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

Objectives

To conduct a Delphi study to develop a consensus-based definition of complex case management within the UK context.

Setting and participants

This study was conducted with members of the British Association of Brain Injury and Complex Case Management (BABICM).

Design

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.

Results

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.

Conclusions

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.