Virtual wards: A rapid evidence synthesis and implications for the care of older people

Virtual wards are an area of rapid development within the National Health Service in the UK, and frailty has been selected as one of the first clinical pathways to be developed. This is in the context of existing longstanding hospital at home services in some areas. A rapid evidence synthesis was completed to guide the local healthcare system in the North West of England. This is a rapid approach to synthesising existing research which focuses on existing evidence synthesis where possible. Questions were addressed on clinical-effectivness, cost-effectiveness, barriers and facilitators, models of care and use in practice, and staff and patient and carer experience. We found that whilst there was a significant evidence base for hospital at home, there was less evidence for virtual wards. There is lack of guidance for key aspects of virtual wards including team characteristics, outcome selection and data protection. We recommend that research and evaluation is integrated into development of virtual ward models of care. Of particular relevance for older people cared for on virtual wards is the issue of carer strain, an area which may be frequently overlooked.