtual ward isn’t without cost or difficulties, but the rewards are worth the investments. Knowing how much you need to invest is part of the virtual ward challenge though, and it’s important to properly cost such a care development. 

Below are two of the most commonly asked questions: 

• How much does a virtual ward cost to set up? According to a Royal College of Nursing case study of South Eastern Trust virtual ward in Northern Ireland, the total set up cost for a virtual ward is approximately £32,974. 
   
• How much does a virtual ward cost to run? The approximate annual operating cost for a virtual ward is £566,273, according to a Royal College of Nursing case study of South Eastern Trust virtual ward in Northern Ireland. This figure is subject to change due to the difficulty in measuring costs when assisted by other internal departments as part of existing duties or existing external partners who may report to other teams primarily. 

These estimations are useful, but they are not wholly accurate. Virtual ward costs vary per region and relating to the NHS trust they are operating within, as well as based on what existing support is available in that area and the needs of the local population. 

Recruitment and equipment are core costs. You need staff and you need kit. Both need to be managed and utilised properly. The NHS has its own recruitment pathways, but for software solutions it will need to outsource. The Access Group offers Access Assure, which is a digital telecare or home monitoring kit with related software to track a person’s vitals, but this is just one of many solutions available. 

Other costs include things such as training courses, departmental meetings, leaflets and posters, whilst there are also indirect costs such as office space required for a team and desks.

Virtual ward costing model

A costing model is another way of describing money management. It is financial planning; forecasting the cost of a product or a service, or perhaps comparing it to other available products and services on the market. 

A virtual ward costing model is important. NHS funds are highly sought after and carefully managed before being granted, so a trust needs to meticulously display its financial calculations, forecasts, and the return on investment (ROI) in order to demonstrate value for money to the NHS but also to show that the trust can be… trusted. 

The key things for a costing model to track are: 

• Rostering (workforce + management costs) 
• Staff recruitment 
• Staff training 
• Provisioning (equipment + management costs)
• Software onboarding 
• Advertisement/promotion costs 

It is important to demonstrate that the best deals and supplier arrangements have been reached. No proof of market research and competition will not be looked upon favourably, whereas evidence of research and proof of product or service costs shows a pursuit of efficiency and proper management of the virtual ward project. The NHS is not looking to waste money, it is looking to invest in the future of the UK.

Are virtual wards cost effective? 

Referring to the aforementioned Royal College of Nursing case study, a hospital bed costs approximately £350 per day. This figure is based on cost analysis performed in 2014/15, and has been adjusted to account for inflation levels. 

Current Health, care-at-home competitors to our very own Access Assure, have a Croydon case study which states that the estimated cost saving per patient, by moving to a virtual ward homecare approach, was £522.12 saved on home visits and £220.32 on bed days, totaling £742.44 overall compared to a standard ward patient. 

medRxiv medical publishing also said similar with a case study into a virtual Covid ward in Leicestershire and Rutland. The study found savings of over 1,100 bed days, which equated to £529,719 net financial savings. Readmission did occur in sporadic cases, though the 30-day readmission rate was reportedly just 2.9%. 

The Royal College of Nursing study is the most positive report however, as it is arguably the most detailed. Their research suggests “considerable economic benefits” by virtue of reduced A&E attendance, avoiding hospital admissions, and enabling earlier discharge. Statistics show 4,547 hospital bed days were saved by the Northern Irish trust, and the costs avoided totaled £8.8 million annually, calculated over a three-year period. Deducting the £566,273 annual operating cost, that means a saving of £8,238,256 per year. 

A final costing perk is staffing. Statistics from Norfolk and Norwich University Hospitals NHS Foundation Trust reported zero sick days amongst their virtual ward team. The flexibility of virtual ward monitoring and support meant that staff who would not normally be permitted to work (due to the risk of spreading coughs, colds, and worse in the workplace) could perform lighter duties from the comfort and safety of home, including patient monitoring and patient check-in calls via tablet devices or laptops.