We believe that the answer to fixing the UK’s broken healthcare care system is to bring together acute and social care.  The acute sector has a capacity challenge – there are not enough hospital beds and associated resource.  Our social care sector has a value challenge – their services do not receive adequate funding to cover the cost of paying and retaining the required workforce.   

By bringing together these two sectors, in the delivery of hospital-level care in the home, enabled by an integrated workforce from the acute and social care sectors, Virtue solves the challenges of both sectors.   

We solve the capacity challenge for the acute sector by creating thousands of new ‘virtual hospital beds’ in the home, capable of treating acute medical patients at a cost far less than that of treating the patient in hospital.   

We solve the value challenge of the social care sector by involving its national home-based workforce in delivery of this high-value model of hospital level care in the home.   

In doing so, we reduce the cost of care to the patient and state and increase the revenue and profit of social care companies, as well as creating exciting and lucrative career progression opportunities for their staff, attracting and retaining new talent into the social care sector. 

Excited by this vision, what to make a difference and improve the performance of your business?  Explore how to partner with us. 

From our work with domiciliary care providers, we understand that ~30-40% of their patients can be admitted to hospital each year.  This has detrimental impact to their business for the following reasons: 

• The moment a patient is admitted, they lose their income for the patient for the duration of their hospital stay, for which the national average is 21 days 

• If a patient is admitted without knowledge of the domiciliary care company, they have a legal obligation upon arrival at the patients’ home, to locate the patient.  It can take hours of ringing around local hospitals to find them. 

• Staff rotas need to be changed to redeploy staff to other patients, causing administrative cost, disruption to staff and potentially attrition of affected staff 

• Owing to the significant degeneration of patients during long hospital stays, they are often not fit to return home and are discharged into care homes.  This is a catastrophic life event for patients – costing the patient their home and ultimately poor health and earlier death.  This also creates significant loss for the domiciliary care company, as patients often therefore never return home to their services.       

For any patient, an urgent hospital admission can be a catastrophic life event, which for an elderly patient is even more so – it can be the start of a negative cycle of decline, leading to loss of their home and earlier death.   

Owing to the life changing degeneration and risk of hospital acquired infection, patients can leave hospital with greater frailty, loss of independence and ongoing health challenges (link to ‘understanding the impact of a hospitalisation patient health’).  In a lot of cases, this results in the patient not being able to return to their home, but rather be discharged to a nursing home.  Once such degeneration occurs, patients often face an unsurmountable challenge to regain their previous health and independence – a challenge that is even more stark given the lack of rehabilitation services in the UK compared to other European and US health systems.    

The unfortunate reality is that in the UK this story is becoming a common story, experienced by too many vulnerable people, their families and loved ones, for following reasons: 

The UK has fewest hospital beds of any comparable country  

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The UK has just 2.5 hospital beds per 1,000 of our population, compared to France which has 5.8 and Germany with 7.9.  This number has been declining since 2005 and due to population growth is forecast to decline further still.  Put simply, this means that the UK has a constrained bed capacity, which is unlikely to be sufficient to serve the needs of population, especially in light of the ageing demographic. 

Source:  Organisation for Economic Co-operation and Development (OECD) 

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NHS England introduced a national standard in 2010 stating that 95% of people arriving at an A&E department should be admitted to hospital, transferred to a more appropriate care setting, or discharged home within four hours.  The A&E standard has been missed every month since July 2015 at a national level.   Performance has continued to deteriorate since this time, and in 2023/24 only 58% of all attendances were seen within four hours.  

Just over a quarter (28%) of people who attend a major A&E department end up being admitted into a hospital bed.  In recent years, long waits for admission have reached record levels. The number of people waiting more than 12 hours after a decision to admit (sometimes referred to as ‘trolley waits’ or ‘corridor waits’) has increased from less than 150 in the first quarter of 2014 to nearly 150,000 in the first quarter of 2024.   In January 2024 the average waiting time for an admission, following a decision to admit, was 6 hours and 12 minutes (source: Nuffield Trust, ‘A&E waiting times’ June 2024). 

42% Percentage of A&E attendances that fail the NHS 4-hour target 

6 hours 12 minutes Average waiting time* for a hospital bed following decision to admit 

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A recent study by Public Health England revealed that 81% of people aged 75 years and older had at least one hospital admission in their last year of life and 96% of these people had at least one emergency admission.  Of this group, 47% of patients aged >85 years had hospital stays of 15 days or more, with >25% of such hospital stays being 29 days of longer. 

Source: Older people’s hospital admissions in the last year of life, Public Health England 2020 

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The amount of time people aged over 80 spend in A&E in England has almost doubled in a year, leaving them at increased risk of coming to harm and dying, emergency care doctors are warning.  An analysis by the Royal College of Emergency Medicine (RCEM) found that people of that age are spending 16 hours in A&E waiting for care or a bed.    

Source – Royal College of Emergency Medicine analysis of NHS England Data.  

While in hospital, older people can spend up to 83% of their time sitting in bed and often a further 12% in a chair (source: Arora, 2018).  This inactivity and lack of movement can affect physical function and wellbeing, leading to older people developing additional complications and being unable to complete everyday tasks.  This is known as deconditioning syndrome. Problems can include:  

• Reduced muscle strength that can cause a greater risk of falling, loss in confidence and further mobility problems  

• Increased risk of acquiring hospital infections, breakdown of your skin causing pressure sores and further decline to health and wellbeing  

• A loss of independence with everyday tasks including washing and dressing  

• Becoming disorientated and confused  

• Reduced appetite, poor digestion and constipation  

Research indicates that when people over the age of 80 are admitted in hospital and remain in bed for 10 days, this can lead to 10 years of muscle ageing (source: Dolan, 2019).  Furthermore, up to 65% of older people can experience decline in function during hospitalisation (source: British Geriatric Society, 2020) and for older people, regaining function can often take twice as long (source: Dolan and Holt, 2021).   

Ultimately, the associated loss of independence caused by long hospital stays means that people are not able to return to their own home and are often discharged to care homes.