Virtual wards: A comprehensive guide for carers
- Nikki Brown
- 5 days ago
- 14 min read
Updated: 2 days ago
Virtual wards are a relatively new way of delivering NHS care from someone’s home or care home. They are designed for people who are well enough to leave - or avoid going into hospital, but still need an ongoing level of support from medical professionals. This might look like regular health checks, support with medication such as an IV, or just a watchful clinical eye while they recover.
Put simply,
“Virtual wards (also known as hospital at home) allow patients to get the care they need at home safely and conveniently, rather than being in hospital.” - NHS England
These services are part of a wider shift in health and care, with growing emphasis on early discharge, home-based treatments, and digital solutions to reduce pressures on hospitals.
As more virtual wards are rolled out across the UK, those of us looking after a family member or friend are playing bigger roles in making them work, but many of us don’t even hear about them until we’re suddenly involved. And while virtual wards can support the recovery and comfort of the person we care for, they may leave us feeling unprepared, unsupported, or overwhelmed.
This blog will help us understand what virtual wards are, what support we’re entitled to, and where we can go if we’re feeling unsure or stretched too thin. It will include real experiences from other carers, explore common concerns, and offer practical advice on coping with this new type of care.
What is a virtual ward?
In a recent poll, nearly 70% of carers who responded shared they had never heard of virtual wards, yet they are something many of us may become involved with during our time looking after someone. So what are they?
"I've never heard of virtual wards and know nothing about them, I’m curious."
Virtual wards allow patients to leave the hospital sooner by continuing to receive care from home, or to avoid going to hospital altogether if care and monitoring can be delivered from home or a care home. They are a relatively new way of delivering NHS care at home, often involving remote monitoring technology.
The NHS is expanding this model due to ever increasing demands on hospital services, the ageing population, and advances in remote monitoring technology. They allow someone to be sent home earlier from hospital, or to avoid hospital admission altogether, if it’s safe to do so. Ongoing care is provided either in person or remotely by nurses, doctors, physiotherapists or occupational therapists - depending on the person’s needs.
"I have used a virtual ward before and found it extremely easy and helpful."
Virtual wards are part of a larger shift in NHS care, designed to meet the increasing demand for hospital beds, especially during higher pressure periods such as winter or post-pandemic recovery. By enabling more people to safely recover at home, they help reduce the strain on hospitals.
But how does it all work?
Patients on a virtual ward are usually monitored through a combination of:
Regular home visits from NHS professionals
Remote monitoring equipment - such as through devices that measure temperature, oxygen levels, or blood pressure or others
Regular phone calls or video check-ins.
It is important to note that virtual wards do not replace other care services, such as help with bathing or dressing. If someone needs that support, the virtual ward team should work with local social care services to put both in place. If the person we look after has increased needs, or we are new to caring after a change to their health, we should complete a care needs assessment and carer’s assessment to see what help we can get alongside the virtual ward. We know - yet more admin. But it can make a real difference to our situation and level of support.
Who are virtual wards for?
Virtual wards are most commonly used for people with conditions such as respiratory illness (like COPD or COVID-19), those recovering from infections or surgery, or those who need more continual care due to age or a long term illness.
They are designed for people who are stable enough to leave hospital, or avoid going in, but still need regular monitoring. Virtual wards help to ensure the right care is given in the right place, at the right time – ideally reducing hospital stays.
“My wife has end-stage cancer and wanted to be home. Various teams have been out to her including a virtual ward to administer antibiotics by IV. They come over at the same time everyday, do full observation before administering medication, and the GP has monitored us by phone most days. For us it has been a good experience. My tip would be don't be shy about asking questions!”
How virtual wards work - step by step
Virtual wards can feel confusing. Understanding how the process works can help us feel more prepared and confident. Here’s a typical step-by-step journey from hospital to home-based care:
1. Assessment for Virtual Ward
Before someone is sent home, the hospital team will assess whether they are medically stable enough to be cared for from home (ours or theirs) - or from a care home. They’ll consider things like the person’s health, mobility, risk of deterioration, and whether monitoring can safely happen outside the hospital.
It might also be the case that a patient is never admitted into hospital, but admitted into a virtual ward instead to receive medication and monitoring with regular checkins from medical professionals.
