Community matrons provide proactive management of long-term conditions, enabling and educating patients to help them live with and manage their disease.
The service has five main functions:
- Clinical: community matrons have advanced nursing assessment skills and knowledge in managing long-term conditions.
- Care coordination: the service helps to manage care across providers, supports admission avoidance and timely and organised hospital discharge, and proactively addresses patients’ future care needs.
- Communication: the service provides timely and ongoing communication with the patient, their general practitioner (GP) and their family.
- Coach: community matrons empower the patient to self-care and help them to understand their conditions.
- Care champions: the service helps patients to plan and achieve their care preferences and goals.
Eligibility criteria and referrals
Eligibility criteria and referrals vary according to location. For details, choose a service from the list below the map.
Where can you find this service?
- AHillingdon Community Matrons ServiceContact Centre, Kirk House, 97-109 High Street, Yiewsley, Middlesex, UB7 7HJmore service details
- BMilton Keynes Long Term Conditions TeamWhalley Drive Clinic, Whalley Drive, Bletchley, Milton Keynes, MK3 6ENmore service details