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the equivalent of four home nurses to two group practices, a further attachment of the
equivalent of one and a half home nurses was made to another practice in September,
1969.
Severe limitations on the extension of these schemes is imposed by the continuing
shortage of qualified staff. Furthermore, before any such scheme can be started there is
need for adequate initial discussions and careful consideration of such matters as the
suitability of accommodation, selection of staff and the problems arising from the
overlapping of practice areas with health visitors' geographical areas.
Each health visitor makes follow-up visits to those patients who live in her district
and who attend the practice. She also acts as liaison officer between the general
practitioner and the health visitor concerned with those who live outside her district but
within the borough boundaries.
All health visitors keep in touch with general practitioners in their areas and there is
continuing contact between general practitioners and the home nursing service. Wherever
suitable, the opportunity is taken to increase liaison with general practitioners,
particularly in group practices, in preparation for further attachment schemes when the
staffing situation allows.
Handicapped and Observation Register
Work continued on the build-up of the handicapped and observation register, with
increasing exchange of information between the Department, hospitals and general
practitioners. The objects of the register are:—
(i) to follow up those children who are "at risk" of developing a handicap
because of genetic, pre-natal or post-natal history so that there is early
warning of a handicap developing
(ii) to ensure care and attention for the handicapped child and his family
(iii) to obtain statistical information to help the Department with its routine work
and to assist medical research.
Notification of- these children is received from a- number of sources, including the
birth notification, the discharge notice from the hospital or domiciliary midwife, the
health visitor, hospital reports and general practitioners.
The term "At Risk" is used normally to describe a baby whom the midwife, general
practitioner, obstetrician or hospital consultant considers may acquire a handicap, mainly
because of unusual circumstances pertaining prior to, at the time of, or soon after birth.
These children are medically examined at six monthly intervals and are removed either on
transfer to the handicapped section of the register, or completely if they can walk, talk
and are otherwise developmentaly normal. The "at risk" section of the register contained
the names of 3,691 children at 31 December, 1969.
A handicapped child may be defined as one who suffers from any continuing
disability of body, intellect or personality which is likely to interfere with his normal
growth, development and capacity to learn. Some handicaps are recognisable at birth; for
example, an obvious anatomical abnormality. Others, such as deafness, blindness,
metabolic disorders etc., must be deliberately looked for and discovered as quickly as
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