Inpatient care and treatment - virtual capacity: interview findings

Background

Countries around the world are looking at ways of addressing increasing levels of demand on acute care services (Shepperd, 2016). Demographic changes, including an ageing population and increases in the population burden of disease, have significant implications for how care is delivered in Scotland (Scottish Government, 2021a).

The pandemic highlighted how innovations in community based approaches and technology can be harnessed within healthcare systems (Scottish Government, 2021b). One of the key new ways the NHS in Scotland is delivering more healthcare in the community and providing treatment closer to home is through “virtual capacity” (VC). This is where traditional acute level care is provided in alternative settings, which in many cases is in people’s homes (Scottish Government, 2022a).

These services aim to provide additional capacity by saving hospital bed days (Scottish Government, 2022b). The objectives of VC are to reduce the need for hospitalisation (admission avoidance) or length of stay in hospital (early supported discharge) by offering alternatives to inpatient care, improve patient experience, and reduce the need to travel for care (NHS Greater Glasgow and Clyde, 2022; NES, 2022).

Funding has been provided in recent years to develop and expand Virtual Capacity services across Scotland (Scottish Government, 2022a). At the start of 2022, there were 440 virtual beds, though the aim was to double this by the end of 2022 (Scottish Government, 2022b). Reducing avoidable travel also contributes to the wider net-zero agenda (NHS Scotland, 2022).

This research report aims to provide an understanding of what virtual capacity is and how it is currently operating in Scotland. It is split into two parts; firstly focusing on delivery, and secondly on outcomes. Part one provides an overview of the development and scale of VC in Scotland, as well as barriers and facilitators to implementation. Part two is a rapid evidence review of literature on the effectiveness of VC, alongside patient experience. Where evidence from Scotland is limited, the review will also consider similar initiatives across the UK^[2] and abroad.