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Matron scheme 'is not a failure'

From Dr Richard Smith, chief executive, UnitedHealth Europe

Your report and comment on the final evaluation of the Evercare pilots fails to tell the full story (News, 16 November). Far from concluding that the pilots were 'a multimillion-pound failure', the evaluation says: 'The stimuli to invention, debate and the reappraisal of community nursing practice, and of the role of primary

care more broadly, appear to justify the initial decision to pilot the Evercare model experimentally.'

The conclusion of the report was not that community matron schemes should be abandoned but rather that the schemes should learn from experience and move on. This is exactly what is happening, with schemes improving the ways to identify patients to put into the programme, making links with out-of-hours services, providing alternatives to hospital admission, and making other improvements.

In many places GPs are taking the lead in developing programmes. Pulse reported in October how an analysis by NHS Employers found community matrons had successfully cut emergency bed days, costs and GP workload.

The Evercare evaluation included information on GPs' reactions to the pilots and how some GPs 'supported, indeed volunteered to participate in, case management and became keen to retain the APN support dedicated to their practices'. GPs found that the programme reduced their workload.

If doctors in the past had followed your advice and abandoned innovations after two years we would have no cardiac surgery. It took years to get right.

I'm confident that the many different sorts of programmes now under way can reduce unplanned hospital admissions – and many GPs agree.

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