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Hospital at home and virtual wards provide safe alternatives to hospital care in the community. There is considerable variation in how they are operationalised at a local level. In general, their common feature is to provide healthcare in people’s homes through a multidisciplinary clinical team. Care is delivered both remotely and face to face. They aim to help avoid admission as well as facilitate rapid discharge. The models vary in terms of who leads the service; the hours of operation; the staffing model; the conditions they support; the length of support; how technology is used; and how patients and professionals access the service. In March 2025, NIHR Evidence held a webinar showcasing research on two home-based alternatives to hospital care from three evidence reviews: admission avoidance hospital at home and virtual wards for people with frailty. The webinar addressed: the key elements of hospital at home and virtual wards their impact on outcomes their impact on service costs factors that contribute to their success.

Examples of how two NHS trusts have designed a virtual ward using the system-wide digital healthcare platform, Luscii. The team at Maidstone and Tunbridge Wells NHS Trust (MTW) in collaboration with the Home Treatment Service (HTS) have designed a virtual ward to cater for frailty patients, allowing them to provide acute-level care without the need for hospital admission. MTW’s innovative approach means patients are empowered to live fuller and freer lives with access to hospital care from the comfort of their own homes. Maidstone and Tunbridge Wells NHS Trust_ Frailty Case Study.pdf Nurses at London North West University Healthcare NHS Trust (LNWH) have created a virtual ward caring for hundreds of heart failure patients. The new virtual heart failure ward is a fascinating case study of the power and potential for technology to optimise the use of critical resources and improve care outcomes. The Future of Care - Inside LNWH's Virtual Heart Failure Ward (1).pdf

England is likely to need between 23,000 and 39,000 more hospital beds by 2030/31. Providing hospital care in people’s homes could be a practical alternative to building more NHS facilities, helping to reduce risks and improve efficiency. There have been high expectations of remote monitoring as a key element of NHS England’s virtual ward (otherwise known as “Hospital at Home”) programme. But its use on virtual wards caring for people with frailty has been low compared with other virtual wards. The reasons why remote tech monitoring hasn’t had such high uptake on frailty wards aren’t clear – so THIS Institute set out to find out. This study looks at the views and experiences of people involved in virtual wards – for example as health professionals, managers, policymakers, or evaluators. The project was guided by a patient and public involvement group. What the study found There were four main challenges with using remote monitoring in virtual wards for frailty care: Healthcare professionals weren’t sure about the benefits of remote monitoring for people with frailty. Some people said that that remote monitoring would require significant changes in how patients, carers, and staff worked. The right tools and technology weren’t always available, and products needed to be improved to give frail patients and virtual wards better support. Virtual wards differed greatly in operation and use of remote monitoring, making comparison difficult. Standardisation efforts were sometimes viewed as unhelpful, and the balance between standardisation and local flexibility wasn’t always right. Although using remote monitoring has been a major goal of the NHS virtual wards programme, this study highlights several of the key challenges in making it work for frail patients. If technology is going to work, the solutions will need to be co-designed with input from patients, carers, and staff who care for patients with frailty across different health and social care sectors.

Virtual wards, also known as Hospital at Home, treat patients in their own homes who would traditionally be cared for in hospital. Their rapid rollout by NHS England has led to lots of discussion – heralded as both a potential solution for the capacity pressures on the NHS and cautioned against due to a lack evidence about their effectiveness.  The current 11,635 virtual ward ‘beds’ across England represent a huge investment of funding, staff and other resources during a time of unprecedented pressures on the NHS. With an initial allocation of £450m over 2 years, it’s not a surprise many have been asking – do virtual wards actually work? That’s a very complex question to answer. The Improvement Analytics Unit, a partnership between the Health Foundation and NHS England, has been working to understand the evidence – and gaps in evidence – on virtual wards.

