P-135 A year in analysis of a hospice virtual ward – utilisation and economic impact

<h3>Background</h3> In 2023 St Columba’s Hospice Care established a Virtual Ward offering daily face-to-face medical and nursing assessment, care and support. A pilot service evaluation outlined the utilisation and positive impact of the Virtual Ward over a period of three months. Patients reflected those admitted to our hospice inpatient unit, were able to be supported in their own homes and have their symptoms alleviated. Remaining unknowns were how the service performed over a full year and its economic viability. <h3>Aims</h3> To monitor use of the Virtual Ward over 12 months and undertake a service cost-saving analysis. <h3>Methods</h3> Over 12 months we gathered data on patient demographics, admission length of stay and outcome and collated informal patient feedback. We estimated the number of ‘bed days’ of a patient in the Virtual Ward and carried out relative cost saving analysis to the hospice and the NHS based on published Scottish data for patients in the last year of life (Diernberger, Luta, Bowden, et al. BMJ Support Palliat Care. 2021 Feb 12;14(e1):e885-92). <h3>Results</h3> Demographic profile, main diagnosis and phase of illness of patients admitted to the Virtual Ward mirrored those admitted to the inpatient unit. The average length of stay in the Virtual Ward was seven days with 41% enabled to die at home. 33% transitioned back to Community Palliative Care Team support, 20% were admitted to the inpatient unit and 2% were admitted to hospital. Patient feedback was overwhelmingly positive. The annual ‘bed days’ of a patient in the Virtual Ward was 1,141, saving £935,620 to the hospice if all Virtual Ward patients were admitted to the inpatient unit. Given the average length of stay for those in the last year of life admitted to acute hospital is 7.7 days, Virtual Ward care represents a saving of £1,029,182 to the NHS. <h3>Conclusion</h3> The Virtual Ward service is a valued and viable alternative to inpatient unit care. Potential savings for NHS acute services are considerable.