Inpatient care and treatment - virtual capacity: interview findings

Virtual Capacity (VC) enables traditional inpatient care and treatment to be provided in alternative settings, often in people’s homes. This report which includes findings from interviews with pathway representatives and a rapid evidence review provides an understanding of how Virtual Capacity is operating in Scotland.


Definitions

Bed days saved[1] – the number of days receiving a VC service and not occupying an inpatient bed.

Community Respiratory Response Teams – Community Respiratory Response Teams provide treatment at home to patients with chronic respiratory conditions (e.g. COPD) who would traditionally require hospitalisation.

Covid Remote Health Monitoring – This was for individuals with Covid-19 who did not meet the threshold for hospitalisation, but who still required medical intervention. Covid Remote Health Pathways (RHPs) were piloted in Scotland and implemented from January 2021 as a new service enabling people diagnosed with Covid-19 to self-monitor their symptoms. The pathway was used to detect and manage early deterioration of patients, indicated by breathlessness and decreased oxygen saturation.

Heart Failure Pathway - The pathway was introduced to support heart failure patients through access to specialists to reduce the risk of hospitalisation and premature death by facilitating earlier heart failure therapy for patients newly diagnosed with the condition.

Hospital at Home – Hospital at Home is a short-term, targeted intervention providing a level of enhanced intermediate care in an individuals own home or homely setting as an alternative to acute hospital care. This has generally been used to describe the pathway provided to adults with a focus on older people in Scotland. However, Hospital at Home is now being used as an umbrella term to describe the activities provided by each of the pathways (in a similar way that the term Virtual Capacity has been used). We have retained the term Virtual Capacity in this report however to avoid confusion with the Hospital at Home pathway and in order to ensure consistency with the terminology used in the wider academic literature.

Length of stay – this includes length of hospital stay and length of treatment via a VC service.

Readmissions – readmissions to hospital from hospital level care. This can include being admitted to hospital from a VC service.

OPAT – Outpatient Parenteral Antimicrobial Therapy (OPAT) is a multidisciplinary clinical service which provides an alternative to hospital admission for patients with a range of infections which require treatment via intravenous or complex oral antimicrobials.

Virtual Capacity - traditional acute level care provided in alternative settings, such as in people’s homes. VC aims to increase capacity, improve patient experience, and reduce the need to travel for care.

Virtual Ward - utilises technology to monitor patients remotely.

Contact

Email: Arfan.Iqbal@Gov.Scot

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