Innovative delivery of specialist neurological rehabilitation in virtual beds: 7 years’ experience

One of the main priorities of the Integrated Care Systems (ICS) is to expand the number of ‘virtual wards’ and deliver multidisciplinary care for patients closer to home. We present to you the Specialist Neurological Rehabilitation Service (SNRS) which has demonstrated over the last 7 years that intensive neurological rehabilitation can be delivered successfully in the patients’ own homes. A novel commissioning model has been used in partnership with different NHS trusts to provide a unified neurorehabilitation service with both inpatient hospital beds and virtual beds in the patients’ own homes. While patients are on the virtual bed pathway, they remain under the care of the Consultant in Rehabilitation Medicine with support from the Clinical Nurse Specialist and have access to diagnostics/interventions and clinic reviews. The patients get daily intensive MDT therapy input from the skilled community team who provide the same frequency of therapy sessions at home (as they would get in a level 2 inpatient neurorehabilitation unit). This pathway is supporting the earlier discharge of patients from hospital. Additionally, the analysis of data from the virtual bed pathway shows that rehabilitation outcomes in patients’ own homes are similar to those of bedded units for this subset of patients with complex neurological needs. This illustrates that the virtual ward model can be successfully implemented in neurorehabilitation.