Background Avoidable hospital admissions and prolonged in-patient stays cause patients distress, limit hospital bed capacity, and are costly to the NHS. Virtual wards are being introduced in Integrated Care Systems in England as a new way of delivering care to patients who would otherwise be in hospital. Using digital technologies, patients can receive acute care, remote monitoring, and treatment in their own homes/place of residence. Commissioners have an important role in the development of implementation plans and effective adoption of this care delivery model in clinical practice. This research aimed to explore the acceptability and feasibility of implementing virtual wards in England from commissioners’ perspectives.

Methods We conducted a qualitative study, using elements of rapid qualitative inquiry (RQI). Semi-structured interviews were conducted with 20 commissioners employed by the NHS in various geographic regions of England. Initial key findings were documented during data collection using rapid appraisal procedure (RAP) sheets as per the RQI method. In the second stage of analysis, thematic analysis was conducted, structured using the Framework approach, and informed by the Consolidated Framework for Implementation Research.

Results Preliminary findings indicate high levels of enthusiasm for virtual wards, driven by a strong desire for patient-centred care; commissioners held a strong belief that virtual wards could improve both patient experience and clinical outcomes. Though there were conflicting views over the cost-saving potential of virtual wards in the long-term, other anticipated system benefits included reducing waiting-lists, unmet demand, and emergency admissions, having better referral options in primary care, and improving integrated working across all care sectors. Successful implementation was considered contingent on having motivated and passionate clinical leads. Key challenges to implementation included: recruitment difficulties; liability concerns; lack of interoperability of tech and time-consuming procurement procedures; unrealistic timescales to evidence effectiveness; and restrictive parameters of success. There was further discussion around suitability of patients and the risk of widening health-related inequalities.

Conclusion Virtual wards have the potential to reform patient-centred care though whole systems change and digital transformation. However, for the model to work, commissioners need more time to evidence impact, more specifications around tech procurement, and more focus on patient-centred measures of success. Further, clear pathways need to be developed, with consideration of local need support services, to ensure that inclusion health groups are not further disadvantaged through this model of care.