Community matrons to manage chronic disease
pharmafile | January 5, 2005 | News story | |
A new role of community matron is to be created to help millions of people with long-term conditions improve their quality of life and prevent emergency hospital admissions and premature deaths.
More than 17.5 million people in the UK suffer from one or more long-term conditions, such as diabetes, asthma and arthritis, which the government says often go 'unmonitored' and 'unmanaged' until patients are admitted to hospital.
The new roles draw on a body of evidence (the US Kaiser Permanente model in particular) which shows integrating services in the community can reduce admissions to hospital by providing proactive care, thus improving the health of patients and saving the health service money.
The NHS is now committed to creating 3,000 community matrons across England by 2007, and the government hopes they will contribute to a 5% reduction in beds used by emergency in-patients admissions over the next three years.
Currently just 10% of patients account for 55% of stays in hospital, and many of these patients have multiple chronic diseases.
Announcing the NHS and Social Care Model, which the government is calling a 'major overhaul' of health and social services, health secretary John Reid said new ways of working needed to be developed to cope with growing numbers of patients with long-term conditions.
"There are already some excellent examples of long-term conditions management, but we want to see this excellence spread across the country. The new model of care announced today will provide the NHS with the blueprint to do just that," he said.
Few practical details of how the community matrons will fit into existing services have been provided, but the health secretary said he expected the nurses to be 'fully incorporated' into existing NHS and social care structures. He conceded that the new roles would mean organisational change in some areas, but said: "these changes will be vital to the health of many patients and will ultimately save lives".
Dr Hamish Meldrum, chairman of the BMA's GPs Committee, said many GPs will 'take exception' to the Department of Health's comments that many long-term conditions go 'unmonitored and unmanaged'.
He added: "If the idea of Community Matrons is going to work, they have to be fully integrated into primary care, working with general practice and not at cross purposes. The government is already investing additional resources via the new GP contract, funding family doctors to do precisely this work. GPs want what is best for their patients. If this initiative provides additional resources to do that, it will be a positive move, but if it is starting up a separate service there is a danger it will duplicate the efforts of everyone involved."
General Secretary of the Royal College of Nursing, Dr Beverly Malone, has backed the new initiative, which will see community matrons establishing multi-professional teams to identify the most needy patients in their locality, with the aim of providing proactive care before their conditions worsen.
The NHS and Social Care Model will be followed by the publication of the National Service Framework for long-term conditions later this year. As many long-term conditions are already covered by other NSFs, the new framework will focus on improving the treatment of neurological conditions, but it will draw on models of care, treatment and support which can be applied to any long-term condition.
