What is the Community Matrons Service?
The service consists of advanced nurse practitioners who provide intensive and personalised care and support to patients with one or more complex and chronic long-term condition, with the aim to promote self-management of their conditions.
This service is available Monday to Friday, 9am to 5pm. An out-of-hours telephone advisory support service is available to care homes seven days a week, including bank holidays, 5pm to 8am. The service is delivered by registered nurses and care support staff.
Community Matrons are advanced nurse practitioners who provide intensive and personalised care and support to patients with more than one complex and chronic long term condition. The main aim is to ensure that patients can stay safe and healthy in their own home or in their chosen environment.
The Community Matrons aim to reduce the need for patients to access unscheduled care as well as reducing unplanned re-admissions to hospital. If the patient is admitted, the Community Matrons aim to enable early discharge. Individuals receiving continuing care will also be included in this service provision.
We provide support for those with long term conditions and the frail/elderly.
Develop an individual clinical management plan with the patient, carers and relatives, which will include ways to overcome potential exacerbations of their condition
Educate the patient and carers about the illness
Support patients to self-manage their conditions
Case Management
Coordinate patient care across other Health and Social Care Professionals