Covid-19 virtual ward monitors patients at home in Lancashire and South Cumbria

NHS hospital trusts are working together with GP practices and local providers across Lancashire and South Cumbria to monitor vulnerable patients with Covid-19 from their own homes.

The Covid-19 ‘virtual ward’, also known as ‘pulse oximetry at home’, is being rolled out across Lancashire and South Cumbria; set up in response to the significant challenges and impact that the pandemic has had on local residents. This at-home monitoring service will be available for those with a positive Covid-19 test result or clinical diagnosis of Covid (within the last 14 days), who have coronavirus symptoms, and are identified as being particularly clinically vulnerable to having low blood oxygen levels due to their age or a pre-existing condition.

New systems are in place that will automatically send Covid-19 test results to GP practices as well as sharing them with the patient. This will give GPs visibility of which of their patients have had Covid-19 tests and whether they have tested positive or negative. A senior clinician will review results daily and, if a patient is at risk from Covid-19, they will determine whether they would benefit from referral to the pulse oximeter at home service or whether alternative care arrangements may be more appropriate. This scheme will also help to ensure that hospital beds are available to those who need them most during the Covid-19 pandemic.

To use this remote monitoring service, patients will be given a pulse oximeter so they can measure the oxygen levels in their blood several times a day. Healthcare professionals will check-in on patients over the phone or through a mobile phone app.

Steve Tingle, Director for Digitisation of Regulated Care at Lancashire and South Cumbria Integrated Care System (ICS), said:

“We have been working really hard to find innovative digital solutions to ensure that we are able to care for vulnerable people with coronavirus in their own homes, where it is safe to do so. This remote monitoring service will enable staff to monitor and check-in on these patients, whilst ensuring that they only need to go to hospital if it is necessary.

We know that people with coronavirus who suffer even a slight drop in their oxygen levels can be at a heightened risk from the virus, which is why it’s vital that we monitor this. Pulse oximeters are a small device that clip painlessly onto the finger, and beams of light measure the amount of oxygen in the blood at the same time as measuring the patient’s heart rate. Full instructions are provided about how to use this equipment along with what to do should a patient see their oxygen level reducing.”

If Covid-positive patients with low oxygen levels can be identified early, there are proven treatments that can improve their survival rates, their chance of recovery and also reduce the need for a stay in hospital (or reduce the length of stay if they do need to go to hospital).

This service is being rolled out through partnership working across the whole of Lancashire and South Cumbria throughout November and December and will be delivered by NHS providers and their local medical and home support provider services.

Peter Tinson, Executive Lead for Out of Hospital Services at Lancashire and South Cumbria ICS, said:

“NHS staff and organisations across primary care and secondary care have been working in partnership to look at ways to innovate and collaborate to continue to support patients in new ways.

Providing patients with oximeters to use in their own homes and the sharing of positive Covid-19 test results with GPs, will ensure that the most vulnerable people in our community receive the support they need to manage their condition from home.

It will help them, and the medical professionals monitoring them, to know when they should attend a hospital.”

Dr Neil Hartley-Smith, Blackpool GP and Group Clinical Director at Fylde Coast Clinical Commissioning Group, said:

“The Covid-19 virus has presented a significant challenge to GPs - as well as the rest of the NHS - since it became widespread early this year. One of the main concerns is how it can cause what is called ‘silent hypoxia’. Silent hypoxia is when your body is starved of oxygen but without causing noticeable symptoms such as breathlessness. This results in patients not realising just how unwell they actually are due to their perceived symptoms being mild.

A way of identifying silent hypoxia is by monitoring blood oxygen levels. This can be done by using a small device called a pulse oximeter. The device displays your pulse and blood oxygen level, and you can monitor this from the comfort of home. If your level starts to drop, this will be picked up early so treatment can begin in a more-timely fashion.

Receiving a positive diagnosis of coronavirus can be worrying for a number of people, particularly those who are clinically vulnerable. This early warning system should provide some reassurance that any deterioration in health will be picked up sooner.”

Dr Jim Hacking, GP Executive lead for Mental Health and Urgent Care at NHS Morecambe Bay Clinical Commissioning Group said:

“It is really important that we learn all of the lessons we can from how Covid-19 impacts some patients worse than others. Using these monitors will help us to recognise earlier when patients may be deteriorating and act much more quickly to offer additional treatment, either at home or in hospital. Being able to work in partnership with patients and carers to monitor how things are going will provide reassurance that we are giving the best possible care at this very busy time.”

Claire Heneghan, Chief Nurse at NHS West Lancashire Clinical Commissioning Group, said:

“A positive test for Covid-19 can be incredibly daunting. Patients who are 65 years and over or those under 65 with a chronic condition, will now be supported at home via this new digital telehealth approach. This is a significant level of support for anyone who is isolating at home. It allows clinicians to closely monitor their condition while also empowering a patient to have an element of self-care. For these individuals at home, this is hopefully a huge source of comfort for them; reassured in the knowledge that being at home doesn’t mean they are alone and that clinical support is available to them, as and when required, based on their individual needs.”

Dr Mark Dziobon, Medical Director for NHS Pennine Lancashire Clinical Commissioning Groups said:

“The Covid-19 virus has presented a significant challenge to the NHS and we have learnt a great deal about the virus since the first wave. There are now proven treatments that improve the survival rates, improve recovery and reduce the length of stay in hospital. We are using pulse oximetry at home as a way for patients to monitor the oxygen levels in their blood without needing to be in hospital. Any treatment required, if their level starts to drop, can be identified and delivered straight away, including for ‘silent hypoxia’.”

Dr Ravi Gokul, a local GP and GP Director at NHS Chorley and South Ribble Clinical Commissioning Group said:

“The blood oxygen level is one of the strongest predictors of risk from Covid-19 infection. By remotely monitoring people safely at home, we will be able to provide oxygen support earlier, before a person might even realise their oxygen level is falling to a dangerously low level, which is what we call ‘silent hypoxia’. We will also be able to help our hospital-based colleagues safely discharge more people home, with this monitoring put in place to support these people.”

If you do have to go to hospital, please be assured that it is safe - NHS services in Lancashire and South Cumbria are working together to ensure patients, with and without Covid, are cared for safely whilst ensuring that we can continue to see those who are waiting for treatment.

Find out the latest Government information on coronavirus (opens in a new window).