COVID Virtual Ward – Stop:Start simulation

To access resources related to this work you will need an account for the the FutureNHS Collaboration Platform. Further information about how to register or join workspaces can be found at the bottom of this webpage.

Standard operating procedure for COVID Virtual Ward

• This can be accessed through the FutureNHS Collaboration Platform. If you do not have an account, you will need to register using the instructions below.

National guidance summary, including example flowcharts and pathways

• Example pathways and standard operating procedures can be accessed through the FutureNHS Collaboration Platform. If you do not have an account, you will need to register using the instructions below.
• National guidance summary can be accessed through the FutureNHS Collaboration Platform. If you do not have an account, you will need to register using the instructions below.

Safety netting

• When safety netting, consider not overloading patients with information, particularly those who are older or feeling particularly unwell. Could you send written information and check understanding by asking them to repeat the information back to you?

Other methods include:

• Services through which you can send text messages with a linked COVID diary and leaflets for safety netting
• You can read the National safety netting leaflet on the FutureNHS Collaboration Platform.
• Patient information leaflets for COVID Virtual Wards can be found on the FutureNHS Collaboration Platform.

Remote consultation guidance

• It is important to ask open questions. Using the ‘golden minute’ to encourage the patient to describe the problem or explain their concerns. Further information about consultation models can be found in this article.
• Framework for history taking via the unfamiliar format of telephone consultation. Further guidance can be found on the RCGP website.
• Read this GMC article for more information about understanding communication failures involving doctors.

Using clinical judgement

• There is some evidence that pulse oximeters may underestimate blood oxygen levels in individuals with darker skin. However further research is required to understand the causes and implications of this. Clinicians should take this into account when assessing participating patients and, wherever possible, recommend that patients record a baseline oxygen saturation at onboarding. It is important to also ensure that you use your clinical judgement in assessing patients, monitor trends of both oxygen saturation readings and symptoms, and remain vigilant for other signs of deterioration. Read more about this in this NEJM article.
• It is important to pick up on red flags e.g. check if they can speak in sentences, observing to see if tachypnoeic
• Guidance on assessing breathlessness remotely can be found on the NICE website.
• A list of those at higher risk from COVID19 can be found on the NHS website.

Using an oximeter

• It is important to check that the oximeter is working. The patient should have information about this (resources can be found on the FutureNHS Collaboration Platform and on the HSJ website). Is there a regional number for them to call if the oximeter stops working?
• Do they have cold hands? This may mean that the oximeter is not working as well.
• National and example patient leaflets and videos for patients can be found on the FutureNHS Collaboration Platform.

Deciding whether to admit a patient

• Further information about the National Early Warning Score can be found on the RCP website.
• Further information about a soft signs of deterioration tool (Significant 7) can be found on the UCLPartners website.
• Further considerations include: access to social support, their disease trajectory, how they feel, patient choice and any presence of other worrying signs and symptoms such as chest pain, drowsiness, poor fluid intake, poor urine output.

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Accessing the FutureNHS collaboration platform

Virtual Ward resources can be accessed through the FutureNHS collaboration platform.

• For registered members: log on and click on My Workspaces, then Find a Workspace and search for NHS@Home and National Patient Deterioration Forum.
• For new members to the platform visit https://future.nhs.uk/system/home, register for an account (as below) and request access to the NHS@Home and National Patient Deterioration Forum groups. 

a) Registering for an account

FutureNHS is open to anyone working in health and social care. You can become a member if you are invited to join a workspace by a workspace manager, or self-register on the platform if you work for a trusted organisation like the NHS and have an @nhs.net, @*.nhs.uk or @phe.gov.uk email address.

If you have a different email to these, you can request an invitation to join the FutureNHS platform through our new members page.

b) Joining workspaces

Once you have registered as a FutureNHS member, you will be able to search for and join more workspaces.

Open workspaces are available for any member to join freely, and restricted workspaces operate on a membership basis, where workspace managers can invite individuals or existing FutureNHS members can request to join. All open and restricted workspaces are searchable to all members, helping FutureNHS users to connect with other users, share information and build their communities

Contact

If you have any difficulties accessing the resources above or need accessibility support, please contact alexandra.hellyer@uclpartners.com