Background: Hospital at home care is increasing in popularity as an alternative to hospital admission. Hospital at home care offers potential benefits for children including less disruption to family life, improving psychological outcomes, reducing pressure on hospital beds and reducing hospital-acquired infections.The National Health service in England prides itself in having the largest paediatric hospital at home service in the world and plans to expand dramatically over the next decade.The Paediatric Virtual Ward (PVW) Service in Wolverhampton was established three years ago in 2022 as a response to COVID-19 pandemic, following the success of an equivalent adult model. Its vision was to provide a highly skilled, comprehensive service enabling children and young people to be safely cared for at home.Aim: To evaluate the impact of the Paediatric virtual ward on• Bed capacity• Length of stay reduction• Carbon footprint reductionMethod: PVW is a nurse-led service, operational seven days a week (08:00-20:00). Patients are onboarded via Luscii platform, as an easy downloadable app on phones enabling two-way digital communication with nursing staff.Referrals are taken from the emergency department, paediatric ward, paediatric assessment unit and GP.Initially funded for 20 beds, PVW expanded rapidly to include multiple dedicated pathways:• IV antibiotics pathway- for patients still requiring IV antibiotics but safe to manage at home• Awaiting Diagnostics - for patients pending scans, tests, but need monitoring.• Respiratory pathway - for patients with bronchiolitis, viral wheeze, and asthma that needed monitoring, support with inhalers, 48hr GP reviews and education.• Henoch-Schönlein Purpura pathway- for patients with HSP monitoring their appointments and assisting with education on dipsticks reading.• Nephrotic Syndrome pathway- for relapsing patients requiring close monitoring.Data analysis was analysed over a 7-month period ( July- Dec 2022) with a total of 189 patients.Results: Patients from 2 years to 16 years formed the majority of patients treated (n= 107, 57%), with 64% of patients seen in the winter months. Respiratory conditions such as bronchiolitis and viral induced wheeze remained the most common diagnoses seen comprising 55% (n=104). Length of stay on PVW was an average of 3.1 days. A total of 1110 bed days and a total of 59,190 kg of carbon footprint were avoided. The average number of face-to-face contacts was 2.1 visits per patient, and the average telephone visits was 2.6 calls per patient. High positive feedback from patients and caregiverswas received via the digital platform. The estimated cost savings for the local trust in that period was close to £700, 000.Conclusion: The Paediatric Virtual Ward model demonstrates real-world benefits by optimising bed capacity, reducing hospital stay, cutting carbon emissions, and improving continuity of care.With increasing healthcare demands, this model represents a sustainable solution for relieving hospital pressures, particularly during winter surges. Future research should explore patient and staff experiences of PVWs and equity of access, ensuring underserved populations are not left behind.The PVW service is transforming care delivery — achieving better outcomes, improving patient experience, and saving the NHS hundreds of thousands of pounds annually.