If we will be involved in their care, our capacity and wellbeing should always be part of that assessment.
2. Involving the carer
Whoever is likely to play a role in the person’s care should be consulted early. This means talking honestly about what we can manage – physically, emotionally, and practically.
This is the point to ask questions, raise concerns, and request a carer’s assessment if needed. We have the right to say no if it’s not safe or realistic for us.
3. Home care planning
If the virtual ward is agreed upon, the hospital team should work with us to create a home care plan. While this is not a formal discharge we can find more support on this in the Carer's guide to hospital discharge. The plan should cover:
Which healthcare professionals will visit and when
What monitoring or tasks are needed
How to contact the team
Any support needed from social care (e.g. help with washing or lifting)
We should be given a written copy of this plan and feel comfortable with it before the person we look after leaves hospital.
4. Equipment set-up
Before or shortly after the person arrives home, NHS staff will deliver and set up any equipment needed for remote monitoring. This might include:
A pulse oximeter (to measure oxygen levels)
Blood pressure monitor
Thermometer
Tablet or app for recording readings
We should be shown how to use all equipment and have the opportunity to ask questions.
5. Daily monitoring and contact
Once the person is at home, daily contact with the clinical team begins. This might involve:
In-person visits from nurses or therapists
Phone or video check-ins
Recording and submitting vital signs
The level of contact depends on the person’s needs and local service models. We should always let them know if we don’t feel it is enough.
6. Escalating concerns
If the person’s condition changes, or we don’t feel the current set up is sustainable, we can contact the virtual ward team for advice. They will assess the situation and may:
Increase the frequency of checks
Arrange a GP or specialist to visit
Readmit the person to hospital
We should be given clear instructions on what signs to watch for and who to contact out of hours.
7. Ending virtual ward care
When the patient is well enough to no longer need regular medical oversight, they will be formally discharged from the virtual ward. Their care may then return to their GP or community team. The equipment will be collected, and any ongoing needs should be reviewed.
If the person’s health needs have changed, this is a good time to request a review of support at home through a Carer’s Assessment or Care Needs Assessment. Alternatively the virtual ward may end if the patient needs to be readmitted into hospital for more intensive care, or if they were to pass away. Coping with either of these changes can be incredibly hard, and we may find comfort in one of the below.
What NHS virtual wards mean for carers
Supporting someone at home through a health condition may already feel like being on a virtual ward - so what’s the difference? The biggest change is the level of support from medical professionals we can expect to receive - and possibly the amount of care the person we look after requires. If the person we look after is placed on a virtual ward, we may be asked to support some aspects of their recovery at home. This might include encouraging them to take medication, helping them to use, over overseeing monitoring equipment, or simply being around in case something changes. But this does not mean that we are on our own or solely responsible for their medical care. Carers in the Mobilise community have expressed some concerns on the shift to more patients being treated via virtual wards:
"I’m worried that support and backup will not be available."
“I feel that this is another way to push more responsibility onto us.”
“While I can see that this will free up beds and enable people to get home more quickly I am seriously concerned that it will push onto stressed unpaid carers at home even more nursing duties.”
It’s important to know that we are not being expected to become nurses. We shouldn’t be asked to take on clinical tasks unless we’re trained and comfortable with doing them. And if we’re not able to take on more responsibility - physically, emotionally, or practically - this should be included into the decision about whether a virtual ward is appropriate. This is never something we have to do.
Hospital staff should always discuss the plan with us at each stage before moving to a virtual ward at home and make sure we feel informed and supported. If that hasn’t happened, it’s OK to ask questions or say we’re not comfortable with taking on the responsibility.
It can be helpful to know what should, or should not sit with us.
We might be asked to: | The medical team is responsible for: |
Support with taking medication | Prescribing and adjusting medications |
Help with monitoring devices | Interpreting health data |
Watch for symptoms or changes | Responding to medical concerns |
Provide emotional reassurance | Managing clinical treatment plans |
While virtual wards can support recovery and comfort for the person we care for, we (and the medical professionals) are often very focused on their needs. Thinking about our own needs at this time might feel unnatural - but is incredibly important for us and the person we look after. If we take on too much, don’t understand our role in the virtual ward, or are putting ourselves in a situation we don’t feel comfortable with - that won’t be good for anyone involved. It could easily lead to us worried we will get things wrong, burning out physically or emotionally, or feeling increased resentment towards the person we care for.
