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Day in the life of a: community matron

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Despite brilliant patient feedback, Liverpool’s children’s community matron service isn’t resting on its laurels

Most nurses would love to get 100% in a patient satisfaction survey. However, the children’s community matron service at Liverpool Community Health consistently strives to improve the quality of care.

The service looks after children with long-term, complex conditions, aiming to prevent avoidable admissions and promote early discharges. Set up in March 2008, it was the first of its kind in the country and last month got brilliant scores from a patient satisfaction survey.

All the survey respondents said they felt they were treated with high levels of dignity and respect; had high levels of confidence and trust in the clinical staff treating their child; said they completely understood when the health professional explained their child’s treatment to them and felt as involved as they wanted to be in decisions; and all said that they were extremely likely to recommend this service to their friends, family or colleagues, rating the service either as “excellent”, “very good’ or “good”.

Caroline Doyle, one of the team, commented: “We are always striving to improve the service we provide, so it’s always good to get some feedback you can work on.”

The service was set up reflecting a model of care offered in adult services, aimed at people with long-term conditions. The children’s community matrons are Ms Doyle, Jan Rowlands and Joanne Walker, who together offer a range of support for children who have tracheostomies, gastrostomies, are oxygen dependent and have life-limiting conditions.

The team all have advanced-level skills and are involved in clinical assessment, diagnostics, prescribing and case management. The three children’s community matrons have a wealth of experience in looking after children with long-term conditions, including working in community, acute services and walk-in centres. Their experience provides them with a breadth of knowledge, enabling them to handle emergency situations as well as developing long-term relationships with children and their families.

There were some challenges to setting up the service, as some of their colleagues in other services were naturally reticent about the matrons’ work impinging on their caseloads and responsibilities. This is a fear the children’s matrons have allayed by working with the wider multidisciplinary teams, such as physiotherapists, community staff, consultants and dietitians.

Families, too, were concerned. “They had become used to taking their children to A&E whenever there was a problem and their local A&E was Alder Hey, so had a good reputation. We had to persuade them to let us see them at home,” says Ms Walker. “And for some children, who had been going to A&E for 15 years or so, that was tough - building that trust and confidence.”

But the service has been a success. It has expanded and now works closely with the community respiratory physiotherapists, which Ms Rowlands says has added an extra dimension to the care offered. She further explains she knows of several families who previously had to keep their children off school or the whole family had to spend hours in ED whenever their child fell ill.

“It’s great they can pick up the phone and speak to us, without taking all their family out in the cold,” she says.

The job is a rewarding one, report the matrons, who act as a first port of call for families and children, providing a responsive service for children at home, school or respite.

“The service covers a large geographical area and we are presently working with the trust to improve current IT so that we can access and update patient information more readily,” reports Ms Doyle.

“So while the results of the survey were pleasing, one of the most rewarding aspects for the team was hearing from families who have for the first time spent Christmas at home together,” adds Ms Doyle.

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