Community Matrons

Community Matrons in each PCN take a lead role to proactively identifying vulnerable adults who suffer from multiple chronic diseases and complex long-term conditions. This cohort of patients may be high intensity users of primary and secondary care services and require a holistic assessment to ensure comprehensive care.

Community Matrons work closely with the wider multi-disciplinary team, including GPs, social services , mental health professionals, therapists, specialist services  dieticians and district nursing team. They are responsible for developing personal care plans to support patients in remaining at home thereby potentially preventing hospital admissions. The community matrons are also responsible for ensuring that patients receive a high standard of quality care and a tailored plan to support the individual needs of each patient.