“My Dad had pneumonia. He was weaned off oxygen and sent home on virtual ward. They gave us a pack which included a monitor to measure blood pressure and oxygen levels which sent the readings to the team. They then phoned daily to check how he was. One tip I would have is to really make sure the person has been off oxygen for at least 24 hours before coming home so you have the best chance of not being readmitted.”
While they can feel intimidating, there are bonuses for us with caring being moved to our/ the person we look after’s home or their care home. There may be less travel involved, we can create more of a routine, we may feel more comfortable knowing that we can keep an eye on their care and condition, and we might feel good knowing that they are happier in their own space.
"My dad doesn't want to go to hospital. He is in palliative care at home. A virtual ward would help at times when he's poorly and I need medical guidance without him having to go out of his home."
“My husband was on a virtual ward when he needed IV drugs, he had the critical care team in twice a day and they did everything they would have in hospital. It was far better to have him at home where I could care for him and he was comfortable and had his home comforts. For us it was a very positive experience.”
Technology and virtual wards
Technology in virtual wards can feel daunting, especially if we’re not confident in using digital tools. The good news is that the NHS should provide all the equipment needed - and it is their responsibility to make sure we know how to use it. In most cases, someone will do a home visit to set up the devices and show us how they work.
Monitoring equipment might include things like:
A pulse oximeter (to measure oxygen levels)
A blood pressure cuff
A thermometer
A tablet or smartphone with an app to upload readings
If we don’t have internet access, or struggle with technology, we should say so. The team may be able to adapt the support, offer paper-based alternatives, or arrange more in-person contact to help.
“I found it daunting as I am not the best with I.T. An iPad regularly sent through my mum's readings for blood pressure and oxygen levels and I had a short questionnaire to fill in on her condition. Nurses called to check in every day and let me know the couple of times they hadn’t received the results.”
We can feel assured that data privacy will always be taken seriously and any equipment used, information shared, or levels recorded will be secure.
10 simple tips for starting our first virtual ward
For those of us who are about to start supporting someone on a virtual ward for the first time, here are ten tips which can help us to feel more prepared:
Ask for a full explanation of what the virtual ward involves and who to contact if anything changes, or we need to ask any questions.
Request a written care plan with clear roles and responsibilities.
Ensure the person’s needs are fully assessed, including personal care, not just medical.
Be honest about your limits, physically, emotionally, time wise and what we feel comfortable with doing or not. It’s ok (and helpful for all involved) for us to share clear boundaries.
Get a demonstration of any equipment and ask as many questions as we need if we feel unsure. It’s important we feel comfortable with how it all works. We may wish to make detailed notes, or film the demonstration on our phones to refer back to.
Work together to test all technology during the set up, including Wi-Fi or phone signal.
Keep emergency numbers handy, and know how and when to escalate concerns.
Write down key information, such as medication times or symptom thresholds.
Check how out-of-hours support works, especially for evenings and weekends.
Don’t forget our own wellbeing - plan and take breaks, and always ask for help if needed.
When someone we care for is placed on a virtual ward, it can feel like a lot to take in. Using this checklist can help us feel more prepared, know what questions to ask, and make sure the right support is in place for both the person we look after and for us.
If we are feeling uncertain or need someone to talk to, we should contact our local carers’ support organisation, our GP, or the hospital’s patient advice and liaison service (PALS). We are not expected to take this on alone.
Making virtual wards work for everyone
Virtual wards can work well when the right support is in place - for the person we care for, and for us. If their care needs are too complex or if our own health makes it difficult to take on the responsibilities needed, then it may not be the right option.
We have a right to be included in decisions about starting a virtual ward and to have our concerns listened to. If we’re not sure about something, or need extra help, we can:
Ask the hospital team to explain how the virtual ward will work
Request a care plan that outlines responsibilities, contacts, and support available
Speak to the local carers’ organisation for guidance or advocacy
"A virtual ward would most definitely be more comfortable than a hospital. My fear is that I will lose someone in the hospital system - as long as it was genuinely staffed properly and not just a box-ticking exercise to show improved health-care stats."
