View report page

COMMUNITY NURSING SERVICE
Health Visiting
In common with other Inner London Boroughs the Department had great difficulty in recruiting staff
during the year. Promotion, retirement, marriage and other domestic commitments reduced the Health
Visiting establishment to 33 out of a possible total of 40 by the end of the year.
In spite of these shortages the Department has managed to achieve yet another Health Visitor liaison
scheme, this time with the Neo-Natal Unit at Hammersmith Hospital, bringing the regular Health
Visitor/hospital liaison schemes to a total of 4. In addition, the link with general practitioners has been
extended to include a further Health Visitor attachment in the W. 14 area. As the doctors at this latest practice
intend moving to new premises in 1974 this could prove a most successful attachment providing the staffing
situation improves. A total of 10 Health Visitors are now fully attached to general practice and a further 2
operate a liaison scheme.
During the year a new pattern of nursing management was introduced, with the appointment of 6 middle
managers. Four are concerned with preventive medicine, covering Health Visiting Staff, and School and
Community Nurses within a specified geographical area. The remaining two Nursing Officers are managers in
the district nursing field. All these officers provide a valuable link between the field staff and the
administration. Information flows both ways to the benefit of all, allowing problems to be dealt with at the
grass roots.
In 1972 five students sponsored by the Borough successfully obtained their Health Visiting Certificates, and
a further 7 were sponsored for the course beginning in September.
As in previous years the staff have willingly assisted in providing observational experience for student
nurses and midwives from local hospitals, as well as pre and post graduate students from many other
disciplines. A total of 129 non-nursing visitors were seen in the Department, many coming from the
developing countries overseas.
Health Visitors have been seconded to Refresher Courses and other In-Service Training on a variety of
subjects. In addition, the Department mounted a two-day Conference in October at Fulham Town Hall on
"Family Planning" at which the Family Planning Association provided interesting speakers. At this
Conference places were also made available for Midwives together with Home and Hospital Nursing Staff.
Clinics
After being closed for nine months for major alterations Burne Jones Clinic re-opened in October. The
increased accommodation now available means that ante-natal, cytology and family planning sessions can
also be held there.
In December, Milson Road Clinic moved into a temporary structure a short distance away, while plans for
the new Health Centre can go ahead on the original site. Although, it is not permanent, the new building is well
designed and a great improvement on the old clinic. One disadvantage of the limited space available though, is
that it is impossible to increase the scope of work as the Department would like.
Specialist Health Visiting Service
In addition to the general Health Visiting establishment there are 3 extra staff who work exclusively with
patients from the chest clinics. All those suffering from Tuberculosis are visited at home at least once, and
those with other respiratory complaints are visited when and if necessary. Most of the latter group visited are
those afflicted with carcinoma, particularly in the terminal stages. When this occurs the specialist Health
Visitor will call frequently, perhaps every day, and should the patient require admission to a terminal home,
she will arrange this together with any additional assistance from charitable organisations if necessary.
The hospital ward for chest patients is sited near to the Chest Clinics which enables in-patients to be
frequently seen by the specialist Health Visitors as well.
All patients receiving anti-tuberculous chemotherapy are supervised by the Chest Clinic, or at the District
Nurses Clinic or occasionally at the patient's place of work if an occupational health scheme operates. To
ensure adequate supervision is maintained, attendances are checked each week. In addition, a Clinic staffed by
one of these Health Visitors and a Radiographer, to screen those who have been in contact with tuberculous
patients is held once a week. Screening measures undertaken include skin-testing and X-ray followed by
B.C.G. vaccination if required.
Midwifery
During the year full maternity services were provided for patients whether they were delivered at home or in
the general practitioner unit(s) at 3 hospitals. Women booked for hospital confinement were increasingly
interested in being discharged home early where they are nursed by a domiciliary midwife until the tenth day
when responsibility is transferred to the Health Visitor.
The Borough's Midwives have increased their participation in the parentcraft and relaxation classes
conducted at the Child Health Centres. During the year one partularly popular class dealing with therapeautic
excercises for post-natal mothers was started at Greyhound Road Clinic.
Pupil Midwives from Queen Charlotte's Hospital continued to receive practical experience of domiciliary
work and the wider aspects of community care.
School Nursing
The School Nurses have benefitted from the appointment of the four Nursing Officers referred to earlier. As
C11