England

Virtual wards and hospitals at home allow people to receive treatment and care in their homes, rather than as a hospital inpatient, while maintaining regular contact with health professionals. It is not a substitute for acute inpatient hospital care.

Virtual wards take full responsibility for patient care, delivering medical, nursing and allied health support through a multidisciplinary team (MTD).

Wales

In 2023, Wales’s Health Minister emphasised the need to prioritise community-based services that support patients living independently at home for as long as possible.

Wales is taking a coordinated approach via Technology Enabled Care TEC Cymru, the National digital leadership team in Wales.

Early operational models are already functioning in Swansea Bay University Health Board.

Wales’ policy direction

Wales is delivering the A Healthier Wales (PDF) vision by shifting care closer to home through integrated, community services—often called a ‘home first’ approach.
Research leadership

Cardiff University (PDF) is leading system wide operational research on virtual wards in Wales, including capacity planning and hub location modelling, with open access outputs in its ORCA repository.

Taken together, Wales appears to be moving toward a unified, nationally coordinated, digitally supported virtual ward model rather than a regionally variable approach.

Northern Ireland

In Northern Ireland, all health and social care trusts have established hospital-at-home services. These MTDs deliver intensive home care for patients experiencing acute illnesses.

Scotland

In Scotland, Hospital at Home provides acute care in patients' homes, offering services equivalent to hospital care. The programme has reduced hospital stays, increased patient numbers and expanded services across Scotland. For more information, visit Healthcare Improvement Scotland’s website.

The Scottish Government announced an £85 million investment, targeted at front line NHS frailty services. This would be used to help improve the flow of patients throughout hospitals and provide care for patients in the comfort of their own homes. The ‘Hospital at Home’ service is to be expanded to 2,000 beds by December 2026. It predominantly provides care for frail, older people in their own homes and who may be suffering from acute illnesses and health conditions, including respiratory and cardiac conditions, infections, or treatment after a fall (2025).

In January 2023, NHS England pledged to reduce pressure on hospitals by increasing the use of virtual wards as part of its plan to improve urgent and emergency care. Similar initiatives have been adopted in Scotland, Wales, and Northern Ireland.

Later the same year, the NHS virtual ward expansion was announced. This saw thousands of children being treated at home in every region of England.

Urgent and emergency care delivery plan

The ‘Delivery plan for recovering urgent and emergency care services’ is committed to several measures, including:

• increased hospital capacity
• expanded workforce
• faster hospital discharges
• enhanced community care for older adults
• improved access to the right care
• expansion of virtual wards to 10,000 beds, with the aim of monitoring 50,000 patients monthly.

In Northern Ireland, all health and social care trusts have established hospital-at-home services. These MTDs deliver intensive home care for patients experiencing acute illnesses.

In Scotland, Hospital at Home provides acute care in patients' homes, offering services equivalent to hospital care. The programme has reduced hospital stays, increased patient numbers and expanded services across Scotland. For more information, visit Healthcare Improvement Scotland’s website.

In 2023, Wales’s Health Minister emphasised the need to prioritise community-based services that support patients living independently at home for as long as possible.

Research has shown that virtual wards can significantly reduce the length of a patient’s stay. A study by the National Institute for Health and Care Excellence (NICE) found they can help save up to £9,081 per patient (PDF).

Additionally, staff who participate in virtual ward programmes gain knowledge and clinical skills when supporting patients with complex chronic diseases, according to a study by the South Eastern Health and Social Care Trust.

In summary, the key benefits of virtual wards include:

• reduction in hospital admissions and demand for beds
• supporting early discharge from hospital and freeing up beds
• reducing the burden of travel for families and improving convenience of care
• enhancing accessibility of care for people with disabilities and individuals with complex health needs
• increasing patient comfort by allowing treatment in familiar environments
• offering faster hospital admission if health deteriorates
• providing quick access and support to health professionals
• alleviating hospital pressures through new uses of technology and enabling the remote monitoring of health.

In 2022 NHS England commissioned a comprehensive framework (PDF). The aim was to provide a clear set of standards for the skills and capabilities required by staff working in virtual wards and urgent community response teams.

The updated framework (2025) is used to inform the education, training, and career progression of these staff. They will also be used to inform the development of local workforce models. The key benefits of this framework include:

• Standardisation: It will create a consistent standard of practice across the NHS for staff working in virtual wards and urgent community response teams.
• Improved quality of care: By ensuring that staff have the necessary skills and capabilities, the framework will help to improve the quality of care provided to patients.
• Enhanced patient experience: The framework will also help improve the patient experience by ensuring that staff can effectively use technology to deliver care.
• Improved workforce planning: The framework will be used to inform the development of local workforce models. This will help to ensure that there are enough staff with the right skills and capabilities to meet the needs of patients.

Overall, the framework is a valuable tool that will help to improve the quality of care provided by virtual wards and urgent community response teams.

In addition to the framework, NHS England launched an online hub dedicated to virtual wards, providing resources for patients, information on various clinical conditions and support for family members.