What is a Virtual Hospital?
Services offering acute care at home are on the rise in the NHS, and there is a growing awareness of their potential to deliver significant value to patients, clinicians, providers, and finance managers alike. As national guidance evolves and individual trusts develop their own offerings, teams across the country are collectively discovering what works best, enhancing patient experiences and outcomes.
Medway NHS Foundation Trust is at the forefront of this shift. Their journey began with the Virtual SMART Ward, enabling acutely ill patients to receive high-quality care at home—improving comfort, safety, and cost-effectiveness. Now, they are building on this foundation by connecting virtual services into a comprehensive Virtual Hospital. This system places patients at the heart of care, thoughtfully addressing the diverse paths they may take within, between, and beyond healthcare services. The Virtual Hospital model includes preventive care to help individuals stay healthy, alongside low- and high-acuity treatments for when they are unwell.
“The [patient journey] framework is easy to use, simple, and can evolve as our services evolve. It helps us plan system changes.” Tracy Stocker
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Seamless transitions between services are paramount to ensure patients consistently receive the appropriate level of care, and that is why Livework has partnered with Medway to implement patient journey management, for both the Virtual SMART Ward and the broader Virtual Hospital. Here’s what we’ve learned so far about how journey management can enable some of the keys to a Virtual Hospital’s success.
1. Clinical Governance
Ensuring robust clinical governance (i.e. how the service is operated and overseen) is essential for scaling Virtual Hospital services. This involves engaging a wide set of stakeholders to align on new pathways, assess and mitigate risks, establish metrics for success, and assign clinical responsibility for referred patients. The patient journey framework embeds governance so that these stakeholders can identify what is being governed, by whom, and how. In doing so, it offers a unified reference document that can support consensus building, pathway mapping, and the streamlined operating models.
2. Choosing a Tech Provider
Choosing the right remote monitoring technology is crucial for expanding the Virtual Hospital’s capacity and capabilities. Devices vary in functionality, from continuous monitoring to patient-submitted readings at intervals set by the care team. Integration with Electronic Patient Record (EPR) systems also differs, making this decision pivotal for clinical capabilities, workflow efficiency, and the experiences of patients, families, and staff. Journey management helps to define what functionality is needed to ensure the tech fits the service and operating model.
3. Staffing
Developing an optimal staffing model and skill mix is critical to the success of a Virtual Hospital. This includes extending services to care homes and prisons, as well as transitioning to a 24-hour operational model, ensuring comprehensive patient care at all times. Medway has observed the emergence of new generalised nurses, equipped with diverse and adaptable skillsets suitable for various clinical pathways and care settings. With journey management, these multidisciplinary care teams are able to clearly understand their own and one another’s roles and activities, so as to more effectively collaborate and care for patients.
4. System Integration
Scaling requires integrating the Virtual Hospital into a cohesive and coordinated system. Real-time sharing of patient information across electronic patient records and systems is essential, ensuring remote monitoring data stays with the patient throughout their care journey. Journey management helps to facilitate handovers in patient care, so that the patient journey remains smooth while care teams and tech systems change hands.
5. Data Management and ROI
Effective data management is crucial for improving clinical safety, streamlining processes, and demonstrating the service’s value. A comprehensive reporting system provides an integrated view of patient, staff, clinical, and financial data, mapping metrics, outcomes, and Key Performance Indicators (KPIs) to drive continuous improvement and capture evidence of success. Journey management keeps the patient at the forefront while helping to establish appropriate metrics for clinical, operational, and financial success.
6. Building the Case
To support scaling efforts, trusts must develop detailed and compelling business cases articulating the value of Virtual Hospital services for patients, clinicians, payers, and providers. Livework is helping Medway to outline the funding requirements for the ICS and Trust, ensuring the Virtual Hospital’s sustainability and growth.
7. Sharing Best Practice
Virtual care is advancing rapidly, and the Virtual Hospital must adapt to keep pace. A shared, live, and dynamic platform (i.e. a patient journey framework, or an “interactive Standard Operating Procedure (SOP)”) can support service evolution, foster innovation, and integrate new evidence-based practices to enhance patient care.
Towards the future of connected care
Medway NHS Foundation Trust is creating a blueprint for a fully realised Virtual Hospital by prioritising governance, technology, staffing, integration, and innovation. At the core of this effort lies the patient journey framework, which offers a foundation for meticulously designed services. This framework ensures clear clinical governance, robust data management, strategic capability building, and an unwavering focus on patient-centricity. With these critical building blocks aligned, the Virtual Hospital can contribute to the future of safer, more effective, and more connected care.

I am a senior service designer specializing in healthcare and complex systems. I combine behavioral psychology, systemic design, and process optimization to improve experiences and outcomes for patients, staff, and families.