The complex nutrition virtual ward: a nurse-led service innovation to improve safety, efficiency and patient experience

Virtual wards are increasingly used to deliver acute level care in the community. The Complex Nutrition Virtual Ward (CNVW) was established at Dudley Group NHS Foundation Trust to provide specialist community management for patients with complex nutritional needs who would otherwise require prolonged inpatient admission. This evaluation reports activity, safety outcomes and patient experience over the first 3 years of the ward's operation. Admissions rose from 97 in 2023 to 192 in 2024, stabilising at 188 in 2025. Mean length of stay fell from 13 to 8.48 days across the period, while bed-day utilisation increased from 1296 to 1779. Estimated acute bed-day cost avoidance rose from £330 480 to £453 645. No clinical safety incidents were reported, and clinical stability or improvement was recorded in 96% (2023) and 97% (2024) of episodes. Hospital avoidance increased from 51% to 63%. Patient experience remained positive, with response rates of 42%, 11% and 11% respectively for 2023, 2024 and 2025. These findings indicate that a nurse-led virtual ward can deliver safe and efficient community-based care for patients with complex nutrition needs. Prospective data collection and strengthened safety surveillance are needed to support future commissioning and wider adoption.