Digital project keeps patients safely monitored at home

When coronavirus first hit, it was soon clear that people with long term heart and lung conditions were among the most vulnerable. In those prevaccine 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.

“It was reassuring that the nurses were monitoring my condition every day, it was like a comfort blanket.”

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 clinic-based 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.

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.

The Care Quality Commission is here to make sure health and adult social care services including hospitals, home and residential care as well as GPs in England provide people with safe, effective, high-quality care.

We publish independent inspection reports and ratings about services – information you can use when you’re choosing care for yourself, or a loved one.

You can use our website to search for services you might be interested in by geographical area, or by specialism. For example, a care home that might offer specialist care for someone who has dementia.

We also welcome your feedback on the care you have received – good or bad. We use this information to help inform our inspections and can alert authorities including local social services, if there are safeguarding concerns about care being provided.

You can visit our website at www.cqc.org.uk to find our inspection reports, or share an experience of care. You can also call us to share an experience of care on 03000 61 61 61. Here are some tips to help you choose your care.

Social care Top tips

1 The Care Quality Commission (CQC) registers all care homes and home care agencies. You can find out which ones support specific groups of people, such as people with a learning disability or those living with dementia.

2 CQC’s Chief Inspector for Adult Social Care, Andrea Sutcliffe always uses ‘The Mum Test’: is a care home safe, caring, effective, responsive to people’s needs and well-led? In other words, is it good enough for my Mum (or anyone else I love and care for)?

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Look for care homes and home care agencies where the staff involve people who use services and their families and carers, and treat individuals with compassion, kindness, dignity and respect

Whether you are being cared for in your own home or in a residential setting, the staff looking after you need to be skilled, kind and supportive. They should also be capable and confident in dealing with your particular needs. You should always feel that their support is helping you to live the life you want to.

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If you or a loved one needs help with day-to-day care, you can contact your local council’s social services department. They will ‘make an assessment of your needs’ and depending on circumstances, may be able to help you access financial help For more advice visit Age UK’s website www.ageuk.org.uk/home-and-care.

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If you would like to organise your care yourself, you can find a care worker or personal assistant through an agency Your local social services department should be able to provide details of approved agencies.

CQC’s ratings will identify services as: Outstanding H Good ● Requires improvement ● Inadequate

5 A care home will be a home for you or your loved one. Residents should be treated as individuals with their likes and dislikes taken into account. Think about whether a home is close enough to family, friends, and community facilities

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4 Look at how well-led and managed a home is. What does it have in place to ensure that it delivers high quality care? Does it promote meaningful activity and connect the home with the community?

Safeguarding adults who receive social care is everybody’s business. If you are concerned about the safety of a loved one receiving care, contact the service provider in the first instance. You can also contact social services at your local council. If you feel a crime has been committed, contact the police. You can share your safeguarding concerns with us on our website or contact our National Customer Services on 03000 616161.