'Covid Oximetry @home' describes an enhanced package of care for individuals with confirmed (or suspected) Covid-19 who are at risk for future deterioration. NHS England and Improvement wrote to all CCGs and trusts to encourage the development of local CO@H projects, as outlined in this SOP. This work has been featured on the national BBC.
Covid Oximetry @home is mostly delivered by primary care. If you are looking for the secondary care pathway, please go here.
We are supporting local healthcare systems prepare to establish or expand Virtual Ward pathways. Find out more and join our monthly National Learning Network webinars here: https://www.ahsnnetwork.com/national-learning-network-for-virtual-wards.
NHS England and Health Education England elearning for healthcare have launched an elearning programme on virtual wards, to support doctors, nurses and allied professionals in the use of technology to provide safe, acute-level care to patients at home. This supports the NHS’s ambition in the 2022/23 NHS planning guidance to increase the number of virtual wards across England.
The elearning is for clinicians to gain an understanding of implementing and running a virtual ward enabled by technology. It should be used alongside organisations' own local policies. Complete the programme on HEE’s elearning for healthcare platform in around 30 minutes.
If you have any questions about virtual wards more broadly, contact england.virtualward@nhs.net.
The 'CO@h' package of care involves the remote monitoring of the individual's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately.
This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring.
NHS England and NHS Improvement is working with Academic Health Science Networks and local areas to support the continued set-up of 'Covid Oximetry @home' services. This is one of the priority goals for the additional £150m General Practice Covid Capacity Expansion Fund and is already used in many areas to help detect earlier deterioration of people with Covid-19, both in the community and in care homes.
We’ve put together a Quick Start Guide which contains the key guidance you’ll need to rapidly set up a Covid Oximetry @home service. To complement it, the full set of resources and links can be found below.
For more information about the support available to set up local Oximetry @home services, join the FutureNHS platform: https://future.nhs.uk/NHSatH/grouphome
All CCGs can continue to request oximeters for local use by emailing england.home@nhs.net. Allocation will take account of local infection rates and previous requests.
As individuals with Covid-19 who are at risk of poorer outcomes can be identified by reduced oxygen saturation levels, CO@h allows health care teams to identify those who require further treatment (including admission to hospital) quickly, and is an approach that has been linked to improved mortality rates and the number of Covid-19 patients requiring intensive care admission and ventilation.
Below are links to some resources that further explain the use and benefits of CO@h:
Using the experiences of CO@h pilot sites developed during the first surge of Covid-19, there are six key steps that are recommended you follow to support you to set it up:
1. Engage the local pathway through your AHSN
2. Form a stakeholder delivery group
3. Design and agree your model; this includes example standard operating procedures
4. Develop your implementation strategy and implement it; this includes examples of system wide strategies
5. Request pulse oximeters early; guidance on where to get pulse oximeters and how to manage logistics
6. Developing a local learning system
As the use of CO@h is a new approach that should be adjusted according to local need. An important part of developing CO@h is the consideration of how lessons you learn are shared both internally and externally. To support teams in sharing and using learning from CO@h implementation, a national learning system is operating via the FutureNHS National Deterioration Forum where additional resources are shared and questions raised via a discussion forum.
As Covid @home is developed around the country, it may become more practical to develop local/regional learning systems. If you work in Hampshire, Dorset or on the Isle of Wight, contact us at Wessex Patient Safety Collaborative for further details.
If you work in an area not covered by Wessex, please see the bottom of this page for contacts for KSS and Oxford AHSNs.
Effective measurement is central to understanding the quality of care being provided, and to supporting any efforts to improve care measurement can show us important information on:
• How well our current process is performing
• Whether we have reached our aim
• How much variation there is
• Small tests of change
• Whether the changes made have led to improvement
• Whether a change has been sustained
These resources provide evaluation of virtual ward models and examples of patient experience surveys.
Should you require any help with measurement and evaluation methods, please contact your local Patient Safety Collaborative:
Resources including patient information leaflets and videos, including multilingual versions
To help you set up your virtual ward, this section includes top tips, case stories, training videos and e-learning to support the management of deterioration in care home and domiciliary care settings, e.g. Restore2TM
Please note that this document is being regularly updated. The latest version will appear here.
Covid Oximetry @home - Frequently Asked Questions
Featured video
Covid Oximetry at Home on BBC South Today
BBC Radio 4 Inside Health - Covid Oximetry @home
BBC national news: CO@h
Webinar: Virtual ward with pulse oximetry - full version
Browse all videosResources
Section 1: Guidance for pulse oximetry for virtual wards - NHS England
Section 2: Revised adult primary care Covid-19 assessment pathway
Section 2: Example stakeholder list - Wessex AHSN
Section 2: Stakeholder analysis template NHS Improvement
Section 2: Example Covid Virtual Ward SOP - North Hampshire
Section 2: Example system-wide primary care model - Southampton
Section 2: Call handler SOP for clinicians
Section 2: Remote monitoring quick start guide - Winchester PCN
Section 2: Clinical competency resources
Section 2: accuRx clinician guide
Section 2: Using volunteers to support Covid virtual ward models
Section 2: How to apply for pulse oximeters NHS England
Section 2: Example decontamination protocol Winchester
Section 3: CVW and CO@h definitions for the purposes of evaluation
Section 3: Covid Virtual Ward Models rapid evaluation UCL
Section 3: Examples of patient experience survey questions Wessex
Section 4: Covid Oximetry@home Patient Information Leaflet HIOW
Section 4: Diary for pulse oximetry for virtual wards - NHS England
Section 4: Covid Isolating at Home Safety Netting leaflet NHS England
Section 4: Pulse ox videos multiple languages Slough
Section 5: Covid Virtual Ward top tips and lessons Oxford AHSN
Section 5: Covid-19 virtual ward patient stories Slough
Section 5: PDSA cycles NHS Improvement
Section 5: Cause and effect analysis - NHS Improvement
Section 5: Remote monitoring using pulse oximeters in care homes
Section 5: Remote monitoring using pulse oximetry in care homes webinar Q&A
Section 6: Covid Oximetry at Home FAQs Wessex AHSN
NHS England and Improvement SOP
Section 1: Webinar: Virtual ward with pulse oximetry Dr Matt Inada-Kim
Section 4: Adult pulse oximetry monitoring diary animation HEE
Section 4: Diary for virtual ward translated versions NHS England
Section 5: RESTORE2 deterioration and escalation tool Wessex AHSN
Section 5: NHSI Improvement Hub
Section 5: Guide to quality improvement methods - HQIP
Section 5: How to Improve - IHI
Section 5: Managing the Covid-19 pandemic in care homes - British Geriatrics Society
Section 5: Covid-19 NHS clinical support for care homes - gov.uk
Wessex Patient Safety Collaborative
Publications
