Shifting boundaries of risk-work in virtual wards in North-West England: a multisite qualitative evaluation (29 May 2026)

Summary

Virtual wards, also known as hospital at home, are increasingly being used across the NHS to support people who would otherwise need hospital care to receive treatment and monitoring at home. A new NIHR-funded study led by University of Manchester researchers explored how safe care is delivered in virtual wards, highlighting the often unseen work carried out by patients and carers as they undertake key elements of risk-work previously held by clinicians.

Content

The findings show that virtual wards can provide a safe alternative to hospital care for some patients, allowing people to recover at home while still receiving clinical oversight. However, patients and carers often take on more practical and emotional responsibility than may be recognised as they assume duties that would normally be carried out by clinicians in hospital settings. This includes monitoring symptoms, managing equipment and responding to signs of deterioration, especially overnight or outside normal working hours.

The researchers suggest that hospital at home services that combine technology with in‑person home visits could help make care safer, more flexible, and accessible for a wider range of patients. Recognising and supporting the work undertaken by patients and carers is essential to ensure virtual wards are safely delivered.

As virtual wards expand as a key component of NHS policy to shift acute care from hospital to community settings, practice must ensure there is space for relational and training support for clinicians, patients, and carers so that remote acute care can be safely implemented across health systems.