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NHSE guidance on access to diagnostics on virtual wards recommends priority tests, measures and assessments

NHS England’s recently published guidance on access to diagnostics on virtual wards highlights the main requirements “for the delivery of effective virtual wards” and shares recommended priority tests, measures and assessments that “all virtual wards should consider making available to their patients”.

The guidance notes that all patients on virtual wards should be assessed for acute deterioration, and notes that this contextual understanding should be “the basis for any diagnostics undertaken”. It directs to assessments for frailty and end of life; click here to access them.

NHSE goes on to set out the priority measurements that form a “basic requirement for patients on a virtual ward”, including temperature, pulse, blood pressure and weight. The guidance acknowledges that “while each of these measurements can be clinically significant on its own”, assessments that combine them, such as the NEWS2 score, “can clarify and add value to the clinical picture, provided they are personalised to the patient and the decision-making context”.

On pathology and priority point of care testing (POTC) the guidance highlights the need for virtual wards to consider how samples taken at home will be transported to laboratories for testing; to agree turnaround times for test analysis and reporting; and to plan how results will be accessed. It also highlights the “main PoCT devices” that virtual ward providers are using and links through to further guidance on integrating in vitro point of care diagnostics into virtual ward services.

Finally, on priority tests in a home or care setting, NHSE provides another list of tests that virtual ward providers are “typically” using, including CT, MRI, X-ray, ultrasound, echocardiogram, and handheld ECG. It notes that many providers include portable medical devices in a “kit bag” for patients to take home. Logistically, where patients are visiting a care setting for testing, the guidance highlights the importance of setting up pathways for access, with providers adding that “building good relationships with lead clinicians in other care settings is key to overcoming any operational issues”.

As well as priority tests, measures and assessments, the guidance offers advice on governance around clinical leadership, clinical safety and reporting, information governance, interoperability, and more.

To read the guidance in full, please click here.

In other news from NHSE, a recent board meeting discussed the need to digitally support the workforce and highlighted increased digital maturity as a priority over the next two years.

Elsewhere, NHSE has released priorities and operational planning guidance for 2024/25, with “strong digital foundations” highlighted as “essential for transformation, supporting access, quality and productivity”.