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HOME NURSING
Throughout the county the home nursing service has been provided on the Council's
behalf entirely by the voluntary district nursing associations, with the Central Council for
District Nursing in London acting as the liaison and advisory body. Although from
time to time individual associations have ceased work, others have always taken over their
areas. Since 1948 the Council has paid an increasing proportion of the approved
expenditure of the associations; from 1954 this has amounted to 93 per cent. and for some
associations there has been an additional deficiency grant.
With the coming of the National Health Service Act, 1946 the home nurse, who
previously had provided nursing only for those who could not afford the services of a
private nurse, began to serve all sections of the community. More and more, however,
her concern was with older people. Ever since 1938 the proportion of elderly patients
dealt with by the home nursing service has increased steadily; 52 per cent. of the patients
were over 60 by 1949 and 58 per cent. over 65 by 1962. At the other end of the scale the
improvement in child health has led to a decline in paediatric cases.
New medical knowledge has meant an increase in injection therapy for complaints
which used to need prolonged treatment, but many new patients, including children, now
learn to give their own injections. In addition, there has been an increasing use of oral
therapy, especially for diabetic and cardiac cases. The result has seen a steady fall, year
by year, in the number of visits paid ' for injection only
The shift of emphasis from hospital to the community care of the mentally disordered,
with the operation of the Mental Health Act, 1959, had some repercussions on the home
nursing service. Senility is commonly a reason for repeated visits by the nurse. Home
nurses, too, have been called in to supervise the administration of drugs to the mentally ill
discharged to their own homes.
Other changes since the passing of the National Health Service Act, 1946 have been
the integration of the home nurse with other members of the local authority team (the
health visitor, the midwife and the home help); also the entry into the domiciliary nursing
field, although only on a small scale so far, of the male nurse and the enrolled nurse.
In the past few years there has been a steady decline in the number of patients nursed
and in the total number of visits paid. From 1957-1962 the number of patients fell by
37 per cent. and visits by 21 per cent. The main reason these figures have kept in step is
that the higher number of old people nursed has necessitated frequent visits in a growing
proportion of cases.
Details of the work done by the 24 voluntary grant-aided district nursing associations
who act as agents for the Council are given below: