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GPs go forth

Audit reveals failures of matrons scheme

By Gareth Iacobucci

Community matrons are failing to manage the expected numbers of high-risk patients or to have any effect on emergency admissions, a damning audit


It comes with the final evaluation of the Evercare community matrons scheme set to report within weeks that it will have little impact on admissions


A report by NHS North East reveals matrons have been far less effective than expected at taking on 'very high intensity' healthcare users from GPs.

Matrons are currently managing only 4,354 patients across the North East – 38 per cent fewer than anticipated – despite 23 per cent more being appointed than had been planned. Emergency admissions have risen 1.1 per cent compared with the same period last year.

Rachel Chapman, director of communications for NHS North East, insisted the problems were not unique to the region. She said: 'I think this is typical of trends across the country, but I also think it will improve once the community matrons role is properly developed.

'This is something that we're keeping an eye on. Measures are in place to increase the trajectory of very high intensity users.'

Dr George Rae, a GP in North Tyneside and secretary of Newcastle and North Tyneside LMC, said he had seen nothing to suggest matrons were helping GPs or cutting A&E admissions.

He said: 'We're not getting the feedback to suggest community matrons are helping GPs, although of course we do hope that something will happen.

'There is no evidence base to corroborate that they are cutting down on admissions, particularly of COPD.'

Professor Martin Roland, director of the National Primary Care Research and Development Centre, and leader of the Evercare evaluation, warned: 'We do not believe Evercare or similar schemes will lead on their own to a significant reduction in admissions. This is because they are not enrolling a group with a high enough risk of readmission.'

Evercare, run by the US firm UnitedHealth, is one of the most popular matrons schemes, with a new survey revealing 40 per cent of SHAs use it. It targets over 65s with two or more

admissions in the past year.

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