Community matrons as problem-solvers for people living with multi-co-morbid disease.

Working with patients in their own homes gives community matrons an advantage of seeing patients in the context of their everyday lives. This allows comprehensive assessment of need with an aim of promoting health or promoting stability for people living with chronic disease. Complex issues are resolved through problem-solving and this can result in patients being maintained in their own homes and thus in reduced unplanned hospitalisation.

How can health systems be strengthened to control and prevent an Ebola outbreak? A narrative review.

The emergence and re-emergence of infectious diseases are now more than ever considered threats to public health systems. There have been over 20 outbreaks of Ebola in the past 40 years. Only recently, the World Health Organization has declared a public health emergency of international concern (PHEIC) in West Africa, with a projected estimate of 1.

'I can't walk away': understanding the complexities in embedding a new nurse role.

Background: The community matron (CM) role was introduced in England to provide a single point of access to patients living with comorbid long-term conditions who had, or were at risk of, frequent emergency hospitalisation.

Aim: This study explored the factors that affected embedding of the CM role. The qualitative study was undertaken in community health services in two cities and a rural area in central England.

Public health systems analysis--where the River Kabul meets the River Indus.

In this paper we review two recent paradigmatic shifts and consider how a two-way flow in innovation has been critical to the emergence of new thinking and new practices. The first area relates to our understanding of the nature of public health systems and the shift from a medical paradigm to a more holistic paradigm which emphasises the social, economic and environmental origins of ill-health and looks to these as key arenas in which to tackle persistent inequalities in populations' health experiences. In respect of this paradigmatic shift, it is argued, developing countries were in advance of their more developed counterparts.

Case management of individuals with long-term conditions by community matrons: report of qualitative findings of a mixed method evaluation.

Aim: To consider findings from a study that evaluated case management of individuals with long-term conditions (LTCs) by a community matron (CM) service. The paper highlights issues related to the implementation of a new role and the impact this had on the experience of care across hospital and community settings for patients and their carers.

Background: The introduction of the role of CM was intended to increase effective management of patients with complex comorbid LTCs through the introduction of case management, thereby reducing unplanned hospital admissions.

Public health systems analysis--the transfer of learning between developed and developing countries.

This paper explores the role of systems thinking and operational research in furthering our understanding of and our control over complex public health systems. First, it tracks the evolution of our current perception and conceptual modelling of public health systems and the emerging recognition of the need for a whole systems approach. It gives examples of how methods of operational research, particularly those derivative of problem structuring methods, have been used to assist in clarifying the nature of the complexities that surround public health systems, identifying key change agents within public health systems, supporting these agents in making a meaningful contribution, and thereby planning and implementing effective interventions.