ArticleBMC health services research2026
Commissioners' views and experiences of implementing virtual wards in Integrated Care Systems in England: a longitudinal qualitative study using the Consolidated Framework for Implementation Research (CFIR).
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundVirtual wards (VWs) have been rapidly adopted within the National Health Service (NHS) in England, showing promise for reducing hospital admissions and length of hospital stays. Additionally, VWs are reportedly highly acceptable to patients and may be preferable to physical wards (PWs) in some instances. However, little research exists on how to optimise the implementation of VWs from a strategic perspective. The current study aimed to investigate commissioners' perceptions and experiences of implementing VWs in integrated care systems (ICSs) in England, with a particular focus on changes and continuities in implementation influences over time.
methodsA longitudinal qualitative design was adopted. Semi-structured interviews were conducted via Teams with commissioners involved in the implementation of VWs at two timepoints (TP) six months apart; TP1 (n = 20) and TP2 (n = 14). Interviews focused on perceptions and opinions of the VWs programme, including barriers and facilitators to successful implementation. Data were analysed using the Consolidated Framework for Implementation Research (CFIR) in line with the Framework Method. The CFIR comprises five domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process.
resultsImplementation progress diverged across sites at follow-up, with some scaling back due to challenges while others expanded their VW programs. On a domain level, Inner Setting (ICS) constructs appeared most influential on implementation over time, with constructs in the Individuals domain seemingly becoming less important. The main barriers to implementation included: limited staff capacity, recruitment issues, and inefficient communication and interoperability of systems (Inner Setting); uncertainty around long-term funding (Outer Setting); inequalities in patients' home circumstances and lack of buy-in from clinicians (Individuals); and lack of detailed implementation planning (Implementation processes). Key facilitators included: building on existing similar services (Innovation); collaborative working (Inner Setting); and national guidance (Outer Setting) with flexibility to adapt to local contexts (Implementation Process). Commissioners perceived patient acceptability to be generally high, with a reported preference for receiving care at home.
conclusionsBuy-in from clinicians, collaboration, detailed advanced planning on an ICS level, and sustainable funding are particularly important for implementation of VWs. To avoid generating inequalities, tailored additional support should be provided to disadvantaged patients. Directions for future research includes exploring the perspectives of clinicians.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.