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Trust pioneers ‘clinical matrons’ to boost ward leadership


Hampshire Hospitals NHS Foundation Trust believes it is the first in the country to introduce the role of “clinical matrons” in an effort to get some of the best and most experienced nurses back on wards.

A total of 30 senior nurses and allied health professionals will be recruited to the band 8a post, with most already in place.

“We haven’t got people spending a lot of time in bed meetings, because they are spending times on the wards”

Donna Green

Each matron will be responsible for the running of an individual ward at the trust’s three hospitals – Basingstoke and North Hampshire Hospital, the Royal Hampshire County Hospital and Andover War Memorial Hospital.

The concept was the brainchild of the trust’s chief nurse Donna Green, who said nurses who wanted to progress in their careers were often forced to abandon clinical work.

“In other professions like medicine you can get to a senior position where you remain very clinical, yet in nursing you normally have to go into management, education or specialist nursing,” she told Nursing Times.

“What we want to do is invest in clinical expertise,” she said. “I believe if we have senior clinical experts working at an advanced level on the wards then issues around complaints and things like patient flow will go, because we have those very senior people supporting their clinical teams and making decisions.”

Hampshire Hospitals NHS Foundation Trust

Trust pioneers ‘clinical matrons’ to boost ward leadership

Donna Green

The group is mainly made up of nurses but also includes two physiotherapists who will be matrons on stroke and orthopaedic wards.

The aim is the new matrons will spend 80% of their time on clinical work. Ms Green said there were several strands to ensuring that happened.

“First of all it’s about recruiting the right people who are passionate about clinical and really want to do it,” she said. “It’s also about providing them with the support and training so they feel confident. We recognise that if you have been out of clinical practice for a while you can become nervous – you lose those skills quite quickly.”

Crucially, she said the new approach had also involved looking at ways to support matrons with administrative tasks, with many wards now employing ward manager assistants.

“This is a whole hospital change and not just about one new role,” said Ms Green.

She explained the next phase would involve looking at the role of ward sisters to ensure they had a focus on education, training and development.

The role of consultant doctors and where they were deployed would also be considered with doctors offered extra training in clinical skills.

“This is about changing the dynamics of the team, with clinical matrons working very closely with their consultants on the wards,” said Ms Green.

“My premise is that, if we can get a really strong team working together covering the seven days a week at key times then as well as improving quality, it will help with recruitment and retention as well,” she told Nursing Times.

“As well as improving quality, it will help with recruitment and retention as well”

Donna Green

The trust used innovative recruitment techniques to encourage people to apply for the clinical matron posts, including the chance to talk directly to Ms Green via live web chats.

Applicants included nurses already employed by the trust with about half from outside. They went through an assessment centre process, which involved other staff members and representatives from the trust’s council of governors.

Successful candidates then underwent a month-long induction, which included refreshing clinical skills and leadership training.

The matrons have now been in post for about a month and Ms Green said the trust had already noticed the difference.

“It is early doors but what we’ve noticed is we haven’t got people spending a lot of time in bed meetings, because actually they are spending times on the wards with the patients,” she said.

“There are also decisions being made at local level such as matrons making decisions about discharging patients, whereas perhaps before the team might have waited for the consultants,” she said.

“And we have started having a bit of internal challenge about our processes and how we do thing and that is exciting and what we want them to do,” she added.

She said the aim was for the matrons to work together across the trust and support each other, as well as junior colleagues.

“To a certain extend it is about holding our nerve now”

Donna Green

To enable this, they will have a day away from the wards every month, which will be a chance to meet up for action learning exercises, discuss any issues and devise solutions.

The idea was the matrons’ monthly meeting would also be the “go-to meeting” for other staff to feed into, said Ms Green.

Matrons would also each have a personal development plan to help strengthen skills, whether clinical or in leadership and management.

Ms Green said the impact of the new role would be carefully monitored by looking at both quantitative and qualitative data.

It would include workforce measures like recruitment, turnover, appraisals and sickness rates, as well as performance indicators for patient welfare like falls, pressure ulcers and length of stay.

It would also mean assessing individual personal development and job satisfaction, changes in relationships and how teams work together.

“To a certain extent it is about holding our nerve now because obviously it is not going to be perfect from day one,” said Ms Green. “But this is a long game and what we’re hoping is both our patients and staff will benefit.”


Readers' comments (10)

  • Lovely idea, but seeing as band 7's spend most of their time on paperwork now I doubt very much the new band 8a will be any different!

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  • So a band 8 will be clinical and the band 7 will sit in the office and shuffle papers? Will the band 7 then be promoted to an 8 but be totally deskilled?

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  • Great idea........but wasn't this the point of the Matron in the first place.......they have, unfortunatley been sucked in the coorporate world of meetings and answering comlpaints.

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  • I retired as a band 7. I believed that to promote good practise, facilitate staff to meet their full potential and make good use of the excellent skills I regularly found in various grades of staff that I needed to be present in the clinical area. So often I found myself bogged down with paperwork which I felt could be carried out by a ward manager assistant so I agree there is a place for that role. I was always counted in on the numbers so agree there is a place for senior staff to be supernumerary for part of the working week but believe it is also essential for Band 7 and if introduce Band 8 ward matrons to have clinical input and be accessible to patients and staff as a normal part of their working day. The ward sister/charge nurse when I trained and worked as a staff nurse then ward sister saw each patient on the ward every day something I still believe is important to maintain/promote high standards of care and give staff the encouragement and support they need. I will be interested to see how these roles develop.

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  • Can we please get rid of the gender specific term matron.

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  • Pioneering? New concept? Sounds like reinvention of the wheel again to me...............ward sister (of old) job description springs to mind?

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  • A view would be that a matron is a throwback to the 1990s Blairite management style, too busy looking at cleanliness of walls and the positioning of armchairs. Get real and provide leaders of higher level on every shift on every ward. Whilst I applaude other professions with titles it will cause friction. And the term matron is offensive and sexist and feminises or causes male equivalents to bend to female dominated perspectives and actions. What about patrons if matrons.

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  • Great idea.

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  • Very good idea....We need role models in the clinical areas......junior nurses can learn from them. They can support and teach the staff. I am sure this will improve the quality of patient care and staff retention.

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  • coaching and mentoring support from matrons is a good idea. We have to nauure our future basic grade nurses and up and coming carers . It is a very demanding sector within society and oh so worth it

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