115 Palliative and end-of-life-care (PEoLC) virtual wards: A cross-sectional uk survey highlighting models of care, benefits and challenges

<h3>Background</h3> Virtual wards are part of NHS England’s strategy to reduce hospital admissions. Innovative providers have piloted virtual wards to support palliative patients. This UK survey sought to collect aggregated data about palliative and end-of-life-care (PEoLC) virtual wards. <h3>Method</h3> A cross-sectional online survey was distributed to UK palliative care providers using a multi-level, snowballing methodology. 86 responses were received. <h3>Results</h3> We heard from 20 palliative care providers running 22 PEoLC virtual wards. Models of care differ, but all services support patients with unstable palliative care symptoms who would otherwise need hospital or hospice admission (100%). Some provide step-down care after discharge from hospital (72%) or A&amp;E (69%). Most services rely on specialist nurses and palliative care consultant input daily. A few have regular input from therapists (23%) and pharmacists (17%), which is reported as valuable. Most providers recruited additional staff (65%). Providers use telephone (100%), face-to-face contact (93%) and video consultations (69%), rarely using remote-monitoring technology (15%). As well as reducing hospital admissions, virtual wards were reported to facilitate patient choice and support for loved ones. Respondents reported longer-term funding difficulties for their services. 75% rely on charitable funding and two services have closed due to lack of funds. Some disapproved of measuring the worth of services solely in terms of hospital bed days saved. <h3>Conclusions</h3> Early reports show that PEoLC virtual wards can prevent hospital admissions and save money. They are increasing in number; 25% of respondents are considering launching one. This survey details varying models of care, and reports positive outcomes for patients, carers and staff. It is important that these outcomes are highlighted to commissioners. PEoLC virtual wards resemble frailty models with an emphasis on face-to-face rather than technology-enabled care. Integrated services within a wider virtual ward show promise, but are currently in the minority (32%).