In January 2023, NHS England’s Delivery plan for recovering urgent and emergency services committed the health service to ease the growing pressure on hospitals by scaling up the use of ‘virtual wards’. Also known as ‘hospital at home’, virtual wards allow people to receive treatment and care where they live, rather than as a hospital inpatient, while still being in regular contact with health professionals. This article by The Health Foundation looks at how NHS staff and the UK public feel about the use of virtual wards, based on the results of a survey of 7,100 members of the public and 1,251 NHS staff members. The survey aimed to assess how supportive these groups are of virtual wards and what they think is important for making sure they work well. Key findings The UK public is, overall, supportive of virtual wards (by 45% to 36%). But this support is finely balanced – with a further 19% unsure whether they are supportive or not. So there is further to go in raising awareness and in understanding and addressing the public’s concerns as this model of care is developed. Support for virtual wards is higher among disabled people and those with a carer – groups that typically have greater health needs and who might therefore be expected to be more intensive users of virtual wards. Those in socioeconomic groups D and E are on balance unsupportive of virtual wards, so it will be important to understand and address needs and concerns here. Notably, survey respondents in these socioeconomic groups who said that they would not want to be treated through a virtual ward were also more likely to say that their home would not be suitable for a virtual ward compared with those in other socioeconomic groups. Nearly three-quarters of the UK public (71%) are open to being treated through a virtual ward under the right circumstances, while 27% said they would not be – suggesting that, if implemented well, virtual wards should be acceptable to a large majority of service users. Interestingly, a higher proportion of the public, 78%, told us that they would be happy ‘to monitor their own health at home using technologies, instead of in a hospital’ – describing a scenario often seen as part of a broader virtual ward service, but avoiding the term ‘virtual ward’ – with only 13% saying they would not. This raises the question of whether using different terminology or providing more explanation could help alleviate concerns and build wider support. NHS staff in our survey were, on balance, clearly supportive of virtual wards (by 63% to 31%). When asked what will matter for making sure virtual wards work well, their top two factors were the ability to admit people to hospital quickly if their condition changes, and the ability for people to talk to a health professional if they need help.

Access outline their virtual ward offer and 10 case studies from NHS trusts and other organisations from which they present findings as testimony, to show the impact of virtual wards on the NHS’ ability to provide care.

NHS England believes virtual wards could create much-needed capacity for the NHS, but progress against the national body’s 2022-2023 guidance in this area has been inconsistent. An HSJ roundtable, in association with Akeso and Masimo, explored the barriers to adoption and how they can be tackled.

In this blog, Angela Osei, associate director, NICE implementation support, sets out to understand some of the challenges, benefits and considerations of setting up and running a virtual ward, from the perspective of teams on the front lines.

This report summarises the findings of an evaluation conducted by Health Innovation East and Health Innovation Manchester on behalf of the national Innovation Collaborative for digital health. It presents findings from an evaluation of a chronic obstructive pulmonary disease (COPD) virtual ward that falls within a virtual hospital managed by South and West Hertfordshire Health and Care Partnership. It aims to inform the potential wider adoption of the virtual ward model across the UK and understand the model’s potential to support people with other health conditions. It also considers the success of South and West Hertfordshire Health and Care Partnership Virtual Ward objectives to improve patient care, clinical outcomes, healthcare utilisation, and patient and staff satisfaction. 

This is the recording of a roundtable hosted by the Institute of Health & Social Care Management (IHSCM) about virtual wards. Roy Lilley, IHSCM Chair and health policy analyst, discusses reducing waiting times, being innovative and sustainable and improving patient outcomes and patient journeys with a panel of speakers. The panel includes: Kris Glover, MD & Founder of Neon Health Solutions Paul Rylance, CTO, JKMCare Dr Folarin Majekodunmi, Director at Peopletoo

This is the recording of a webinar hosted by The Patients' Association, looking at how virtual wards work and patients' experiences of virtual wards. A panel answered questions about who was suitable for care on a virtual ward, how they are staffed and what happens if you're not tech-savvy. The panel was: Jono Broad, a patient leader in the southwest of England. He is a Senior Manager for Personalised Care, NHS England South West, works on patient experience, safety and quality. Emma Matthews, Regional Community Development Lead NHS England South West, Consultant Practitioner Older People and Frailty. Dr Shelagh O’Riordan, Consultant Community Geriatrician at Kent Community Health NHS Foundation Trust and Professional Adviser to the virtual ward team at NHS England. She is also Clinical Director for Frailty in East Kent and runs a large frailty virtual ward. Dr Crystal Oldman CBE, Chief Executive, The Queen's Nursing Institute. Crystal qualified as a nurse at University College Hospital, London. In 2017, Crystal was awarded a CBE in the Queen’s Birthday Honours List for services to community nursing and her leadership of the QNI. Crystal is an Honorary Professor at London South Bank University. Patients Association member, Alan Bellinger, who represents patients on the Hospital at Home programme in Hertfordshire, and is a patient representative on the Eastern Academic Health Science Network Review of Remote Monitoring.

Hospital at Home is a short-term, targeted intervention that provides a level of acute hospital care in an individual’s own home, or homely setting that is equivalent to that provided within a hospital. In mid-2020, the ihub within Healthcare Improvement Scotland began working with a number of NHS boards and health and social care partnerships to support the implementation of Hospital at Home services across Scotland. This toolkit was created as part of that work, providing a range of tools and resources to support areas to implement and expand Hospital at Home services.

This long read by the Nuffield Trust looks at priority areas where further development and action could help improve the effectiveness of virtual wards. It outlines different models for virtual wards and looks at how to ensure effective system oversight. It also highlights the need to ensure the workforce is equipped to run virtual wards effectively and safely.