How Rapid Evidence Synthesis helped to inform Virtual Wards in Greater Manchester

A Rapid Evidence Synthesis (RES) led by researchers at NIHR ARC-GM played a pivotal role in shaping the delivery and implementation of Virtual Wards across Greater Manchester.

In 2022 experts from NIHR ARC-GM’s undertook a RES to inform the Greater Manchester Virtual Wards model of care, which aims provide hospital-level care to patients at home.

Virtual Wards deliver a combination of remote monitoring and face-to-face treatment in the person’s home.

The model of care was mobilised at pace during the pandemic and, ahead of wider implementation across Greater Manchester, partners within the system wanted to quickly review available evidence to help inform the process.

NIHR ARC-GM’s framework for a rapid approach to evidence synthesis allowed researchers to provide findings in a timely manner, therefore providing invaluable insights within a short timeframe.

The RES, which was delivered within 6 weeks, found that there was consistent low to moderate certainty evidence that clinical outcomes, including mortality and readmission, for patients treated in hospital at home are probably as good or better than those treated as inpatients.

Other findings included:

• Evidence on cost-effectiveness in unclear
• There is insufficient evidence on the cost implications for patients and carers
• Consistent evidence that barriers and facilitators exist at the organisational, clinical and patient/carer levels. Identified patient-level barriers are likely to have equity implications.

The RES findings were published in a journal article in Age & Ageing which focused on Virtual Wards and implications for the care of older people. It was also the basis of the evidence section of the British Geriatrics Society’s position statement on Virtual Wards and hospital at home for older people.

Dr Gill Norman, who was the Lead Author of the RES, said:

“The RES provided our partners across the Greater Manchester system with reliable evidence gathered using robust techniques within short timeframes. Not only did the RES answer questions around clinical and cost effectiveness, it also identified gaps in research that could be explored further.”

Dr Paula Bennett, RN (Adult) RN (Child) Chief Nurse Health Innovation Manchester who was involved in the Virtual Wards RES from the start, added:

 

“With a large-scaled transformation project of this nature, it was imperative that we looked at existing evidence to shape and design our services. The RES approach allowed us to explore the literature and research available in a matter of weeks and helped to answer key questions about the benefits and impacts of this model of care, as well as the disadvantages. It played an important role in shaping our thinking of what we needed to do as a system.”

The Virtual Wards RES was delivered in collaboration with partners from across the GM health and care system. Over the next few weeks, we will be publishing a series of blogs from key contributors to the process.

The first blog, from Dr Gill Norman, has been published this week here: https://arc-gm.nihr.ac.uk/news/blog/BLOG-Virtual-Ward-RES

published 8th Febuary 2024