Defining Virtual Wards Webinar

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Defining Virtual Wards Webinar CPD Free to Register

Register Here: Webinar - HomeLink 22nd November - Govconnect Conferences

Headline discussion points:

∙ NHS pressures: where virtual wards fit in and current initiatives

∙Real life learning from setting up, rolling out and managing virtual wards

∙Impact of virtual wards on the healthcare system

What attendees will learn:

∙ What is a virtual ward and what needs to be in place to make virtual wards work.
∙ Innovation and initiatives that have been used previously to support delivery.
∙ How virtual wards can be rolled out across a system and new treatments/pathways introduced within a virtual ward.

Tuesday 22nd November 2022
1pm - 2pm

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Carers UK is a charity set up many years to support and advice those caring for relatives and/or friends in an unpaid, non professional capacity.

As such I doubt your Webinar will have much interest or impact on our membership.

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@Michael_CarersUK @susieq @Charlesh47 @Melly1

  • I am sick, COVID +ve, prob the new Autumn 2024 variant ‘XEC’
  • Mum was in hospital Blue lighted in Friday, I decided to spend Monday overnight in the hospital room with her to ensure no overnight discharge. She couldn’t get put on general ward but poss risk of discharge
  • Monday luckily I camped in her room during the day to receive the ‘virtual ward’ training, the OT people came and the nurse from the Virtual ward…ALL things Mum would NOT have been able to understand easily due to her brain fog with Covid!
  • I only just got medication for my symptoms, thanks to a neighbour going to pharmacy to sit and wait for Rx of Amoxicillin
  • I have been ‘tasked’ to do observations: Temp, O2, BP, pulse, Respiration breaths over 1 minute, manually log them into an ipad and ‘submit’.
  • In hospital I said I could only do this 2x per day NOT the 9am, 1pm, 5pm THEY wanted and they ‘kindly compromised’
  • TODAY with no voice, I dutifully submitted Mum’s observations at 9am because she was up
  • I get a call to answer questions about Mum around 13.30
  • I have no voice and I’m getting this whole it’s our SOP to ask these questions and we need to have this daily/every other day to monitor Mum
  • When they started into a long spiel about protocols, I cut them short and said just ask the questions now, answered and they’ve activated the text messages on the iPAD.
  • So with no voice, they’re ‘offering’ to send me the questions via text on their iPAD for me to answer…and I stressed I would answer them sometime during the no, no specific time as I’m trying to rest in between when Mum is resting…
  • ON the patient form I had to sign it says if we don’t do this the patient may have to be readmitted for their safety! Talk about guilting the unpaid carer
  • SO our fault if we don’t do observations
  • We’re not paid but we take observations and we feel ‘grateful’ when they ‘compromise’ their ‘standard operating protocol’
  • WHO set this up this way
  • WHO is not recognising that a patient who is COVID +ve is likely to make their carer COVID +ve too, and thus WE are likely to be ill WHILE we’re caring

SO NOW I’m watching over my mother as she recovers, AND have the extra burden of this virtual ward stressing me out AND THE ONLY benefit is that this ward gives me direct access to the hospital for prescriptions or medical intervention…because the GP would be longer…THIS is the only reason why I’m ‘complying’ because right now, I’m steaming - literally because I’ve been running around and I’m still running a bit of temp.

Can someone PLEASE tell me how unpaid carers who are less tech savvy, who are trying to do their best and emotionally distraught AND ILL can do this?
This Autumn Winter this is going to be a huge issue! COVID is already here and vaccinations are only about to start now, that’s 4-6 weeks before immunity for compromised, vulnerable people kicks in…
See attached - how much of that would scare a vulnerable partner!

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@selinakylie - YOU were right about your comment: https://forum.carersuk.org/t/roll-call-july-august-2023/123452/318?u=victoria_1806

@Chris_22081 if you can, get vaccinated asap 4-6 weeks for immune system to prime itself. (From GP call yesterday he said my Sept 19th booster wouldn’t have protected me)
Immunocompromised people may take longer.

This Covid came with extremely bad Strep throat, now turning into really bad tickly throat with involuntary HUGE coughing fits. TALK to your GP

I’m raging that I have added stress, and you know I’m ill when I say I was near crying on the phone to these nurses who were about to launch into ‘our protocol says’…I MEAN whiskey tango foxtrot I am telling you I’m ill and you’re still only worried about how you get the observations and info about Mum…facilitate and easier way for me to send info in…

Let’s see I may have no voice, collapsed on floor due to tachycardia because my coughing fit has aggravated a covid weaker heart (SOOOOO hoping that’s not gonna happen but it does to some!) and have no energy…but I’ll still have to tap in observations to an iPAD!

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@Victoria_1806 Can you complain to your Surgery? Issue is that you are highly intelligent and compassionate and sadly that goes against you> PALS? Your MP? Sorry I think using your compassion is really wrong. You may not be strong enough now but please consider doing this. It would make a GREAT media article? CC Wes Streeting?

