Analysis

NHS Improvement says matrons need to be visible in clinical workplace

New handbook reflects the expanded role of the modern matron and can be a guide for training and continuing professional development
Picture shows medics having a conversation in a hospital ward. A new handbook reflects the expanded role of the modern matron and can be a guide for training and continuing professional development.

New handbook reflects the expanded role of the modern matron and can be a guide for training and continuing professional development

  • NHS Improvement handbook says matrons should be inclusive, advance opportunity and address inequality
  • As an authoritative presence they should be role models of values and behaviours
  • Matrons urged to lead with kindness and empathy, do clinical rounds and talk with patients

Matrons should be seen in clinical areas undertaking regular clinical rounds, talking with patients and listening to their concerns, new career development guidance says.

The leadership advice is in a new NHS Improvement handbook that reflects the expanded role of the modern matron and will act as a

...

New handbook reflects the expanded role of the modern matron and can be a guide for training and continuing professional development

  • NHS Improvement handbook says matrons should be inclusive, advance opportunity and address inequality
  • As an ‘authoritative presence’ they should be role models of values and behaviours
  • Matrons urged to lead with kindness and empathy, do clinical rounds and talk with patients
Picture shows medics having a conversation in a hospital ward. A new handbook reflects the expanded role of the modern matron and can be a guide for training and continuing professional development.
Picture: John Houlihan

Matrons should be seen in clinical areas undertaking regular clinical rounds, talking with patients and listening to their concerns, new career development guidance says.

The leadership advice is in a new NHS Improvement handbook that reflects the expanded role of the modern matron and will act as a reference guide for non-mandatory training and continuing professional development.

300

matrons at three national conferences were consulted for the NHS Improvement handbook

It can be used as guidance for Nursing and Midwifery Council revalidation and appraisal meetings and is an attempt to ‘highlight, reinforce and celebrate’ the critical role matrons play in healthcare.

The handbook describes ten ‘key roles’ of matrons, which differ from the ‘key responsibilities’ published by the Department of Health some 20 years ago.

Ten key roles that matrons fulfil

  1. Inclusive leadership, professional standards and accountability
  2. Governance, patient safety and quality
  3. Workforce planning and resource management
  4. Patient experience and reducing health inequalities
  5. Performance and operational oversight
  6. Digital and information technology
  7. Education, training and development
  8. Research and development
  9. Collaborative working and clinical effectiveness
  10. Service improvement and transformation

Source: NHS Improvement (2020)

Leading with kindness and empathy

Under ‘compassionate inclusive leadership’, matrons are advised to be ‘leading and influencing all staff with kindness, empathy and care’ by:

  • Being visible and providing an authoritative presence.
  • Using strategic thinking to spread understanding of their organisation’s aims.
  • Demonstrating organisational values and behaviours through role modelling.
  • Being inclusive, advancing equality and opportunity for all and addressing inequality.
  • Displaying clinical and professional credibility by enabling and empowering staff.

Development framework for matrons

The handbook can be used as a development framework to reassure senior management that matrons are fulfilling their roles and competencies.

It states: ‘Ward, department and service leaders should use the handbook to prepare for undertaking the matron’s role.

‘Matrons themselves can use it to prepare for their career development.’

There is also a range of resources and signposting in each section for nurses to find out more about given subject areas.

‘Aspiring matrons would be able to use the document and look at it and get an idea of what the matron’s role is’

Helen Lawes, a matron at Dorset Healthcare University NHS Foundation Trust

Chief nursing officer for England Ruth May says the advice will be ‘a useful tool’ in guiding matrons towards being strong and strategic leaders.

1,600

matrons in a network were consulted for the NHS Improvement handbook

‘Matrons undoubtedly improve the quality of patient care by being visible, compassionate and inclusive leaders who champion education and patient safety,’ Ms May says.

The handbook acknowledges that the matron’s role has evolved since publication of the matron’s ten key responsibilities in 2003 and the matron’s charter the following year.

Details of how the role has grown

Some aspects remain the same, such as the focus on patient safety and experience, prevention and control of infections, and management to promote high standards of clinical care.

The handbook says: ‘The role has grown to include workforce management, finance and budgeting, education and development, patient flow, performance management, digital technology and research.’

A word of advice to matrons...

NHS England and NHS Improvement senior clinical lead April Brown carried out doctoral research on the matron’s role and has the following advice for matrons:

  • Be bold and continually seek your academic limits
  • Work to the limit of your licence and be innovative
  • Seek forgiveness rather than permission for bold decisions
  • Always address it, don’t walk past it, and lead by example
  • Look and go outside and learn from others
  • Listen, hear and listen again to patients, their families and your staff
  • Acknowledge and identify barriers and work together to eliminate them

Source: Brown A (2013)

Hundreds of matrons gave their views about the role in a series of events for the project, including Dorset Healthcare University NHS Foundation Trust matron Helen Lawes.

Ms Lawes says she was excited to be involved in one of the development days, in Bristol, because the handbook brings the matron role up to date to make the guidance valuable and relevant across healthcare settings.

‘Aspiring matrons would be able to use the document and look at it and get an idea of what the matron’s role is,’ she says.

‘For existing matrons it can also highlight areas for development. Perhaps not all matrons may be involved in workforce planning but the booklet gives guidance on how to start thinking about that. It brings up to date how the matron’s role has developed.’

‘It is very important that once nurses reach this level in their careers equality and diversity is promoted and embedded in their day-to-day practice’

Francis Fernando, matron for surgery at Croydon University Hospital

Francis Fernando was matron for surgery at Croydon University Hospital when he was involved in developing the handbook.

An important element of the handbook is development of black, Asian and minority ethnic (BAME) staff.

Mr Fernando says it is a great resource for aspiring matrons not only in the NHS but also in the private and care sectors, and praised the focus on equality and diversity.

He said: ‘Matrons command respect, diligence, care, compassion, collaboration and authority, among other things.

40

subject experts were consulted for the NHS Improvement handbook

‘It is important that once nurses reach this level in their careers equality and diversity is promoted and embedded in their day-to-day practice.

‘There is so much research and evidence emphasising the ethical, moral, legal, economic and social benefits of a truly diverse and representative organisation like the NHS.’

Mr Fernando says that given there are more than 40,000 nursing vacancies in the NHS in England it is time for all nurses’ culture, contributions, expertise, talents and dedication to be celebrated and recognised.

National priority to ensure equality and diversity

Deputy chief nursing officer for England Hilary Garratt agrees it is a national priority to ensure equality and diversity in the workforce.

‘The matron’s role in this is to contribute to addressing and solving problems for underrepresented and disadvantaged groups and individuals within their organisations, ensuring that the needs of the diverse workforce are met and health inequalities are addressed,’ she says.

Ms Garratt says this should be undertaken using nationally and locally available resources, such as the NHS Workforce Race Equality Standard.

The modern matron’s role in the spotlight

‘In their leadership role, I want to see matrons championing BAME staff and those with protected characteristics so they are given opportunities to move up the career ladder,’ says Ms Garratt.

Before the handbook’s publication, the modern matron’s role had already been in the spotlight last year, thanks to a London advanced nurse practitioner.

Barts Health NHS Trust ophthalmology matron Taurai Matare was RCN Nurse of the Year in 2019, helping to raise the profile of the matron role.

Ms Matare also won the leadership category of the RCNi Nurse Awards, supported by Nursing Management, for her innovative work in transforming her unit, its care pathways and workforce over 14 years.

With such public recognition of the importance of a matron’s work, twinned with a new professional focus on developing the role, the future looks brighter for the modern matron.

Stephanie Jones-Berry is a health journalist


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