Palliative Virtual Wards: a Cross-Sectional UK Survey
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Authors
HL May-Miller
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Issue Date
2025
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Abstract
Objective: Various providers have piloted palliative virtual wards in the past four years. This survey provides the first aggregated data from across the UK.
Method: A cross-sectional online survey distributed to UK palliative care providers using a multi-level, snowballing methodology.
Results: 86 responses were received, with responses from 22 palliative virtual wards. All services who responded support patients with unstable palliative symptoms who would otherwise need hospital or hospice admission (100%). Many provide step-down support from hospital (72%) or A&E (69%).
Services rely on daily specialist nurse and consultant input. A few have regular input from therapists (23%) and pharmacists (17%), which is reported as valuable. Most recruited additional staff (65%). Providers use telephone contact (100%) and face-to-face contact (93%). Fewer use video consultations (69%) and remote-monitoring technology (15%).
75% of services rely on charitable funding and two virtual wards have closed due to lack of funds.
Palliative virtual ward professionals report that they reduce hospital admissions, facilitate patient choice and provide support for patients’ loved ones.
Conclusions: Palliative virtual wards are increasing in number: 25% of survey respondents are considering launching one. This survey details varied models of care and reports positive outcomes for patients, carers and staff. These services resemble frailty virtual wards with an emphasis on face-to-face rather than technology-enabled care. Integrated services within a wider virtual ward show promise but are currently in the minority.
Although there may be overlap with home-based community palliative care, palliative virtual wards may be considered distinct in terms of the intensity and aim of the interventions provided. Whereas both approaches support patients and their families to remain at home as long as possible, virtual wards provide an additional layer of concentrated monitoring, visiting and management during a specific time of crisis, e.g. while the patient awaits an inpatient hospice bed, or until a patient’s unstable symptoms are stabilised, that would often be outside the scope of the community palliative care team.
While those working within virtual wards report significant benefits for patients and staff, rigorous evaluation of clinical outcomes and benefits, as well as economic implications is needed to support widespread implementation and adoption.
Given the novel nature of palliative virtual wards, a UK community of practice has been established to facilitate sharing of learning and best practice. Over 200 people attended the first event in January 2025. Those who attended agreed that it was relevant to their field of practice (95.3%) and increased their knowledge (95.4%). 216 people have registered to attend the second meeting in May.
This work has been undertaken by HMM as part of her Darzi Fellowship in Virtual Ward at Croydon Health Services NHS Trust. It was presented at the Palliative Care Congress in March 2025.
References
[1] World Hospital at Home Community. Landmarks in HAH [online]. 2022. https://whahc-community.kenes.com/mod/forum/view.php?id=1018 (accessed 29 March 2025).
[2] World Hospital at Home Community. What is Hospital at Home?’ [online]. 2023. https://whahc-community.kenes.com/mod/page/view.php?id=1042 (accessed 28 March 2025).
[3] Vallée A, Maxence A. The Transformative Power of Virtual Hospitals for Revolutionising Healthcare Delivery. Public Health Reviews 2024;45:1606371. http://dx.doi.org/10.3389/phrs.2024.1606371
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RESEARCH PODIUM PRESENTATION WINNER (2025)