Sharing virtual wards RES evidence base to influence system-wide change
After recognising the strength and value in the Virtual Wards Rapid Evidence Synthesis (RES), Professor Emma Vardy, Deputy Lead for the Ageing Theme at NIHR ARC Greater Manchester (NIHR ARC-GM) and Consultant Geriatrician at the Northern Care Alliance NHS Foundation Trust, worked with lead author Dr Gill Norman to write an academic paper based on the RES findings. The RES has since been published/cited by a number of credible journals and academic sources in acknowledgement of its timely deep dive of the evolving model of care. In this blog, Emma discusses the importance of sharing evidence widely to inform service development and delivery.
Timely insights
The Virtual Wards RES provided incredibly useful information at a time when Virtual Wards were evolving within the healthcare system. From a clinical perspective having a clear understanding of the evidence base is helpful for service development.
The questions the RES set out to answer were specifically framed around healthcare delivery and service development – things that were relevant within the healthcare system at that time. That’s where the RES has the potential to influence healthcare systems.
What made this RES stand out was its comprehensiveness and its focus on considering what the clinical questions might be. There wasn’t anything like this and timely publication is key which is where the rapid nature of RES is invaluable. If people are going to start acting soon, they may as well be doing the right thing.
I felt very strongly that the value of this work should be shared wider so that colleagues beyond Greater Manchester had the opportunity to learn from the work of the NIHR ARC-GM RES team.
Sharing the evidence
I knew we needed to get the message out and share the evidence with other people. An initial opportunity to share the RES outcomes came about through the British Geriatric Society (BGS) which was developing a position statement to outline the issues around Virtual Wards and care of older people. In my mind, the RES aligned perfectly with this, so I pitched the idea of including a section on research and evidence based on the RES, which they welcomed and the statement was published in August 2022.
Gill and I then worked together to tease out more information from the RES evidence around the theme of Virtual Wards in relation to frailty and older people to create an academic paper that would be publishable and accessible to clinicians. Dr Paula Bennett provided a valuable operational point of view from her experience of stepping up Virtual Wards across Greater Manchester.
To bring the RES outcomes to a clinical audience took a lot of reworking and enhancement of the manuscript so it was helpful to have authorship that included both academics and clinicians.
Defining Virtual Wards
An important element of the paper was defining what a Virtual Ward was. At that time there were services that had been called Hospital at Home, and Virtual Wards was a new term coming through NHS England. I knew that there was some confusion amongst healthcare professionals, so we took the opportunity to clearly define what each term meant and any overlap between the two at the start of the paper.
The final journal article for Age and Ageing, which was published in 2023, was very well received by both academic and clinical peers.
The strength of the paper was also further recognised by the BGS when it was selected as one of 26 ‘exemplar’ open access papers to be published as part of a collection for the BGS Autumn Conference.
The proof, as they say, is in the pudding as the Age and Ageing Virtual Wards paper has a high altmetric score and has been widely cited, which is a testament to the robustness of the research and the value of its rapidity to help guide clinical teams.
Download the Virtual Wards RES at: https://arc-gm.nihr.ac.uk/rapid-evidence-synthesis