Technology procurement and developing specifications: NHSE guidance on virtual wards

NHS England has released guidance on the requirements of digital technologies supporting virtual wards across integrated care systems, focusing on the approach to procurement along with developing virtual ward specifications.

NHSE acknowledges that the digital platform chosen to support virtual wards will depend on local need and maturity. The previously-released Digital Technology Assessment Criteria (DTAC) sets out requirements that all digital health platforms are expected to meet; the guidance highlights that this criteria should be included in requirement specifications for virtual wards, along with both clinical and business needs. Once these needs have been determined, NHSE adds that organisations can go on to develop a requirement specification for the use of technology in the virtual ward, which should “ideally be completed at ICS level.” 

In terms of procuring a technology platform, the guidance provides a series of high-level questions for ICSs to consider. The questions focus on a number of key topics, including the current and longer-term plans for virtual wards and technology enablement; the monitoring equipment required to meet the needs of clinical pathways; how patients and carers will be involved in technology co-design; whether an Equality and Health Inequalities Impact Assessment has been completed; whether the clinical safety officer has been instructed to begin collating necessary files and evidence for the clinical safety equipment; and interoperability requirements for the remote monitoring platform.

The guidance goes on to supply further information intended to support identification of requirements, breaking them down into four key areas: must have, could have, should have and won’t have.

In terms of ‘must have’ requirements, the guidance states that monitoring platforms must be able to record all necessary clinical measurements for the chosen clinical pathway, and must be able to specify frequency of monitoring required. Interoperability to enable data flow is also a key requirement, and the guidance highlights that some platforms and devices are likely to be classed as medical devices, and thus will require compliance with the UK Medical Device Regulations.

NHSE states that ‘should have’ requirements – “important but not essential for initial go-live” – might include additional functionalities required of a digital ICS strategy or pathway, for example integration with point-of-care testing devices.

‘Could have’ requirements, defined as “useful to have to enable greater benefits but of lower importance for virtual ward success at this time”, may involve supporting the monitoring of certain long-term conditions and ways to improve user experience of virtual wards.

With regards to ‘won’t have’, NHSE specifies that it is important for stakeholders agree on these to avoid scope creep; they should be the factors considered the “least critical, lowest payback items, or not appropriate currently”.

The guidance can be accessed in full here.

NHSE published guidance for system clinical leaders in April this year, which focused on supporting ICS leaders in creating and developing virtual ward services, aiming to act as a starting point for virtual ward development and highlighting key areas of consideration.

On the topic of virtual wards, the first of the NHS Impact programmes was announced in July, with virtual wards highlighted as a “high impact initiative” to support improvements in the discharge process.