London's Pulse: Medical Officer of Health reports 1848-1972

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Richmond upon Thames 1967

[Report of the Medical Officer of Health for Richmond upon Thames]

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The definitions of attachment and liaison schemes may be summarised as follows:—
Attachment Schemes — The midwife/district nurse/health visitor is responsible
for all patients on the lists of specified general practitioners
within the local authority boundary.
(i.e. traditional geographical districts have been given
up.)
Liaison Schemes — The midwife/district nurse/health visitor is responsible
both for a geographical district and for the patients on
the lists of specified general practitioners. Where pati'
ents live outside the midwife's/district nurse's/health
visitor's district though within the local authority boundary,
she does not herself visit them but is responsible for
liaison between the appropriate midwife/district nurse or
health visitor.
The situation at the end of 1967 with regard to the liaison of nursing staff with
family doctors in the Borough was that there were eleven practices served by our staff
and I set out below a table summarising the position : —

Local Health Authority Nursing Staff

Practice No.Health VisitorMidwifeDistrict NurseClinic Nurse
1.(a)(b)
2.(a)(b)
3.(a)(c)
4.(a)
5.(a)(b)
6.(b)
7.(d)
8.Ob)
9.(b)
10.(b)
11.(d)

(a) the health visitor attends the doctor's child welfare (child health) clinic.
(b) the midwife attends the doctor's ante-natal clinic.
(c) the district nurse calls at the surgery every day to discuss the cases she is visitng from
the practice and to receive instructions from the doctor on these particular cases.
(d) In Practice No. 7 the clinic nurse attends the doctor's ante-natal clinic and in Practice
No 11 the clinic nurse attends the doctor's session for older people.
Each of these various forms of liaison are in the process of evolution and are being
adapted to meet the needs of each of the practices concerned and the Chief Nursing
Officer is keeping watch on the situation to ensure that they develop most advantageously
to all concerned.
29.