West Herts hospital bosses developing ‘virtual hospitals’ for heart and lung patients

During the pandemic almost 4,500 Covid-19 patients were ‘treated’ in their own homes as part of the ‘virtual hospital’

Thursday, 8th July 2021, 3:23 pm
Updated Thursday, 8th July 2021, 3:24 pm

Health chiefs in west Hertfordshire are looking to build on the success of their ‘covid virtual hospital’, by offering a similar service for patients with heart failure and pulmonary disease.

During the pandemic almost 4,500 Covid-19 patients were ‘treated’ in their own homes as part of the ground-breaking ‘virtual hospital’, set up by consultants from Watford General.

Patients submitted their own pulse and oxygen saturation readings throughout the day, while remaining in their own homes.

West Herts hospital bosses developing ‘virtual hospitals’ for heart and lung patients

And instead of traditional ward rounds, doctors spoke to their patients by phone or video conference.

Now it has emerged that the West Herts Hospitals Trust is looking to develop similar ‘virtual hospitals’ for patients with heart failure and pulmonary disease too.

Trust medical director Dr Michael Van der Watt – a cardiology consultant – revealed the plan on Wednesday, July 7, at a meeting of the county’s Health Scrutiny Committee.

A report detailing the success of the ‘covid virtual hospital’ acknowledged the potential to transform the way care is delivered in other areas – reducing admissions and shortening hospital stays.

And commenting on the virtual hospital at the meeting, Dr Van der Watt said: “We were one of the first in the country to set one up to deal with patients with covid who were borderline for admission.

“Over 4,500 patients went through that facility.

“What we have learned from that is that there are quite a few conditions that you can treat at home, that previously you would treat in hospital.

“And so we are about to launch a virtual hospital for heart failure and a virtual hospital for patients with pulmonary disease, in collaboration with our community system and with our primary care.

“So that is really exciting work that is just in development now.”

Dr Van der Watt was one of a number of senior officials from the WHHT attending the committee’s ‘annual patient experience scrutiny’ of various health Trusts in the county – which focussed on the impact of Covid-19.

According to a report submitted to the committee, between March 2020 and April 2021 the Trust admitted 48,000 patients to the – 2,700 of which had Covid-19.

In that time the Trust delivered 440,000 out-patient appointments, including 140,000 virtual appointments by phone or video.

However, ‘elective’ services were ‘largely suspended’ between March and June 2020 and between December 2020 and March 2021.

And it was reported at the meeting that the increased ‘bounce-back’ demand and tackling the ‘backlog’ is now a priority.

Chief executive Christine Allen reported that waiting lists peaked at 1,733 in February, a figure that refers to patients who have been waiting for 52 weeks or longer.

But she said by the end of June that had reduced “significantly” by 47 per cent, to 919 – and had continued to fall in July.

It was acknowledged in the Trust’s report that staff were tired and needed time to recuperate and that “just asking staff to work extra hours is not a sustainable solution”.

And the continued use of the independent sector, clinical prioritisation and some additional capacity, as well as ‘patient initiated follow up’, were highlighted.

Despite the moves towards the new ‘virtual hospitals’, the Trust also acknowledged that out patient appointments would continue to include face-to-face appointments – particularly for a patient’s first visit.

Deputy chief executive Helen Brown said virtual appointments would only be used ‘where appropriate’.

And Dr Van der Watt said: “I think its really important to realise you can’t practise as good medicine virtually as you can face-to-face – because you can’t examine the patient.

“And so I think the direction is going to be that new patients will predominantly still be seen face-to-face – because you need to examine the patients.”

And he highlighted an episode where he had listened to a patient’s chest and in doing so found a malignant mole on their back, which they had not been able to see.

But he said follow-ups were a “very different story” – with some specialities symptom-related and can be virtual.

He said they had already been working through each speciality to determine what percentage of new patients should be face-to-face – and what percentage of follow-ups should be face-to-face.

And he said that there had been different opinions in each speciality area.

“Most of the consultants are now saying they want to get face-to-face back in place,” he said. “And obviously when the rules change imminently that will be a lot easier to implement.”

At the end of the session Roma Mills thanked the Trust, saying: “I would echo comments made earlier that the community as a whole recognise the huge work undertaken by front-line and other NHS staff and I guess we would all want to thank you for that. Thank you.”

Councillors finally suggested they would ask for more structured feedback and for further briefing from the Trust on planned changes to pathology services and on waiting lists.