Medway hospital delivering on NHS England’s virtual ward ambitions

Hospital beds are being freed up and tens of thousands of pounds saved at the Medway NHS Foundation Trust in a ‘virtual wards’ strategy made possible by medical technology from Vygon UK.

The Trust, which operates the Medway Maritime Hospital in Gillingham, and its patients are reaping the rewards of the virtual wards programme that allows people to remain in their own homes while still under the direct care of the hospital.

Thanks to the use of the Accufuser elastomeric infusion pump from medical device company Vygon, paired with remote monitoring technology, staff at the hospital can administer drugs and keep track of patients’ vital signs while they remain at home. Clinicians stay in touch with patients via telephone or video call, with only one in-person visit a day required because the Accufuser pump needs to be changed every 24 hours.

The approach not only suits patients, who avoid a stay in hospital, but it limits their exposure to infection.

It also saves hundreds of pounds per patient for every day of their care, when compared to a conventional ward. While a day on the virtual ward costs £187.51, a stay on a conventional ward can cost significantly more than that – for example, £658 per day for a respiratory patient and £460 for a haematology patient.

Spearheading the strategy at Medway is clinical nurse lead and service improvement manager, Jackie Hammond, who implemented the Surgical Medical Acute Recovery Team (SMART) that runs the virtual ward, and is made up of dedicated nurses, consultants and therapists.

Since the team launched in 2016, the approach has been developed and came into its own during and following the COVID-19 pandemic.

“The days of patients staying in hospital throughout their acute treatment is in the past,” Hammond said. “The recent pandemic highlighted how safe and important receiving care in one’s familiar environment is, by utilising innovation and technology.”

Crucial to the approach is the use of the Vygon Accufuser elastomeric infusion pump, which delivers medication at the correct dose and rate.

The SMART team began using the Accufuser in October 2021 and latest figures show that 64 patients were treated on Medway’s virtual ward using the Accufuser between then and January this year.

All of those patients would have needed to stay on a conventional hospital ward if the Accufuser had not been available.

The device can deliver a continuous infusion of antibiotics or other drugs. Medications with time-dependent administration and short half-lives (the time taken for its concentration in the body to halve) would otherwise need to be administered several times a day. The Accufuser pump is changed just once a day, every 24 hours.

Prior to embedding the Vygon Accufuser into treatment plans at Medway, the SMART team was unable to accept referrals for patients who required IV antibiotics frequently during the day. It was not possible to care for them via a virtual ward due to the 8am to 6pm working hours of the team and a reduced workforce to administer the drugs as needed.

“The demand for beds as well as the apprehension from my patients, recovering in a hospital environment during the pandemic, reinforced the need to introduce Accufuser elastomeric devices for our OPAT (Outpatient Parenteral Antimicrobial Therapy) pathways,” said Hammond.

“This allowed me to accommodate more patients on our virtual ward. The 24-hour fresh filled concept was important for me because my team could spend quality time with the patient during the preparation, plus it gives the opportunity to assess and evaluate the effect of the drug treatment.”

During the first 10 months of using the Vygon Accufuser 35 patients were treated on Medway’s virtual ward using the device, avoiding 496 bed days in hospital and saving the NHS almost £160,000.

Cost savings generated by using the virtual ward vary depending on the patient, their length of stay, and what treatment on a conventional ward would have cost.

Medway figures on a selection of virtual ward patients show a range of costs. For example, treatment for an orthopaedic patient staying 37 days on the virtual ward cost £6,938 (£187.51 per day) compared to £20,350 on a hospital ward – a significant saving of £13,412.

The cost of treating a respiratory patient who was on the virtual ward for three days was £563 (£187.51 per day) rather than the £1,974 cost of a hospital ward – a saving of £1,411.

Vygon business development manager, James Cunningham, said: “The SMART service at Medway is a credit to the passion and work that Jackie and the team are doing.

“As the drive across the NHS for virtual wards accelerates, Jackie has been ahead of the curve and demonstrates that it not only pays for itself but also generates savings for the Trust.

“The use of innovative medical equipment to enable patients to receive care at home is important for their experience, but crucially, it’s a key national priority, which all Trusts are tasked with delivering upon. It’s great to see that the implementation of Accufuser has contributed to this service and had had such a positive impact across the board.”