"Is this change for changes sake or just cost cutting?"
Posted by smithies (as ),
I have been a COPD patient for over 15 years. Mature onslaught of asthma, which led to emphysema and later the development of bronchiectaisis. I can only say that the treatment received from the chest team, ward 24 staff, emergency staff (ambulance, paramedics plus A&E) has been second to none and continues to be an inspiration and a reassuring facility.
However, the newest initiative, the community matron service has to be the best, most valuable resource to be tried out for many years. But, sadly it appears that the tide of change is sweeping over the service and unfortunately the signs of self destruction are plainly visible. Initially, the direct contact approach by telephone to your delegated matron was a rapid response system, which created an ideal source for information, reassurance and advice. If a visit was deemed necessary then a visit would be arranged, ASAP, usually that day if deemed urgent. Not only was it a safety net, but a rapport could be developed in both directions and the matrons could form a mental picture to attach to any conversation which took place via telephone. This must have proved invaluable in forming a judgment as to whether the patient required a visit, a doctors appointment or simply just reassurance and a kindly word.
However, it has come to light that the working practices within the community matron service have been changed beyond all recognition. It is now the accepted and advertised practice that on each day of the extended hours worked, any one of the matrons would be on the switchboard to answer all calls, only till 1600 hrs when another matron takes over for the remaining 2 hours of each week day. Therefore continuity must be extremely difficult to maintain and creates a situation where the patient might not speak to the same person for many many months. By consequence, the matron can in effect spend a whole day talking to complete strangers, trying to make decisions on information relayed by a sometimes, poorly, confused in some cases and shy or reluctant patient to once more relate all the history of their own medical background to a stranger. Continuity surely must be the most important ingredient in the mixture.
Alas it appears that managerial interference and meddling, whatever the reasoning, could be ringing the death knoll of an invaluable service. I do hope that a fresh evaluation of the c/m service will be considered a priority and a return to sanity and common sense becomes a matter of importance and urgency.