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Hero
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The 2022/23 NHS priorities and operational planning guidance has asked NHS Trusts to develop detailed plans to maximise the rollout of 'tech enabled' virtual wards to deliver care for patients who would otherwise have to be treated in hospital. The guidance is asking all Integrated Care Systems (ICS’s) to extend or introduce the virtual ward model by Dec 2023.

See: Tech-Enabled-Virtual-Wards

I think this initiative will cause huge technical and logistical issues for EBME engineers across the UK. Taking acute hospital care directly to the patients home is an exciting opportunity, but will require more money, and more engineers. There is also the issue of working in patients homes. Equipment needs setting up in the patients home, it needs to have remote monitoring, with all the cyber security issues to overcome too.

I was wondering how this will actually work? and whether December 2023 is feasible?


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Super Hero
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... how this will actually work? It won't. Instead it will be yet another unnecessary waste of money, time and effort. In other words, a deviation from the Real Work of the NHS (or at least, the NHS as originally conceived).

These people seem to be mesmerised by "new technology" ... "Oh, wouldn't it be cool if we did this"? Well, how about being able to actually see a GP doctor, or getting a dental appointment? Not "cool", perhaps ... but it's no doubt what Real Folk would actually prefer.

There are plenty of areas that need improvement, and plenty of work that needs doing, before "pipedreams" like this need to be considered. How about training up some British nurses, just for starters?

Back to Basics! How about building some more hospitals (and getting back to sensible beds-to-population ratios - see Germany or France for examples of what that should be more like).

Meanwhile:- "Virtual Wards" and "Hospital at Home" ... oh yes, a great idea for the millions of folk living in rented flats [/sarc]. Also:- lots of travelling for the "neighbourhood teams" (that novelty will probably wear off pretty quickly) - and I don't notice anything being mentioned about tech support (mobile biomeds).


If you don't inspect ... don't expect.
1 member likes this: John Sandham
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Maybe a forum member from the University Hospitals of Leicester NHS Trust, could give us a heads up......

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Hero
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Hi Geoff,
I agree that GP and Dental services need improving, but I quite like having a virtual appointment with my GP. Saves me driving down the surgery unless it is essential.
I think 'virtual wards' will not be an easy fix to the lack of beds in the acute sector, but it may improve the situation.
There are patients cohorts who often call ambulances, and end up being admitted uneccessarily - many of them are able, with the right technology and meds, manage their illnesses at home thereby avoiding coming into hospital.
Research within these suitable patient cohorts show that >90% prefer being at home, sleeping in their own beds, eating their own food, etc.
Don't write off tech enabled care - it can and will be good for healthcare - even though it will cause some logistical headaches for biomed managers / techs, and our IT/clinical colleagues.


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Maybe we could look at the rest of the world and take bits from here and there to create a solution?
In a lot of countries you can go to a shopping mall and have a blood test done, pop next door and have a coffee then a couple of doors down have some imaging performed. A lot of European hospitals have maternity units completely separated and some distance away from each other because why would you put sick people and new born's under the same roof?
The NHS is trying its very best to be a modern healthcare system but still stuck in how it provides this in the same year it was created. People have no trouble going into town for a coffee, collect prescriptions but we insist they attend a building full of sick people to have a blood test or speak with a clinician. Dressing clinics, physio appointments and much much more could be achieved outside a hospital. More and more sites are paying lots of cash on portacabins and modular builds which will only have so much life in them before they collapse, why not the empty BHS building in town? Free up clinic/services and utilize the areas for wards to prevent having to spend vast amounts of finance on an entirely new building.
Its been ok to close a hospital and sell the land for housing, but its not ok to bring the NHS services and clinics into empty buildings within a town?
Shops are closing, buildings are empty and often owned by local authority so would it not make sense to use established buildings rather than spend millions on new builds. People can access towns, they find it difficult and expensive to park in a hospital.
Home care can be achieved but are we really ready? Probably not as we haven't moved with the times in regards to hospitals. Points already raised by others are perfectly valid, safety, liability, libel actions, access to sufficient tools, spares, test equipment. EBME departments are struggling to find budget for spares and test equipment, they will then have to get more and will this budget come?
Will the trust arrange suitable vehicles, will the engineer be able to claim back for parking tickets easily or will it be the usual half hour filling a form for every ticket Or will they be expected to park their own vehicle in an estate/street and face the potential of theft and damage. Will the trust keep up to date with fuel reimbursement?
Care workers in the community are still receiving petrol reimbursement based on prices set at last years price, will the trust keep up to date with this?
I don't believe the NHS in house engineers will be supported, listened to or actually want to do this type of work to be honest. I certainly did not sign a contract that states i will be required to go into a property whereby the resident has not had a CRB completed or if there is a dangerous animal inside but i imagine lots of engineers will be forced to do this and this is not how to handle any member of staff within the NHS right now. Its happening on wards and staff are leaving.
This has contractor written all over it and it will unlikely go to either Serco or a subsidiary of Serco.
The concept of the patient being cared for remotely definitely needs to be discussed and there are a lot of identifiable benefits, its whether the government choose to identify the obstacles is the important bit.


30 years since the Chernobyl disaster and yet we still have no super heroes or zombies.
1 member likes this: Geoff Hannis
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Super Hero
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Sensible proposals? I can't see that catching on.

Good shout about "dangerous animals", by the way.


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Hero
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Many years ago, I did go into patients homes with tools and test equipment - servicing infusion pumps for TPN patients. I agree - not something I wanted to be doing.
There are alternative methods though - service exchange. Keep a stock of equipment and rotate it using courier drop off / pick up services.

A simple, but effective alternative. :-)


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Super Hero
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There are many other "issues" that no doubt get glossed over. Here are just a few:-

1) Continuity (or otherwise) of electrical power "on site".
2) The threat (at least) of intimidation and (or) violence.
3) "Missing" equipment.
4) Language problems.
5) Tampering with equipment
6) Insurance.
7) Cross-infection.
8) 24-hour cover (call-outs).
9) Ethical issues (who connects up the kit to patients?) ... etc., etc.

Re:- couriers. See item 9).

@John:- luckily for me, my only experience of working on kit in people's homes was back in the late '80's - when I did a bit on SATV. I still remember dog "mess" behind the TV set. But I guess that working on kit in vet's surgeries was also (would also be) good "foundation training"!


If you don't inspect ... don't expect.

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