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NURSING SERVICES
Miss Gillian Pittom, Chief Nursing Officer, writes:-
During this year the nursing services were reorganised, following the national pattern
advised by the Department of Health and Social Security. The appointment of a Chief Nursing
Officer was made in the early part of the year and following this appointment a complete
review of the structure was carried out. It was necessary to consider the changing needs in
community care and the increasing demands upon the nursing service, both from closer working
relationships with hospital and general practitioners as well as the imminent changes in the
training of student nurses and midwives. It was agreed that the most useful organisation of
the nursing service would be through line management with managers responsible for all three
services at middle and functional management or first line. These appointments were made
during the year with the exception of the middle management level.
The important moves in the community nursing services have been made with the
integration of the National Health Service in 1974 in the forefront of our minds. The midwifery
and district nursing service by attachment in groups, laid the foundation of much closer
working with general practitioners and completion of this was made when Health Visitors also
became attached to practices during the latter months of 1971.
The establishment of Health Visitors was increased by I Health Visitor and I
sponsored Student Health Visitor in 1971. The establishment is now 35 with 25 Clinic/School
Nurses working in close association with Local Health Authority Medical Officers and Health
Visitors. The present establishment is approximatley I:6,800 head of population, or an
overall of 60 Health Visitors School/Clinic Nurses I:4,000. The circular considers the norm
for Health Visiting (excluding School Nursing) should be I:3,000 — 4,600 according to the
type of area concerned.
The establishment of District Nursing Sisters has been maintained at full strength
with an increase of 4 State Enrolled Nurses each year for three years, from 1971. This makes
the total establishment on 1st April, I 972 60 District Nursing Sisters, approximately an
establishment of District Nursing Sisters I:5,000. All District Nursing Sisters have District
Nurse training as soon after appointment as possible. The circular commends I:2,500 - 4,000
according to the type of area concerned.
The midwifery service is remaining an effective domiciliary service with slightly less
births, but increasing number of early discharges from hospital.
The community nursing team has, during the last year, moved towards complete
attachment to general practitioners and is already showing itself to be undertaking an improved
service to a greater number of people and more satisfying to the staff concerned. This
deployment of the community nursing team enables both Health Visitors and District Nursing
Sisters to apply their own skills more effectively.
During the past year special in-service training schemes have been arranged so that
domiciliary midwives could spend two weeks in Thorpe Coombe Maternity Hospital to refresh
their hospital training and at present a reverse scheme is being offered to Thorpe Coombe
Sisters in the community. Whipps Cross Ward Sisters are spending a day with Health Visitors
and District Nursing Sisters working in Health Centres and visiting with them in the course
of their ordinary routine work. Discussions have taken place with the Director of Education
at Whipps Cross Hospital about the proposed changes in the student nurse training.
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