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70
The Mayston Structure of Management, as mentioned earlier in
this report, was introduced in October, which brought about the
complete reorganisation of the management of the nursing division.
Managerial skills are scarce and must be deployed economically
within a carefully planned line structure, adequate delegation being
essential if the services are to be operated effectively. To this end
three levels of nursing management—top, middle and first line—
were introduced.
A Chief Nursing Officer was appointed to co-ordinate the health
visiting, home nursing, school nursing and domiciliary midwifery
services, thus providing a single channel of communication to the
Medical Officer of Health. Three middle managers were appointed,
two to operate within a geographical area in respect of health visiting,
home nursing and the school nursing service, all exercising
programming and personnel functions, the major content of their
work being operational. The third middle manager is responsible
for health education and training arrangements within the division.
The first line manager's chief function is to co-ordinate the work
of a group of basic field workers within their own discipline.
Finally, it says much for the staff that the reorganisation was
implemented without decline of quality or quantity of service to
the community.
A research project involving the field trial of a new oral poliomyelitis
vaccine was satisfactorily completed in October. In all. a
total of 150 children received the new vaccine and 300 blood samples
were collected in order to assess the efficacy of this new product.
This was a good example of a collective community nursing effort.
Health visiting service
During 1971, we were most fortunate to have a full establishment
of health visitors. The nine student health visitors were
successful in their final examinations and eight were appointed to
the staff in September.
A health visitor from Tooting Child Health Centre was
"attached" to a group practice of two doctors. The health visitor
undertakes all the health visiting work of the practice and visits
the surgery regularly. It is intended that in the near future the
health visitor will have her office in the surgery premises and so
be freely available to patients attending the surgery. The family
unit benefits considerably from the health visitor's wide knowledge
gained through a close working relationship with general
practitioners, and age groups not previously well-known to the
health visitor are constituting an important part of her work.
Discussions are taking place with other doctors and it is anticipated
that more attachment schemes will be introduced in the
near future.