How Lancashire's new 'virtual' Covid ward aims to tackle killer silent hypoxia - with thousands of vulnerable patients able to be monitored in their own homes

Thousands of newly-diagnosed Covid patients in Lancashire could be monitored in their own homes rather than hospitals in case they develop a silent but deadly condition.

Monday, 30th November 2020, 3:45 pm
The device being used to watch the oxygen levels of newly-diagnosed Covid patients, who are deemed to be clinically vulnerable, across Lancashire

Health bosses are rolling out a 'virtual ward' across the county, with medically vulnerable patients hooked up to a small machine that measures their oxygen levels multiple times a day.

They hope the move will ease the pressure on hospitals while also catching cases of silent hypoxia - where patients' oxygen levels drop to dangerously low levels without them knowing it, causing terrible damage to their bodies.

Steve Tingle, one of the NHS chiefs responsible, said: "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."

Dr Neil Hartley-Smith, a Blackpool GP and director at the local clinical commissioning group (CCG)

GPs will now be told when one of their patients tests positive for Covid and will decide whether the virtual ward is right for them, given their age and any other medical conditions.

They will be given a pulse oximeter, which fits over the end of their finger and measures the oxygen levels in their blood, and called or contacted through a mobile phone app.

"Full instructions are provided about how to use this equipment, along with what to do should a patient see their oxygen level reducing," Mr Tingle said.

Dr Neil Hartley-Smith, a Blackpool GP and director at the local clinical commissioning group (CCG), which is responsible for organising and paying for residents' health care, said one of his main concerns since the start of the pandemic has been silent hypoxia, which is "when your body is starved of oxygen without causing noticeable symptoms such as breathlessness".

The chief nurse at the NHS West Lancashire CCG, Claire Heneghan

He said: "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. 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.”

Health bosses believe getting patients with silent hypoxia into hospital faster could boost their chances of survival, and have around 8,800 pulse oximeters at their disposal.

The chief nurse at the NHS West Lancashire CCG, Claire Heneghan, said: "This is a significant level of support for anyone who is isolating at home."

All patients whose conditions worsen will be offered the chance to go to hospital.

Some may choose to die at home, however, including those on end-of-life care for other conditions such as cancer.

Those on the virtual ward, which has been rolled out in most areas already with the others to follow by the end of 2020, will not be counted as hospital admissions.

Dr Ravi Gokul, a local GP and director at the NHS Chorley and South Ribble CCG added: “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.

"We will also be able to help our hospital-based colleagues safely discharge more people home.”

The virtual ward scheme was first revealed by Dr Grahame Goode, the deputy medical director at Blackpool Victoria Hospital.

He said during a recent Covid briefing: "Another innovation which we've done with our GP partners in primary care is a virtual Covid ward.

"There are a number of patients who are monitored in their own home - with oxygen saturations - and visits from the primary care teams.

"We have the capacity to manage up to 60 patients in the community rather than being in hospital.

"This is a really big bonus for us to get people out but managed safely in the community."