Background: Virtual wards are an increasingly important component of the NHS strategy to help early supported discharge. We present data from the COPD Virtual Hospital (VH) pathway in West Hertfordshire Teaching Hospitals NHS Trust and Herts & West Essex Integrated Care System.

Methods: MDT was implemented for COPD inpatients. Patients were assessed at MDT for VH suitability and discharged with 7-days follow up: pulse oximetry monitoring, app and tablet provided, daily nursing virtual contact and consultant virtual ward round. Outcomes for VH group (n=81) were compared to non-VH group (n=792), from December 2021 to August 2022, and a standard care group (January to August 2019 admissions) (n=959).

Results: Demographics were similar between VH group and a random selection of 50 patients in non-VH and standard care groups; there was no significant difference in to gender, age, co-morbidities, performance status, frailty score, spirometry (FEV1, FEV1/FVC ratio), smoking burden, home oxygen or NIV use. VH group however had more exacerbations than non-VH (p=0.037) or standard care groups (p=0.002). When comparing both VH and non-VH groups to standard care group there was a significant reduction in admissions per month (p=0.00011), readmissions within 30 days (p=0.00033) and 90 days (p = 0.00001) and fewer bed days utilised (p = 0.0006). Subgroup analysis suggested VH pathway led to a reduction in readmission within 30 days (RR 0.66, ARR 3.17%, p=0.354) and 90 days (RR 0.71, ARR 4.6%, p=0.291) compared to non-VH group, however did not reach significance. There were no deaths while on VH pathway and patient feedback was positive.

Conclusion: Our data shows safety and benefit of virtual wards to assist future hospital and community care.