and disseminate information between patients, their carers, GP practice staff, virtual ward staff, out of hours providers, emergency services, and hospital staff. Medical input as obtained as needed by the virtual ward team. In most cases the virtual ward team will meet weekly with the GP practice to discuss patients on their case load. The team is also able to book surgery appointments to see any patient's usual GP. The virtual ward develops close working relationships with organisations such as hospices, drug & alcohol service and voluntary sector agencies. Daily routine Members of the virtual ward staff hold an office-based ward round each working day. Patients are discussed at different frequencies depending on their circumstances and stability. Depending on the size of each ward, there will be a number of beds identified as red, amber and green, from highest to lowest dependency. The virtual ward team with the GP can move patients between these different intensity beds according to changes in their clinical condition from day to day. Patients in a "red" bed should be reviewed by the team daily, "amber" beds reviewed at least weekly, and "green" beds reviewed no less than monthly. Any patients that the clinical team decide are no longer in need of regular review should be considered for discharge from the ward. The virtual ward clerk needs to track these patients in the appropriate level bed, track admissions and discharges, and ensure that up-to-date information is available to be supplied to engaged stakeholders. Discharge The predictive model used for identifying patients for admission to a virtual ward is also used to prompt the virtual ward staff when it is time to consider discharging the patient. When a patient has been assessed by all relevant virtual ward staff, and has been cared for uneventfully for several months in the "monthly review" section of the ward, then the ward staff may feel that the patient is ready to be discharged to an alternative service, which might include self-directed care, care of the GP or care of another community service. A discharge summary is recorded at the practice, and a discharge letter (written using lay terminology) is sent to the patient. After discharge the patient is still able to contact the virtual ward for advice, and may be readmitted if their clinical need dictates it. This not only ensures that the patient is borne in mind, but these