UK - NIHR Call for research on Virtual Wards, 2025

It's a great idea, but lot would depend on the conditions of grant. Usually existing providers apply for them, and if that's the case here integrated care boards or individual hospitals would apply to run a local service. They'd use their knowledge of the particular issues in that area to make a case.

If that is the way it works (and I don't know, of course) it would be tough to apply for a service for very severely ill ME/CFS patients. Most hospitals will never have seen one, and no one knows what part of the country the next person in Maeve's situation will live in.

It might be feasible to try for a national centre of excellence, but applicants would still run up against the problem of demonstrating they have the experience and capability to run it. The best case scenario might be that charities are allowed to apply, because if AfME or the MEA teamed up with their local hospital to trial a new service, it might look at lot more appealing.

Of course I might be making up difficulties that don't really exist. But it's fairly likely applicants will have to demonstrate demand, that's pretty ubiquitous when it comes to public sector service delivery grants. We know the need is there, but it isn't not quite the same as demand. It wouldn't be easy to evidence it well enough to stand up in a competitive bidding round.

Anyway I'm probably getting boring now with my objections, so I'll try and shut up!

 

This would definitely have helped Graham, who had moderate ME, for at least some of the time he was in hospital.
He had problems hearing/understanding. His wife and son could not visit, partially due to risk of catching Covid and part due to their health.

He couldn't eat onions/garlic and several other veg, so getting enough food was a huge problem...

 

I have so many thoughts on this!
In my day job I have operational oversight of a virtual ward for older people with frailty (known locally as hospital at home). Mainly for people with moderate to severe frailty who are unwell and would otherwise have to go into hospital. For this group of people a nurse, doctor or therapist tends to visit them most days depending on needs (rather than remote monitoring, although we can monitor vital signs remotely). Although we do provide some additional care support, in most cases the family are keen to help to prevent a hospital admission which is often disorientating and unsettling (especially for those with dementia). It's not perfect - for example we are only just starting IV antibiotics at home and our capacity is limited but patients and their families really like the fact they remain in their own home. There has been research done about cost effectiveness for the older population which stacks up quite favourably.

I have often thought there had to be some way of supporting people with ME through a virtual ward model - and now that virtual wards are becoming more common I wonder if there is some way of a hub and spoke model with central expertise in ME linking in through local virtual ward services. TPN would seem like an obvious intervention for a virtual ward (recognising the many challenges with TPN that currently seem to exist!)

That's as far as I have got with thinking about it!!!

 

What’s TPN?

 

Total Paterternal Nutrition
feeding through veins

 

In what way is this different from the home visits of 50 years ago?
It doesn't sound very virtual if you actually go in and see people in the flesh!!

 

Can’t «virtual» mean «almost» or something like that, as in «virtually everyone wore red to the match»?

So a virtual ward would be «almost a ward», although that’s probably a generous description.

 

It may indeed - we can't actually afford a ward but you can have something that almost seems to be a ward. There won't be anyone there when you really need someone but we are trying to cut back on things like that.

 

Of course, nobody is disputing that. What I think people should be very wary of is the idea that somehow 'sort of being in hospital' is a good description for what used to be a standard form of care and now isn't because there are much poor resources people aren't even looked after at home.

If a procedure is called a 'virtual ward' then before you have said Jack Robinson it will be subject to protocol standards for virtual ward procedures and you will have to fill in forms to show that it virtually is virtually a sort of ward situation. So instead of getting on and looking after people we will have health care professionals sitting at their computers logging in just how well they fit the protocol requirements. Just like everything else these days.

 

For sure, if it were me and there were no reasons necessitating to be in a hospital, I would 200% go for this. Hospitals are wretched places to be in even when healthy. No one wants to go there by choice or spend more than a minute than necessary. Have you seen how many people die in hospitals every day?!