NHS North West London ICB cuts virtual ward capacity

Recruitment issues, industrial action and the end of ring-fenced national funding have contributed to a cut in virtual ward bed capacity, NHS North West London Integrated Care Board (ICB) told Digital Health News.

In May 2024, NHS England announced proposals to increase access to virtual wards in a bid to cut avoidable hospital admissions and reduce emergency department waiting times.

However, the virtual ward provision figures for May 2024 published by NHS England, show that nine of the 42 ICBs in England have reduced their virtual ward bed capacity since December 2023.

The number of patients in a virtual ward at North West London ICB increased 5.6% from 300 in December 2023 to 317 in May 2024.

However the number of virtual ward beds available at the ICB has been cut from 588 in December 2023 to 431 in May 2024, representing a 27% decrease.

This is a drop from a capacity of 24.6 ‘beds’ per 100,000 GP registered population to 15 ‘beds’ per 100,000 GP.

The NHSE longer-term ambition, outlined in the ‘2023/24 priorities and operational planning guidance‘, is to reach 40-50 virtual ward ‘beds’ per 100,000 people.

Ring-fenced national funding for virtual wards came to an end in March 2024, with virtual ward services now having to be drawn from wider urgent and emergency care funding.

The NHSE supporting information for ICS leads, ‘Enablers for success: virtual wards including hospital at homes‘, published on 24 April 2022, says: “No ringfenced recurrent funding will be made available from 2024/25. Systems will therefore need to ensure virtual wards are built into long term strategies and expenditure plans”.

A spokesperson for the North West London ICB told Digital Health News: “The ICB performed a review of available virtual ward capacity at the start of 2024 and revised our virtual ward bed capacity to 431″.

They added that the cut had been due to “several factors, notably to do with recruitment and the impact of industrial action“.

They said capacity levels had also been affected by the process of procurement, changing digital provider and “the cessation of ring-fenced funding in March 2024”.

NHSE told Digital Health News that ring-fenced service development funding had supported the rapid expansion of virtual wards across ICBs, but added that funding is still available to support virtual ward expansion.

“Virtual wards continue to be an important priority in delivering care closer to home, preventing unnecessary hospital admissions, and reducing the time patients need to spend in hospital, and funding has been made available to all ICBs to support virtual ward expansion as part of the £1bn UEC recovery fund in 2023/2024 and 2024/2025,” the spokesperson said. 

“Our world-leading virtual wards programme has allowed hundreds of thousands of patients to receive hospital-level care from the comfort of their homes, and we have widened their scope to include a range of health conditions including illnesses associated with frailty, heart failure, acute respiratory infections and paediatrics,” they added.

Meanwhile, University Hospitals Plymouth NHS Trust’s virtual ward beds are now more than 80% occupied with plans to expand further, according to its May 2024 board papers.

A recent analysis by NHSE also found that black and ethnic minority people are underrepresented in virtual ward patient cohorts.