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OH I already have a list for PALS from Friday when Acute oncology service, AND triages for antivirals ALL made me go through teleprompted quesitons and NONE asked if her symptoms were escalating or advised ambulance.
Can’t complain to surgery this is a hospital service
Yes complain to PALS hon, BUT as with all things, like you said no energy right now will do when have some, and sharing with oncologists, and medics…I’m not doing a newspaper article…I am sharing on my website to alert other caregivers…This is not a general media thing I want to highlight how the virtual ward is good for patients to get direct access BUT not with burden on caregivers everyday…this process does NOT empathise with caregivers.
It’s not about how intelligent or tech savvy a carer it’s about making sure the service tailors to the patient AND carer’s situation…maybe her word 'compromising was too triggering for me! BUT WTF it’s patients AND carers FIRST NOT a darn protocol!

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@Victoria_1806, you can complain about it to the health board, I regularly do, as well as my local Am. I have tried one of these virtual wards and they are usless, no help really and had the same response with mum having no help from them either as they never came back as promised over a matter. The response I had from them when I got hold of them and they didn’t like it I got hold of them from their response but my answer was just as blunt. Makes me think of a comment of your wasting your time.

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@Victoria_1806 cyber hugs totally get where you are coming from.

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@Victoria_1806 you and your Mum’s situation sounds like a potentially safeguarding issue.

Expecting a carer to carry out monitoring health checks on a caree, report them following an imposed protocol and sign a contract about compliance and the all whilst providing the usual care is a huge ask.

Particularly in your case as you really need to rest to allow your immune system to fight the virus.

You are an experienced, capable, knowledgeable and tech savvy carer - how an inexperienced/ burnt out/ stressed out / sandwich carer etc is supposed to cope with the demands of a virtual ward on top of everything else.

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THANK YOU @Melly1
YES, anyone else it could be safeguarding issue… NO ONE really takes the big picture holistic view of what we do into consideration…it’s the short term transactional needs to tick boxes in a sequential process that they do…

So I’m going to bottom out soon, because I think the symptoms are nearly as bad as they can get and I’m 2 Amoxicillin tablets in…with 19 tablets to go (7 days treatment of 3 tablets (500mg) each tablet).
So I’m doing my best to push through to ensure Mum’s ok - because that’s what I do for LOVE not because of some protocol.
I sound like a walrus having an uncontrollable cough right now I’d do memes with comics and sounds if I had the energy (so you know how bad I am!)

A walrus cough is a symptom of croup, a viral infection of the voice box that causes a barking cough that sounds like a seal

I’ll be okay but THIS all makes me SO concerned for others! ESPECIALLY NOW with this XEC strain and delayed vaccination boosters - did anyone else realise how a booster right now will only give folks immunity in 4-6 weeks!

FYI this is NOT just COVID, there’s a really painful strep throat that accompanies this.

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Victoria, it’s so unfair that they are ignoring the fact that you too are poorly.

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Thanks @bowlingbun YESSSSSS
Seems that these days everyone is SO caught up in productivity of the NHS they’ve forgotten what the mission and purpose is…to CARE for people

I’m raging inside but SO tired…
They’re magnanimously compromising for me to ‘just text’ and I ‘only need to send 1 message to answer their questions’ ohhhhhh how kind of them to compromise THEIR protocol for ME, when I’M the one who’s been caring for Mum for last 4 years and we both Cared for Dad 5years before…
Seems AGAIN like 1 process is cut for everyone…this kind of hand holding directive do this do that for stats may be ok (not really!) for some…but to us long term carers this is like telling us how to suck eggs…OR WORSE…POLICING how we care for our loved ones…because THEY need to tick boxes…
What added benefit exactly IS there to all this for us?!?

@Paola_Carers_UK @Michael_CarersUK May I recommend a survey on Virtual Wards and their impact on the burden of care that Unpaid carers have…
These days we have unsafe discharge risks (that I overcame by staying overnight-24hrs in Mum’s hospital room)
AND NOW we are ‘forced’ to do these reports so that the nurse team can triage or say they’re following up?!?
BUT in out of hours we still have only Emergency services or out of hours doctors…that I would call ANYWAY when I see escalating symptoms!

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Hi @Victoria_1806. I’ve been following this but needed time to think it over. I have a natural suspicion of anything that sounds good until you start asking questions.

It’s all about emptying beds. Funny thing. The NHS has been systematically reducing the number of beds available for 45 years, while the population has been increasing, and politicians are concerned that there is a bed shortage because people don’t really need the beds. Except…the study I’m quoting here shows that from 1987/8, when we had 299,000 hospital beds, there are now about 140,000 available. Of which there are always at least 90% in use at any one time, and 95% or more over winter. During covid, that was probably even higher, which explains why so many old folk were dumped into care homes to free up bed space. NHS Hospital Bed Numbers: Past, Present, Future | The King’s Fund (kingsfund.org.uk)

Hospital at home was introduced a few years before covid hit, and it can be effective. It originally relied on staff, rather than carers, doing home visits to take readings, etc., but since covid and Brexit, staff shortages have got worse. That means they can’t service the patients occupying the beds, let alone those in “virtual wards” (the other name for hospital at home), so it seems now that carers are given the job to do. In some cases it’s like a plasterer demonstrating how to skim a wall and sending you home with the tools and materials to do it yourself. No thought about aptitude, confidence, health, overload, just an expectation that you’ll do it, and as Victoria found out, the warning that if you don’t, the patient will end up back in hospital, with the implication that you are at fault as the carer, and guilty of neglect.

