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Wolverhampton Information Network

Community Matrons

Case management for adults with long term conditions or who are at high risk of hospital admission.   Short term interventions to support patient self-management and prevent unplanned hospital attendance/admission.

Pro-actively manage patients to reduce hospital admissions and lengths of stay

Provide a direct link between the acute trust and community services via an on-call community matron

Support the acute trust with complex discharge planning

Provide patients with the knowledge and understanding of their long term health conditions to enable them to self-manage

Provide 100% of all patients with multiple long term conditions an electronic personalised management plan which is accessible via hospital records.

The Community Matrons within the team are independent non-medical prescribers with advanced physical assessment skills

 

 

Who to contact

Contact Name
Community Matrons
Telephone
01902 442609

Where to go

Name
West Park Hospital
Address
Park Road West
Wolverhampton
West Midlands
Postcode
WV1 4PW
Notes

City Wide

South East Locality– Bilston Health Centre

South West Locality– West Park Hospital

North East Locality– Primrose Lane Health Centre

Time / Date Details

When is it on
Service operates Monday – Friday 8.30am – 5.00pm
Time of day
Morning
Afternoon
Evening

Other Details

Availability

Referral required
Yes
Referral Details

Yes, via health or social care professional 

Referral Criteria

a) Be taking 4 or more regular medications (poly-pharmacy) and

  • Frequent primary care consultations / GP call outs in the last 6 months
  • Recent exacerbation or decompensation of chronic illness
  • Medically unstable, cognitively impaired.

OR

b) Have ONE long term condition and

  • Take many different medications (poly-pharmacy).
  • Recent exacerbation or decompensation of chronic illness
  • Cognitively impaired, living alone, medically unstable, and high intensity social service package.

Record Last Updated on: 07/07/2017

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