VIRTUAL CARE by Jackie Rankin

People in hospital often yearn for the normality and comfort of home.

Patients in heart failure can spend a large part of their lives in hospital. Now a revolutionary new approach is giving them the same care, treatment, and support at home as they’d receive on a hospital ward.

We meet the nurse at the forefront - and a woman whose life has been changed since she went onto the ‘virtual ward’.

Nisha Jose (pictured) has 20 years of experience as a coronary care nurse. She’s seen the impact on patients and families of having to stay in hospital many times while their symptoms are stabilised. It may be a simple tweak of medications, but admissions mount up. In some cases someone’s total stay could be up to 60 days a year.

We can do everything that would happen in a ward.

The situation can be distressing for both patients and staff, says Nisha, clinical team leader at Mersey Care’s Clinical Telehealth Hub.

“People yearn for normality and the comfort of home, yet when they get home, they may become worried. It’s heartbreaking to watch.”

When health services became remote during the COVID-19 pandemic, a different way of supporting these vulnerable patients was needed.

Mersey Care was already at the forefront of using Telehealth – remote monitoring of people in their own homes, by specialist nurses at a clinical hub.

The service, developed in partnership with Liverpool University Hospitals NHS Foundation Trust and digital health company Docobo, allows patients to record vital signs, such as oxygen levels and blood pressure, onto the Docobo secure monitoring system via a device provided by the NHS, or the patient’s own smart phone. The system uses the data provided to identify any deterioration of symptoms and complications.

It was already being used to enable patients with other chronic health conditions and those hospitalised with COVID, to be treated at home. Nisha says offering that to heart failure patients was a ‘lightbulb moment’.

“We knew we had the platform and the clinical expertise, so we were excited. But we were also very clear - the system had to improve quality of life for people who had already spent so much of their lives in hospital.”

Mersey Care’s team worked closely with coronary care experts from the Royal and Aintree Hospitals to develop the programme and invite people in their care to take part.

Patients are trained to use a handheld device that enables observations – normally carried out in the ward – to be taken remotely and sent electronically to specialist nurses. They review results and will contact the person to advise of any concerns. Results are also reviewed by a cardiologist during a daily virtual ‘ward round’.

She says the Telehealth vision is to replicate a ward setting, striving for perfect care and operating 24 hours, seven days a week.

“We can do everything that would happen on a ward,” says Nisha. “We take observations every six hours, like staff on a ward, to identify any issues. We can even carry out ECGs at the patient’s home.

“We may not be standing beside the person when we are caring for them, but we have the clinical skills to identify the early signs of deterioration, and we’re there when they need us – it’s like pressing a buzzer on the ward.”

FIND OUT MORE about Telehealth at: merseycare.nhs.uk/telehealth