Unacceptable. It is up to the hospital to carry out an assessment to see if the Hospital at Home option is practical and safe for those involved. Given the number of covid strains, there’s even the possibility that Victoria and her mum could have contracted different ones, leaving the unpleasant thought that they could cross-infect each other, which would be disastrous. That’s highly unlikely, of course, but…

The point is that as Victoria is covid positive, and symptomatic, she needs to get as much rest as possible to be able to fight it off, and she’s being expected to carry on as normal - caring for mum - plus the extra elements for Hospital at Home.

Irresponsible.

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ABSOLUTELY spot on @Charlesh47 I concur…I’ve worded my texts carefully - ‘When is the earliest poss date to discharge from virtual ward’ because I DO NOT WANT people to come here, question or ask Mum ‘ARE you being properly looked after’ and it to turn into ‘SOP is compulsory and you’re not following it so you are not safely caring for you mum’ :poop: :poop:
I can see how easily that could happen.

Yes it’s about that who ‘no bed blocking’ thing, also about ‘productivity’ measures and ‘proving they’re doing something’ tickboxing…
There is only 1 SOP for everyone, NO differential for long term carers who will know their loved ones better than the 10-15briefing of directives they want us to do
Directives only nothing about what added benefits or value, if any this offers to us…
SO we are unpaid lackies that give meaning and justification for discharge…

THIS DOUBLY reinforces why I am SO glad I camped out 24hrs Monday 10am to Tuesday 3.30pm discharge…at least the D-dimer test done at 4pm on Monday reassured us she has no DVT/pulmonary embolism - a COVID risk

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If it’s a virtual ward shouldn’t there be a 24 hour Ward sister you can ring?

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The observations I give in the morning ‘feed’ the team’s system for MDT (multidisciplinary team meeting each day), when I call the main line there is a voicemail or administrator to direct my query. So far 2 queries 1 answered.
I got them to enable text message yesterday because I have NO VOICE
I asked a few questions…basically about what I could expect in way of help over the weekend (we ALL know Fridays and weekends are the nightmare times)
The Virtual ward is 8am to 8pm everyday
BUT I’m still unclear about what added benefit or value they give me…so far I’ve had a few VERY CARESPLAINING comments about drinking water, hydration - whiskey tango foxtrot FOR DUCK DUCK DUCK sake!

TODAY, I’ve asked for the earliest discharge date from Virtual ward.
WE ALL know if there is an emergency/if I see an escalation of symptoms or something bad I’m dialing 999 anyway…
Bottom line - right now I’m more ill than mum is…

'scuse the TMI but I’ve just had to clean up toilet from antibiotics effect post breakfast, which is ALL normal and fine, but just got scared poop-less because she shouted for me…Can tell I’m SOOOO burnt exhausted because practically crying with the adrenalin rush!..PHEW thank G Mum is all mentally here nad is being extra careful and safe!

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Hi Victoria. I’m sorry to hear that you and your mum are both unwell. It sounds really tough to be having to do regular checks on your mum when you need to rest and recover from Covid.

I’ve passed on your post to our Policy and Public Affairs team so that they are aware of the pressures being put on carers through virtual wards. We may also have received feedback on virtual wards through our 2024 State of Caring Survey.

If you’d like to make a complaint about the expectations being put upon you by health professionals, you might find the following page from our website helpful.
https://www.carersuk.org/help-and-advice/practical-support/arranging-care-and-support-for-someone/making-complaints/

Wishing you and your mum well

Michael

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Thanks @Michael_CarersUK The NHS has missed a HUGE opportunity to PARTNER with Carers…if a first question was
‘do you have a loved one/carer who helps you, and can we talk to them about how we can help’…

Thanks, I’ll add that one to my list…right now the most urgent one is the PALS complaint for Acute oncology service not advising to dial 999 and the subsequent triages at the antivirals centralised system 2 telephone eligibility triages for a cancer patient who is named and quoted to be eligible already for antivirals - taking 6 hours to get through, and NO check about escalation of symptoms…Process over practical, hence why I got GP and ambulance.

It’s been a week…UNDERSTATEMENT! :crazy_face:

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Just had phone call - We are NOW discharged from the ‘Virtual Ward’ no further readings required
Thank DUCK for that…maybe now I can concentrate on caring more for me to get better as well as Mum now.

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Which makes me think, @Victoria_1806 that virtual wards are a way of reducing the stats on unsafe discharges…

I hope you are able to rest in between caring duties. I caught Covid off S in the summer, not easy caring when you have a fever, sore throat and all you want to do is curl up and sleep.

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