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At two of the teaching hospitals in the area, assessment clinics are held in the paediatric departments. At
both, a principal medical officer from the health department attends to undertake psychometric testing and
to co-ordinate further training and parent guidance.
It will therefore be seen that Westminster provides a complete and comprehensive service for
handicapped children of which it may well be proud.
MANAGEMENT STRUCTURE OF THE LOCAL AUTHORITY
NURSING SERVICES
By Circular 13/70 from the Department of Health and Social Security, the Secretary of State for the
Social Services requested all local health authorities to consider their senior nursing structure in the light of
the report of the Government Working Party set up to review senior management structure in the
Community Nursing Services.
The Working Party in formulating their subsequent recommendations took into consideration the
principles of the Salmon Report on the senior staff structure and improved management training
recommended for the hospital nursing services. It was their view that a sound management structure should
be established in the local authority nursing services on a comparable basis. The Working Party pointed out
that with growing pressures on the hospital service, and on hospital nursing manpower in particular, and the
closer ties with general practitioners, demands on the community services were bound to increase. Indeed,
the health visiting and district nursing services are facing continually increased demands on their time in the
care of the steadily growing numbers of elderly persons who require their advice and assistance; the
situation is aggravated by the early discharge of patients from hospital.
Following a comprehensive report by the Medical Officer of Health to the Health Committee in
November 1971 which detailed the Working Party's findings and recommendations the City Council
approved a three-tier management structure for the City of Westminster's nursing service composed of top,
middle and first line managers. The Chief Nursing Officer will be responsible for policy and co-ordination at
top management level with the City divided into four geographical areas each containing approximately the
same number of staff, health establishments and general practitioner attachments. A middle management
officer will be in charge of each area, with overall responsibility for all nursing services in her area; in
addition certain of these officers will specialise in matters connected with district nursing, health education,
supervision of midwifery and co-ordination of training. Two first line officers will be appointed in each area
to deal with the day-to-day management of the field personnel in health visiting and district nursing
respectively.
The revised management structure was brought into operation early in 1972, senior nursing
appointments being made in March of that year.
THE HEALTH VISITING SERVICE
Miss E. A. Evans, S.R.N., S.C.M., H.V.
Chief Nursing Officer
This service is provided by a staff of trained nurses who also hold a post registration qualification, the
aim being to bring a continuing service to families and individuals in the community. The health visitors are
responsible for a geographical area in which they carry out the full range of duties covering the whole
spectrum of preventive care, which includes all age groups. This is achieved by constant home visiting, and
in doing this the health visitor builds up, over a period, using her special skills and knowledge, useful
information about the needs of the community and the groups at risk.