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Prime minister recognises game-changing potential of virtual hospitals

Posted: 9 January 2023

Picture of Dr Niall Keenan outside 10 Downing Street.

The ongoing success of the UK’s first virtual hospital – set up in west Hertfordshire – was mentioned in glowing terms by the prime minister when a group of senior clinicians and NHS leaders discussed approaches to the current pressures in a summit led by Rishi Sunak on Saturday 7 January.

Dr Niall Keenan, a consultant cardiologist and the associate medical director at West Hertfordshire Teaching Hospitals NHS Trust (WHTH), was invited to explain how the virtual hospital (VH) model has freed up beds and provided high quality care to patients in their own homes.

Dr Keenan said: “On behalf of the whole virtual hospital team I was delighted to be invited to the Downing Street NHS Recovery Forum. The prime minister was very interested in the potential of our virtual hospital data on a national scale. He recognised this would be game-changing for the NHS in the way patients are cared for and how beds are used. We are proud to be leading the way and sharing our success with others.

“The progress we have made is a great example of what can be achieved when services are organised around the patients. As well as the fantastic contribution of our own VH team at West Herts and our NHS partners, I’d like to pay tribute to our trust board who supported this work in its infancy and enabled clinical staff to adopt this innovative approach.”

A comprehensive multi-agency virtual care model was established at Watford General Hospital in 2020 to prevent it from being overwhelmed by demand for beds for Covid patients.

A VH model of care uses technology to provide a regular feed of health data from the patient in their own homes to a virtual hospital hub where the results are closely monitored by clinicians.

More than 5,000 Covid patients were treated via the VH, saving thousands of ‘bed days’ whilst keeping patients safe. Excellent clinical outcomes and positive patient feedback spurred the team on to rolling out this model of care for other conditions; heart failure and COPD (chronic obstructive pulmonary disease).

This wraparound model of care where the patient is the central focus surrounded by a team of specialist nurses, doctors, therapists and physiologists is being developed and provided by different NHS organisations working together in a new partnership which has really made a difference.

Patients enter the VH from being an inpatient, or directly from the emergency department or via a GP referral instead of a traditional admission. The first steps for the patient are to familiarise themselves with the technology they will use. The equipment usually includes a blood pressure monitor, an oximeter to measure oxygen levels in the blood and a tablet for uploading data if needed (much of the data is fed automatically back to the VH hub).

A daily multidisciplinary team meeting is held to discuss each patient in detail and decide what, if any, input is needed, such as a visit from the community nursing team, input from the voluntary sector, a GP appointment or a hospital visit for a diagnostic procedure or a consultant appointment. Alerts are triggered for patients whose observations move out of a specified range. A ‘stay’ in the VH is typically seven days.

An independent review of this service provides compelling data on the benefits of providing hospital care in people’s homes. The clinical outcomes, patient experience, saved bed days and lower readmission rates demonstrate what can be achieved with the combination of clinical ambition and digital healthcare technology.

The heart failure and COPD virtual wards opened at West Herts in December 2021 and have admitted 426 patients (144 COPD and 282 heart failure) to date. Patients have been largely transferred from the acute (reducing their length of stay), but are increasingly transferred in from the community, avoiding acute hospital emergency department admission and general admission altogether.

For all respondents to date, the average score out of 10 for overall satisfaction with their experience in the virtual ward is 8.3 for COPD and 9.1 for heart failure. Given the fact that the hospital aspect of VH care is delivered online or over the phone, the degree of comfort and confidence patients have in the model is important. The percentage who reported feeling safe in the virtual wards is 95% for COPD and 97% for heart failure.

Maria Buxton, consultant respiratory physiotherapist and service lead, Central London Community Healthcare NHS Trust said: “As a consultant physiotherapist leading the community respiratory team, I have seen first-hand how beneficial it can be for patients to recover in familiar surroundings, closer to their loved ones. It gives me great pride to be able to reassure patients that they are in safe hands and receiving hospital-level care at home. We have received positive feedback from patients, carers and family members who have used the service and it is fantastic to have the work of the virtual hospital recognised nationally.”

Dr Jane Halpin, chief executive of the Integrated Care Board that oversees the NHS in Hertfordshire and west Essex, said: “The virtual hospital service that local NHS partners are delivering is really making a difference to patients. And this is exactly the kind of thing that we will be seeing more of – removing the barriers between local NHS organisations so they can work together to give patients the very best care and treatment, and in the right place too.”

There are plans to expand the range of conditions that can be treated in this way. The virtual hospital team have highly developed plans to roll out this model of care to pneumonia, frailty, diabetes, and kidney disease.


  1. This film explains the virtual hospital model in more depth. (A shorter version is also available).
  2. For more information, please contact the communications team on: 01923 436280 or email: For out of hours media enquiries please call the Watford General Hospital switchboard on 01923 244366 and ask for the on call communications manager.
  3. West Hertfordshire Teaching Hospitals NHS Trust serves people from across Hertfordshire, north London and further afield. It operates from three hospitals; Watford General, St Albans City and Hemel Hempstead. The trust has a catchment area of over 500,000 people and is one of the largest employers locally, with around 5,000 staff and volunteers.
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