VIRTUAL WARDS (VWs) significantly reduce carbon emissions compared with traditional inpatient care, new research has shown, offering a more sustainable model of healthcare delivery without compromising patient outcomes.
As the NHS implements digitally enabled care pathways to expand capacity and improve patient experience, it is essential to consider the environmental impact alongside clinical efficacy and cost. Virtual wards, which provide acute care remotely to patients in their own homes, have been widely adopted but their true carbon footprint has not been fully evaluated. This study aimed to assess the carbon emissions associated with a VW pathway for patients with acute respiratory infections and frailty in a large acute hospital trust, comparing these to conventional inpatient bed days, and to evaluate two methods of carbon calculation: manual data audit and automated business intelligence (BI) data extraction.
A retrospective cohort analysis was conducted, including 1,260 patients managed in virtual wards and 30 patients reviewed through manual audits for more granular out-of-hospital data. Carbon emissions were calculated across the entire patient journey. The findings showed that an inpatient bed day on average produced 37.9 kg CO2 equivalent (CO2e), four times higher than the 8.8 kg CO2e associated with a virtual ward bed day. This equated to an avoided carbon cost of 285 tonnes of CO2e during the study period due to patients being managed remotely, although this did not reflect a net hospital carbon reduction, as beds were repurposed for other patients. The comparison of data collection methods revealed that manual audits captured more carbon activity points, particularly relating to community and out-of-hospital care, resulting in a higher calculated carbon cost than automated BI extraction, suggesting the latter underestimates emissions and avoided emissions. These findings highlight important limitations in current automated carbon accounting methods and the need for more comprehensive data capture.
The study demonstrates that virtual wards represent a lower carbon model of care compared to traditional inpatient stays, supporting NHS goals for net zero healthcare delivery. Clinically, virtual wards may provide an effective means to manage acute patients, especially given hospital capacity pressures and ageing populations, while reducing environmental impact. Future practice should prioritise enhancing data capture methods to ensure accurate carbon accounting and inform sustainable service development. Further research is needed to assess carbon impacts across diverse clinical pathways and patient populations to optimise both care and environmental outcomes.
Reference
Townsend K et al. Exploring the carbon impact of virtual wards in a large acute hospital. BMJ Innovations. 2025;DOI:10.1136/bmjinnov-2024-001347.
