Defining complex case management in the UK: a modified Delphi approach.

Abstract

To conduct a Delphi study to develop a consensus-based definition of complex case management within the UK context. This study was conducted with members of the British Association of Brain Injury and Complex Case Management (BABICM). A methodological approach informed by a modified Delphi design was employed, incorporating expert focus groups and two rounds of questionnaires distributed to members of the BABICM.Initial focus groups (n=2) with eight expert case managers generated themes which were used to create a draft definition. Five definitions-four existing and one newly developed definition-were reviewed and refined through two rounds of online questionnaires. The top two definitions in round 1 were retained for round 2 (with no refinement required based on qualitative responses). The final definition was agreed-on when consensus was reached ≥80% agreement. In round 1, 130 (10.8% of the 1200-member population) BABICM members ranked five definitions and provided qualitative feedback. Based on round 1 rankings, two definitions were retained for round 2. Definition 4, developed through expert focus groups, was ranked as the most preferred in round 1 (60%) and round 2 (85%), thus meeting the consensus threshold. The final definition emphasised collaborative, tailored support across systems, advocacy and person-centred care for clients and their families. This study provides a consensus-based definition of complex case management in the UK, reflecting the complexity and interdisciplinary nature of the role. The definition offers a foundation for standardising practice, informing training and guiding future research and policy development.