Without the support of Nottingham CityCare Community Matron Kenisha Bryan, Alexander Cannop says he would have needed hospital care many times over the past four years.
The 76-year-old, who is living with multiple conditions, including lung problems and type 2 diabetes, says care and support from Kenisha, helping to co-ordinate his overall care and support package, has given him the confidence to remain independent in his own home.
“I’ve got quite a few specialists, but I always ask Kenisha to break it down (their diagnosis) for me. Our words, you know, because sometimes it can go over my head.
“She’s good like that. She’ll check my heart, my breathing, my blood pressure, weight and liver. All I have to do is ask, explain the problem and she’s there and she will solve it,” said Mr Cannop.
The relationship between Kenisha and Alexander goes deeper, after years of care, he explains: “Kenisha is the Matron, and a friend. Sometimes I have problems, and I keep them inside. I don’t know how she does it, but she can walk through that door and tell straight away that something’s wrong.
“There has been a couple of times where I’ve had tears, especially about the wife and that, but she’s always been there for me.”
Nottingham CityCare’s Community Matrons, part of the largest provider of NHS community healthcare in Nottingham, deliver care in patients’ homes and in their communities.
With a dedicated team of Assistant Practitioners, Registered General Nurses, Senior Nurses, District Nurses, and Community Matrons, CityCare is committed to delivering high-quality healthcare that keep patients out of the hospital and supports their overall wellbeing.
CityCare's Community Matrons play a crucial role in the Neighbourhood Team, acting as a vital link between patients, other parts of the NHS and health system and social care and support providers.
They ensure patients, often with multiple, complex conditions, receive the right care at the right time.
This dedicated service supports patients with long-term conditions or those recovering from episodes of ill health, who are unable to access services outside their homes.
Community Matrons are highly trained, senior nurses who are experts in assessing and treating complex medical problems and supporting people who live with long-term conditions. They work closely with GPs, district nurses, community-based specialist nurses, and hospital specialists.
"Our Community Matrons play a pivotal role as advanced clinicians, expertly managing complex care for our patients," said Judith Douglas, Director of Nursing, Allied Health Professionals and Quality.
"By acting as a vital link between patients, other providers, and support agencies, they ensure our community receives the most appropriate care, keeping our patients healthier and out of hospital whenever possible."
Mr Cannop has multiple conditions, including asthma, angina, type 2 diabetes, COPD (chronic obstructive pulmonary disease), and liver cirrhosis. He appreciates the support of his Community Matron, which has prevented frequent hospital admissions.
"If it wasn't for my Community Matron, I would be in hospital regularly. She just knows me and understands my needs," he said.
Kenisha Bryan, a Community Matron who looks after Mr Cannop, said: “We give the patient that freedom to look after themselves in their own environment. To feel comfortable and confident in doing so because they know they have the right support around them.
“The Community Matron role is integral because it’s not just about the medical aspects of a patient, but it covers the social, financial and psychological areas of care.
“We spend time with the patient, other carers and the family to find out what they need – medication, prescribing, titration – we look at the patient from a holistic view and that’s how we manage them in the community.” The Neighbourhood Team’s services include diabetes care, wound management, end-of-life care, continence assessments, medicines management, and case management for long-term conditions.
The team also provides nursing for housebound patients with acute, short-term nursing needs and offers advice to patients, carers, and home care providers.
Community Matrons oversee this process, identifying additional support needed to avoid hospital admissions and manage long-term conditions in partnership with GPs for medication management and prescribing.
CityCare is dedicated to delivering compassionate and comprehensive healthcare services to the community, ensuring that patients receive the support they need to live healthy and fulfilling lives.
For more information about CityCare's Community Matron service, please contact: 0115 883 9654.
Date published: 6 February 2025
Case study
Krystyna Leszczynska, 79, is on the end-of-life pathway and has breathing problems that require oxygen at home. The matron service has fulfilled her wish to stay out of the hospital and manage her care in the community.
“The care from everybody is excellent… and Michelle just looks after me. She’ll look after the medical side of me, the blood pressure, heart. She’ll even make me a drink and a couple of sandwiches before she goes,” she said.
"The Community Matron service has allowed me to stay in my home and live comfortably during my final days. If I’m lucky, I will get an extra couple of months.”
Michelle Bartley is her Community Matron and she believes that Krystyna’s objectives have been met.
“Ultimately, Krystyna wants to make sure that the time she has left is not in the hospital and that’s something we have achieved,” she said.
“She was in and out of hospital until her GP referred her to us. She’s independent and likes to do things for herself, but I make sure her care keeps her on track with the right medication and paying attention to her skin, her blood and weight. This is what Community Matrons do.”
Case study
Philomena Hoy, 80, with heart failure and frailty, has benefited greatly from the care provided by her Community Matron. "I am now much better. Before, I couldn’t breathe and there was swelling around my ankles. I didn’t know what was the matter.”
“Having someone like Michelle is a great thing to be honest. The service is good, and she is always available if I need her. She has such a friendly approach, and you can be open with her. I’m very grateful and I know she has kept me out of hospital,” she added.
“The care you get is nothing like when I was a nurse. Maybe a visit or two from a district nurse but not like this. The Community Matron’s are very helpful and confident. I feel relaxed when they are here.
The life-threatening fluid build-up is no longer a problem, and my assessments, with her help, mean that this is now regularly monitored using the right medicine."