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The arrival of the modern community matron

Lynn Young
Primary Healthcare Adviser
RCN

Dr John Reid, Secretary of  State for Health, recently announced that England is soon to appoint 3,000 community matrons. Believe me this came as a great surprise to the RCN! We did not have plans in place, so swift thinking and action were required! But, where did our amiable minister get the idea that it would bring health benefits to the community and brownie points for the government?
It is all about the Big Conversation - the modern method of bringing politicians and members of the public together so that discussion can take place on how people wish their public services to be. We have been told that during a Big Conversation event a number of participants were vociferous in their views regarding the equivalent of a strong hospital matron being present in the community. So, along comes Modern Community Matron - or will come, before too long. Since the announcement was made there has been little further information on this initiative, but the RCN is working closely with senior nurses throughout England and the Department of Health (DH) to ensure that the community matron is positioned in the best way possible to bring the best nursing care to people in the community.
Many community nurses may resist the title, while others may not in the knowledge that it is tricky to challenge what the public says it wants in these days of patient choice and public involvement. Those of us who have been working in the world of primary healthcare for many years applaud the call to have a number of senior community nurses who are clinically focused and have authority, status and influence. If such a development has the blessing of the government, and the title of matron is what they and the public want, so be it - who are we to say it is a bad thing? Patients are beginning to drive change, and about time too!
The RCN is working closely with the DH on the matter of community matrons. It is important for us to learn from other initiatives, such as the Evercare project and  the secondary care initiative Modern Matrons. Nurses who are given responsibilities and authority need the talent and competence to do what is expected of them, and, yes, they are urgently needed in every community. Many highly vulnerable patients receive dedicated and expert nursing in the community, while others - mainly on account of failures in the system ­- are being prevented from receiving this essential service. Some carers wax lyrical about the constant support they receive from community nursing, while others seem to be without the support they desperately need. Bring on the community matron to ensure that patients receive the expertise and support that should be freely available.
The NHS Improvement Plan: Putting people at the heart of public services (www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyA...) makes reference to the community matron: "In primary care, GPs will increasingly be working with more diverse teams, including GPs with special interests and community matrons, to ensure patients' needs are met in new ways in the community rather than in hospital. […] In addition to their extended clinical roles, nurses will be given a lead role in improving the experience of patients in both the hospital and the community. This will build on the success of the modern matron."
From the nine PCTs running Evercare, we can see that models of care can provide rich learning, making it possible for us to have a better chance of taking the development of community matrons forward in the best possible way. Expertise in chronic disease management, skilled multisectoral working, strong management and inspirational leadership skills, plus a range of other competences, are on the community matron menu. This could sound daunting to the faint-hearted, but I have been in the public healthcare game long enough to be absolutely convinced that we have the talent and the enthusiasm among the current nursing workforce to make community matrons both possible and essential.