Table 1.
Description of VWs using the taxonomy used by Roland and colleagues (2005)
| Target population | Patients at high predicted risk of unplanned hospital admission in the coming 12 months as determined by a predictive risk model.1 |
| Assessment and care plan | Initial assessment by a VW clinician and care plan developed by the members of the multidisciplinary VW team. |
| Monitoring | Monitoring and review conducted on ‘ward rounds‘ (i.e. regular, office-based multidisciplinary team meetings of all VW staff). |
| Exit | Death; or Self-discharge; or Decision by the VW team that the patient’s care has been optimised; or Reduced predictive risk score. |
[i] 1In two of the sites, patients are identified exclusively according to the predictions of the NHS Combined Predictive Model. In the remaining site, patients are chosen according to a mixture of clinical referrals and the predictions of the PARR predictive model.
Table 2.
Comparison of the virtual wards in Croydon, Devon and Wandsworth
| Population | Deprivation | Variant of the virtual ward model | ||
| % of patients living in the most deprived quintile of lower super output areas | % of patients living in the least deprived quintile of lower super output areas | |||
| Croydon | Inner-city and suburban | 22% | 5% | Multidisciplinary team led by a community matron. No regular input from a doctor. |
| Devon | Market town and rural | 2% | 0% | Multidisciplinary team led by a community matron with support from a ‘GP champion’ and regular input from a community geriatrician. |
| Wandsworth | Inner-city | 14% | 7% | Multidisciplinary team led by a dedicated, full-time virtual ward GP (‘VWGP’). |
Table 3.
Details for each site
| Site | Period of study | Number of patients admitted to virtual ward (as at 15 June 2010) | ONS corresponding health areas |
| Croydon | 15 May 2006–1 September 2010 | 1624 | Enfield, Waltham Forest, Greenwich Teaching, Redbridge |
| Devon | 1 October 2008–1 September 2010 | 106 | Somerset, Cornwall and Isles of Scilly, Shropshire County, Herefordshire1 |
| Wandsworth | 1 March 2009–1 September 2010 | 196 | Hammersmith and Fulham, Camden, Islington, Westminster |
[i] 1North Yorkshire and York PCT and Dorset PCT have been excluded because they had virtual ward schemes or equivalent in place during the comparison period.