THE ROLE OF THE COMMUNITY MATRON

1. THE ROLE OF THE COMMUNITY MATRON Lorraine Jackson Community Matron Prudhoe Health Centre.

2. FORMAT OF PRESENTATION • Overview of Community Matron implementation • Main aspects of role • Application of role in practice

3. HISTORY OF COMMUNITY MATRON IMPLEMNTATION • Governmental response to public demand for ‘Matrons’ to be reintroduced into NHS • ‘Unplanned’ hospital admissions for patients with Long Term Conditions (LTC) costly to patients and service • NHS Improvement Plan (2004) – focus on co-ordinated management of patients with LTC • Case Management central to LTC care strategy

4. Case Management ‘ One key person who acts as both provider and procurer of care and takes responsibility for ensuring all health and social care needs are met so that the patients condition stays as stable as possible and wellbeing is increased’ (DOH 2004)

5. Data analysis Comprehensive assessments Prescribing Clinical care/health promotion Care co-ordination Education – warning signs/complications Information to ‘empower’ patients Matron to be ‘highly visible’ as person in charge of care – both by patients and colleagues Key Aspects of Case Management

8. Implementation of role National and Regional variations

9. NORTHUMBERLAND’S MODEL

10. QUALIFICATIONS • Pre- registration qualifications of …. • BSc (Hons) Community Nursing • Specialist Practitioner Award • ENB Higher award in Community Nursing • Independent Nurse Prescribing • Clinical skills qualification • Long term conditions/chronic disease management • Continuing professional development

11. MAIN ASPECTS OF ROLE

12. CORE ASPECTS OF CLINICAL ROLE CASE MANAGEMENT CASE MANAGEMENT

13. MANAGERIAL REMIT GOVERNMANTAL CHANGES DEPARTMENT OF HEALTH ORGANISATIONAL REQUIREMENTS GOVERNANCE

14. ROLE AS EDUCATOR

15. 84 year old gentleman with LTC’s – COPD, CVA, prostatic/continence problems. High risk of exacerbations/unplanned admissions Small semi – detached LA housing – equipment +++ Comprehensive care package x 4 daily plus carer respite x 2 weekly – daughter input daily MDT input – matron case manager ‘Risk assessed to bed’ – massive implications Patient/family in crisis Matron admission to secondary care Discharge facilitation CHC – nursing needs Step down to RBH Discharged to extra care housing facility – LOCAL KNOWLEDGE/NETWORKING Case Study

16. Outcome • Now in ‘Manors’ Extra care scheme • Regular care package supplemented with ‘on site care’. Funding for ‘nursing care’ • Out and about. Breakfast / lunch most days in restaurant • General health and well being much improved – management of LTC more co-ordinated • Wife and daughter having ‘quality’ time

17. Daughter’s summary of Matron input …… “… the person who was integral to this change was Matron Jackson, who communicated, coordinated and collaborated in a proactive and consistent professional manner, an individual and personalised programme of care; with her flexible continuity and ‘on the ground knowledge’ she was able to assertively negotiate with other agencies in a hands on style, which in my humble opinion is essential in the provision of 21st century effective health care” Trudy Jobling, Sept 2010