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Durham e-Theses
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Organising case management for people with complex long-term conditions: learn from the experiences of Case Managers and Community Matrons

Organising case management for people with complex long-term conditions: learn from the experiences of Case Managers and Community Matrons.
Doctoral thesis, Durham University.

PDF (PhD Thesis ) - Accepted Version


Case Management (CM) requires a structured and systematic approach in order to be an effective tool for managing a growing population with complex long-term conditions (LTCs). This study aims to characterise, describe and explain the complex organising work of CM in relation to the roles of community matron (CMN) and case manager (CMR), and their training and service arrangement in UK localities through Translational Mobilisation theory (TMT). A qualitative descriptive research approach was used including semi-structured interviews and framework analysis. From interviews with 32 CMNs and CMRs, the study discovered that these roles enable the realising of political aims with regards to the reduction of service usages and improved quality of life for people living with complex LTCs. Their proactive, holistic and individualised care approach in these roles was perceived to be distinctive compared to other health care professionals, but these were not well understood and supported. This was a barrier to effective CM. Secondly, CMNs found that their education programmes on advanced clinical skills improved their knowledge of general illnesses but provided insufficient clinical practice and mentorship for treating common LTCs. In comparison, CMR’s self-directed their learning of common LTCs based on inconsistent organisational funding and course availability. Thirdly, the participants working in different service arrangements in rural and urban areas contributed different benefits and barriers in delivering their role. From the findings, this study proposed a standardised CMN and CMR training based on their common learning needs. Their role requires detailed practice guidelines and a practice-based CM approach with detailed plans to organise CM. Thus, a more standardised and systematic approach to CM is indicated by this study. Therefore, this approach needs extensive research.

Item Type:Thesis (Doctoral)
Award:Doctor of Philosophy
Keywords:case management, community matron, case manger, long-term conditions
Faculty and Department:Faculty of Social Sciences and Health > Sociology, Department of
Thesis Date:2020
Copyright:Copyright of this thesis is held by the author
Deposited On:22 Apr 2021 14:35

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