How community matrons perceive their effectiveness in case management

The aim of this study was to explore community matrons' experience of caseload management and identify situations that may restrict or enhance patient care and outcomes. The Department of Health advises that community matrons should have a caseload of 50, based on the Evercare model from the US. However, there is little evidence to justify this caseload target.

A phenomenological approach was adopted to analyse data from interviews with six community matrons based in two south west primary care trusts. Maximum variation sampling was used.

There are difficulties in building and maintaining a caseload of 50 complex patients with long-term conditions. The higher the caseload the less effective the community matrons perceived themselves to be in reducing hospital admissions.

Targets should not be set from similar models such as Evercare. A more integrated approach is required with the service being available 24 hours a day. Further research is required to identify the most appropriate caseload size and the of managing such high-risk patients. Quantitative research would help to determine the effect of variables.