Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites

Abstract

Background: Patients at high risk of emergency hospitalisation are particularly likely to experience fragmentation care. The virtual wardmodel attempts to integrate health and social care by offering multidisciplinary case management to people at high predicted risk ofunplanned hospitalisation.Objective: To describe the care practice in three virtual ward sites in England and to explore how well each site had achieved meaningfulintegration.Method: Case studies conducted in Croydon, Devon and Wandsworth during 2011–2012, consisting of semi-structured interviews,workshops, and site visits.Results: Different versions of the virtual wards intervention had been implemented in each site. In Croydon, multidisciplinary care hadreverted back to one-to-one case management.Conclusions: To integrate successfully, virtual ward projects should safeguard the multidisciplinary nature of the intervention, ensurethe active involvement of General Practitioners, and establish feedback processes to monitor performance such as the number of professionsrepresented at each team meeting.