Knowing our rights
While it can be easy to be swept up in what the person we look after wants and the medical professionals are telling us - it is important to remember we get a decision here too.
Anyone who will be involved with the care of a virtual ward has the right to:
be involved in any home care decisions
refuse a virtual ward
receive a new or updated Carer’s Assessment
ask for clarity on responsibilities
request alternative arrangements - such as if digital access is a barrier
complain or appeal decisions
FAQs on virtual wards
What if we don’t feel able to take on more care at home?
That should be a key part of the discharge decision. If we can't provide more support due to our own health or circumstances, we must say so. The person should only go onto a virtual ward if it’s safe - both for them and us.
Will we receive physical help at home?
Not usually from the virtual ward team, but if personal care (like washing, toileting, or hoisting) is needed, social care should be involved. The hospital should arrange this as part of of home care planning.
What technology is needed, and who provides it?
The NHS provides any equipment needed for virtual monitoring, such as oximeters or tablets. Someone should show us how to use it and offer ongoing support if needed.
How much responsibility will fall on unpaid carers?
We may be asked to help monitor symptoms or support recovery, but we should not be expected to provide clinical care or make medical decisions. If something doesn’t feel manageable, speak up.
Is there someone we can contact in an emergency?
Yes. The virtual ward team should give us clear contact numbers for urgent issues. Out-of-hours arrangements vary by area but should include access to 111 or 999 when needed.
How quickly can help arrive if something goes wrong?
That depends on the service. Some virtual wards operate 24/7; others may have delays out of hours. It’s important we’re told what to expect.
Will we have in-person support or only phone check-ins?
Many virtual wards include home visits, especially early on. If we’re worried about being left alone to manage, we should request more face-to-face contact.
What training or support will carers receive?
We should be shown how to use any equipment and supported to understand what’s expected. If we're unsure or need extra guidance, we can ask for a reassessment.
What happens if the person’s condition gets worse?
Contact the virtual ward team immediately. They will advise what to do and, if needed, arrange for hospital re-admission or emergency care.
Is the person still under the hospital’s care?
Yes, for the duration of the virtual ward stay. They may be under a specific clinical team or a hospital consultant, depending on local arrangements.
Will their usual GP still be involved?
The GP might be kept informed but isn't usually responsible for care during a virtual ward stay. The hospital team leads the care plan.
Can someone live alone and be on a virtual ward? Only if the virtual ward team is confident that it’s safe. They’ll consider how often staff will visit, whether the person can manage their needs, and what support is in place.
Will a virtual ward always be from their home?
A virtual ward might be from their home, our home, someone else's, or a care home. The location will be one of the details considered and agreed during the admittance into a virtual ward.
Is this just a way to shift more work onto unpaid carers?
That’s a concern for many of us. The NHS says it aims to support recovery at home, not rely on unpaid carers to replace professional care. But the reality must match the promise. If we feel overwhelmed, we should raise it and ask for more support.
Will carers get access to the medical team or records?
We should be involved in discussions and decisions if the person consents. Ask for contact details for the team and clarity on how we can raise concerns.
What if we have no internet or struggle with digital skills?
Tell the hospital team. Alternative arrangements should be made, like paper-based monitoring or in-person check-ins.
How do you get referred to a virtual ward?
The decision is usually made by the hospital team, based on clinical criteria and whether care at home is safe and appropriate, but we can make the suggest ourselves for consideration.
What if we’re not sure we understand everything?
Ask for a written care plan. This should include contact numbers, what to do in an emergency, and who is responsible for what. It is always better to ask for clarification than feel unsure.
Will a virtual ward always follow a hospital admittance?
No, in some cases a virtual ward may be set up to avoid the patient needing to go into hospital altogether. This depends on their condition and care needs, and the virtual ward team will provide an assessment. If we feel the person we look after should be admitted into a hospital rather than a virtual ward we should always say so.
Final thoughts & next steps
Virtual wards might be the future of care for some conditions - but they should not mean added stress for us. We can expect, and advocate for, clear information, honest conversations, and meaningful support.
And if we’re looking for a place to talk about our experiences with virtual wards, ask other carers for tips, or just speak to others in the same boat then the Mobilise Hub is a great place to start.
