Digitisation of the NHS: Are Remote Nursing Models And Virtual Wards The New Normal?

"One patient encouraged us to continue to “pour magic down the phones” to patients on our virtual wards"

Covid 19 accelerated the demand in the NHS to use technology to solve Healthcare problems. Here’s what a Nurse using Doccla on virtual wards thinks of remote patient care and whether it’s here to stay.

Topics Covered In This Article

Covid 19 Brought The Digital Future To The Present For The NHS

What Is Doccla?

Reduced Staff To Patient Ratio

Is Technology Translating Into Savings?

How The Virtual Ward Works

What Do The Patients Think?

Some Positive Outcomes For Nursing Staff

Does The Data Call It A Success For Doccla?

Is This Remote Nursing Model The New Future?

Covid 19 Brought The Digital Future To The Present For The NHS

Well some fifteen or so years ago people were talking about AI taking over job roles and reducing cost for some employers in various industries.

My thoughts back then was that nursing would not be affected too much by this digital age.

Fast forward to 2021 and here I am working from my bedroom at home on a virtual ward via a work laptop, monitoring patients recovering from Covid -19 who no longer require intensive medical care, but still need to be on oxygen and continuing nursing and medical care.

What Is Doccla?

Doccla is the Healthcare digital system we are using in the NHS for virtual and remote patient monitoring and medical care.

The Doccla package also includes smart phones that are set up for each patient to input their data, which then becomes visible on my laptop.

Plus: an Oxygen saturation monitor and Thermometer Blood pressure machine are also provided in the Doccla package.

We also have a Doccla administration team as part of the remote monitoring system.

They admit the patients to the Doccla system and help us move them between wards.

Reduced Staff To Patient Ratio

The number of patients on a given day mostly varies from 12-20 patients.

This is roughly the workload I would share with one more Registered Nurse, and two to four Healthcare Assistants on the ward, before I was sent home to shield, and was redeployed to work from home on this virtual ward.

Other staff on the ward are a visiting Pharmacist, a GP, a Nurse Prescriber, a Nurse Manager, Occupational Therapists and Physiotherapists, domestics, admin and clerical and kitchen staff.

Often we would have maintenance men come in to look at the showers and call bells.

So by contrast, using Doccla we require fewer high speciality staff and even fewer lower-paid non-professionals.

Is Technology Translating Into Savings?

The ratio of staff to patient is much less on the virtual wards.

So it would be interesting to see if the cost of setting up, maintaining and using Doccla remote monitoring system is a better use of resources compared to the in-house care of patients.

The system helps the process of early discharge home and prevention of admissions and readmissions, so it should reduce NHS spending but only time will tell for sure if it really is doing so.

How The Virtual Ward Works

Once the patient is transferred by ambulance to their home with their oxygen and Doccla kit, having been taught how to use it, they are monitored remotely and visited by a Community Nurse only if any investigations like blood tests and ECGs are needed.

While monitoring them we gradually wean them off the oxygen as they are able to maintaining their oxygen saturation within normal limits.

If they deteriorate and become unsafe, they are readmitted to their District General Hospital via ambulance.

What Do The Patients Think?

On the virtual wards we still have daily Doctor's ward rounds, but this is now a remote process via Microsoft Teams.

The patients are allocated to mild, moderate, severe, and palliative wards depending on their medical history, current acute illness and level of monitoring and support needed.

Most of the patients are happier to be home from hospital and welcome the calls and reassurance we offer.

They are in their own space and familiar surroundings, not exposed to hospital acquired infections any longer, not disturbed by Nurses' and other patients' noise as the case would be in hospital.

Some Positive Outcomes For Nursing Staff

For us Nurses, we get to avoid the commute, the need to launder and press uniforms, pack lunch or buy it from the staff restaurant or a vendor.

I personally feel that I am keeping better hydrated, eating healthier and am certainly more comfortable working in my PJs (and no need for the life saving/preserving PPE, hallelujah!).

We obviously continue to be paperless using the same Healthcare software from the hospital via VPN (virtual private network).

So while I do need my NHS smart card to login, I don't have to worry about getting trapped outside in the cold because I forgot my card to get access to the hospital entrance out of hours, as often happens when going into work on the actual ward.

The BOC delivers oxygen cylinders if required and collect them when we discharge the patient from our care.

Doccla drivers also collect the monitoring kit from the patient's home when we notify them that remote monitoring has ended.

Does The Data Call It A Success For Doccla?

The Doccla website reports 95% compliance by patients, 35% cost reduction and 100% NHS staff approval since the pilot trial commenced with the NHS in July last year.

This is only one of the new precedence of digitisation in patient care that has become a new way of working in the NHS since to start of the pandemic.

Most patients are now having video (some via Q Doctor) or telephone consultations with their GP and paperless notifications from both primary and secondary level care.

Is This Remote Nursing Model The New Future?

So I will have to think seriously about delving deeper into the world of technology than I previously thought necessary, in order to keep up to speed with my beloved profession.

This remote nursing model is also being scrutinised with a view to applying it to other patient groups such as those affected by heat failure and or respiratory disease.

Digitisation is certainly becoming more common place in Healthcare (in primary care in the community and all the way up to tertiary Healthcare).

We started going paperless over 10 years ago.

The Coronavirus pandemic has ramped up the demand on the NHS for rapid innovation.

Remote primary Healthcare is helping to maintain capacity at a time when it is desperately need by the NHS.

So far, the majority of staff and patients using this model of care have given positive reviews of the system.

One patient after his discharge from our care wrote back to say how excellent his experience was of being supported to get rid of his oxygen tubing, encouraging us to continue to “pour magic down the phones” to patients on our virtual wards.