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7
groups, each group having its headquarters or office for the most
part in purpose-built Centres situated throughout the area. The
opening of the Tooting Child Health Centre during the year has
taken this a stage further and when the three comprehensive health
centres now being planned come into operation, this process will
be greatly reinforced.
The groups of health visitors are therefore said to be "linked"
to all the health services, including the family doctors, in the area
where they work. Within this linkage system we are able to arrange
for specific liaison with individual doctors but this is not and
cannot be to the extent of a complete attachment. This combination
of "liaison within linkage "seems to work very well and has
many advantages, to which I have drawn attention in previous
years.
So much for health visitors and their linkage with local health
services. Turning now to home nursing services, much the same
principles apply. It is generally agreed that the deployment of
home nursing staff should encourage maximum productivity in that
the most skilled and difficult nursing tasks should be undertaken
by nurses with the highest qualifications and the greatest experience,
whilst the less skilled tasks such as straightforward blanket bathing,
can be undertaken quite effectively by members of the nursing
team who need not necessarily hold an academic nursing qualification.
This, in fact, is the basic principle of the nursing organisation
in a hospital ward where the head of the ward nursing team is
the Sister, a State Registered Nurse of considerable experience,
who is assisted by her staff nurses, also State Registered, and supported
by appropriate nursing personnel, some of whom may be
State Enrolled nurses, others at various stages in their training and
yet others without any academic qualifications, and with no intention
of obtaining them, but who have had some practical training
and experience in nursing techniques; these are usually known as
nursing auxiliaries. It is not merely a play on words to say that this
ward organisation in a hospital can be applied to a "ward"
organisation in the community, for if a number of municipal
wards are grouped together to cover an area of the Borough, the
same principles can apply. In Wandsworth, our home nursing staff
are, in fact, organised along these lines. Accordingly, we have
eight self-contained groups of home nurses, each of which is headed
by a group leader who is a State Registered Nurse of considerable
experience and members of the team consist of other State Registered
Nurses, some State Enrolled Nurses and yet others will be
the equivalent of a hospital ward's nursing auxiliary but who are
known by the somewhat indeterminate title of "bathing attendant".
In the same way as the health visitor team has a link within the
area within which it works, so the home nursing team has similar
links, particularly with the general practitioners. This organisation
enables the deployment of nursing skills to be such that each
nurse is accorded tasks within his or her capabilities and best