Leicestershire Partnership NHS Trust - Lung patients benefit from daily monitoring

Digital project keeps patients safely monitored at home

A project launched during the pandemic to help patients stay safe at home is being turned into the usual way of providing care.

When coronavirus first hit, it was soon clear that people with long term heart and lung conditions were among the most vulnerable. In those pre-vaccine days, there was a premium on keeping them away from possible sources of infection – such as they might experience when travelling to clinics or even staying in hospital. Yet their original conditions were serious and required regular monitoring to ensure their medicines and exercises were working appropriately. Leicestershire Partnership NHS Trust, University Hospitals of Leicester NHS Trust and Leicester-based technology company Spirit Digital worked together to launch a series of “virtual wards” to care for these patients. This involved the patients using simple gadgets at home to measure their vital signs such as blood pressure and oxygen levels, and then communicating these to clinicians who could offer the patients tailored advice to help them. The results have been patients spending more time in their home surroundings, reduced infection risks, and outcomes which were better than the previous clinicbased way of managing their care. In some cases the virtual wards meant inpatients could leave hospital sooner than expected. Barry James, a heart patient, would advise others to ? use the technology instead of spending more time in hospital. He said: “There’s nothing like being at home in familiar surroundings. “It was reassuring that the nurses were monitoring my condition every day, it was like a comfort blanket.” As the number of inpatients with Covid got to its peak, the virtual ward concept was used so that some of them could be discharged home early under supervision while being gradually eased off oxygen. One of these patients was Philip Walker from Leicester. He said: “Because I had Covid I was just stuck in my hospital bed. I wasn’t allowed any visitors and couldn’t go for a walk, so when I was told I could go home I felt like I’d won the lottery! It was a great relief.” Patients are given access to software which enables them to fill out a daily questionnaire about their symptoms, using their mobile phone or tablet. If they don’t have access to one, they are loaned one for as long as they need it. They are also given a thermometer and an oxygen monitor which clips on to their finger in order to record these details on the system. Patients are monitored for at least 14 days, and can contact the team at any time if they have concerns.

Virtual ward patients l-r: Barry James and Philip Walker

Patients complete simple questionnaires asking them about their condition

The first virtual ward set up in response to the pandemic was so successful that rates of readmission to hospital were half those seen in settings where this service wasn’t available. More than 360 patients have now been discharged onto this service, with around 50 being monitored at any one time during the peak of the pandemic. More than 1,000 patients have benefited from all remote monitoring schemes since the beginning of the pandemic. Alex Woodward, deputy cardio-respiratory lead at Leicestershire Partnerships Trust, said: “The virtual ward has been a real success. Not only has it eased some pressure on the hospitals, it has had an immeasurable impact on patients’ wellbeing and recovery. “The success of this service is purely down to how much effort and hard work every member of the respiratory, heart failure, rehab and admin teams have put into supporting their patients during the pandemic. They have all really gone above and beyond to ensure their patients got the absolute best possible care.” Irene Valero-Sanchez, consultant respiratory physician and clinical lead for integrated care at University Hospitals of Leicester, said: “The feedback we have received from patients has been fantastic. Readmission rates were really low, in part because people felt confident that they were being supported and because they had direct access to a specialist team to address their concerns. “Evidence shows that people recover better in the comfort of their own homes and for the Covid patients in particular, it was so important to get them back home and out of hospital where they’d been through what was, for many, one of the most frightening experiences of their lives.” The project was shortlisted for a Health Service Journal award – the healthcare version of an Oscar.