What next for COVID Oximetry and virtual ward?

Abstract

The recent roll-out of COVID Oximetry and virtual ward services across the NHS in England has occurred at a staggering pace. In February 2021, >27 000 high-risk patients with COVID-19 have been treated at home since the first national standard operating procedure was introduced in November 2020 (further information available from authors).1 Observational evidence relating to the effectiveness and value of these local services has started to emerge, with larger national evaluations of the service currently ongoing.2 As services look to become sustainable in the long term and the prevalence of COVID-19 is relatively low, we will soon be presented with an opportunity to decide which elements of these services we wish to amplify and which we should discard. As a result, NHS England is increasingly looking at how it can support automated remote patient monitoring at the patient home through integrated digital platforms for high-prevalence, ambulatory-sensitive conditions such as hypertension, chronic obstructive pulmonary disease (COPD), heart failure, and diabetes. This is moving beyond the usual modes of care delivery such as office-based care for these conditions. This has led to much discussion about whether oximetry and virtual wards should evolve into a single integrated NHS@ home remote patient monitoring service.3 Here we look at whether the enablers achieved through COVID Oximetry @home and virtual wards will be sufficient to overcome some of the historical barriers to introducing telemonitoring services and achieve a coherent, deliverable vision of NHS@home (Figure 1). Figure 1: Historical barriers and current enablers to delivering NHS@home. Source: adapted from Kruse et al. 4 Despite findings from a number of randomised trials,4,5 telemonitoring was not universally adopted within the NHS pre-COVID. Lack of a coherent organising vision, with different stakeholder …