Clinical acuity and National Early Warning Scores (NEWS2) of remotely monitored patients on virtual wards: A retrospective cohort study

BACKGROUND: Virtual wards are an NHS priority, designed to deliver acute care, monitoring and treatment to people at home, providing an alternative to hospital admissions or facilitating earlier hospital discharge. The aim of this study was to understand the clinical acuity, care pathways and outcomes of people admitted to virtual wards in Bristol, North Somerset and South Gloucestershire (BNSSG) who were remotely monitored. METHODS: A retrospective observational cohort study of all remotely monitored patients aged 16 + years admitted to a virtual ward in BNSSG between October 2023-February 2025. Clinical observations (respiratory rate, oxygen saturations, systolic blood pressure, pulse rate and temperature) were collected, and National Early Warning Scores (NEWS2) were calculated. The area under the curve (AUC) of NEWS2 to predict hospital (re)admissions is presented. RESULTS: 2,533 admissions across five care pathways were included: respiratory (41%), frailty (18%), outpatient parenteral antimicrobial therapy (19%), heart failure (7%) and general (18%; pathways not mutually exclusive). Median virtual ward length of stay was 10 days (interquartile range 6-14). During the study period, 177 (7%) virtual ward admissions resulted in a hospital (re)admission and 9 (