View report page

33
Personal Health Services
In addition to their work, most of the district nurses take part in the training of the third year
students from four of the local hospitals. Attachment schemes with four groups of general practitioners
are working extremely well and the patients are treated promptly. I am pleased to report that Doctors
and Nurses are very happy with these arrangements.
One District Nurse acts as a liaison officer between the Geriatric Unit and the district, thus quick
information is passed around regarding admissions and discharges of patients.
There is a marked increase in the number of geriatric and young chronic sick who require a great
amount of care by the District Nurse. Some of these cases are very heavy indeed, and to facilitate
their nursing care eight hoists are in use, and it is hoped to have one or two more in the very near
future. A fair amount of disposable equipment is also used. During the year 3,184 patients were
nursed and 2,254 of these were over 65 years of age.

General Practitioner Attachment
During the year an approach was made by a firm of General Practitioners regarding home nurse
attachment. The group was expanding to include four doctors, the premises were being enlarged
and the receptionist staff re-organised. The practice was reasonably compact in area and it seemed
an excellent opportunity for attachment. Preliminary discussions took place between the senior General
Practitioner, a Principal Medical Officer and nursing staff, in order to explore the needs of the practice
and the services to be made available by the local authority staff. Two health visitors and one home
nurse were attached to the group, the home nurse doing surgery work in the main, but some emergency
visiting, and acting as liaison officer to her colleagues. As no regular time was set aside for obstetric
work, the matter of attaching midwives to the practice was left in abeyance. The scheme started in
October and was subject to review after some months.
In another part of the Borough, a group of two doctors enquired about health visitor attachment.
The circumstances here were different, as the area covered was more scattered, and it did not seem
practicable to make the same type of arrangement. In this case one health visitor had the biggest
number of families who were on the doctor's list. She arranged to visit the surgery regularly for discussion
of problems which concerned her directly, and to act as a link with those of her colleagues
who were also involved. As a very good social relationship already existed in this district between
the doctors and nurses, this scheme needed minimal encouragement and arrangement, and has worked
very well.
In two other practices a home nurse attends daily and acts as a surgery nurse, and in Harefield
which is geographically distinct, General Practitioners carry out the immunisation and vaccination
procedure in the local clinic, while the midwife attends the surgery ante-natal clinic.
By the end of 1968 a request for attachment was received from yet another group of General
Practitioners.
There is a growing awareness of the benefits to be gained by both sides from these schemes, but
a great deal of thought and preparation is required in arranging them. It is vital that the personalities
of those working together should blend satisfactorily and a lot of General Practitioners do not realise
fully the scope of the health visitor, her potentialities and her limitations. Furthermore they are not
always prepared for the fact that her activities may make more work for them, although in the long
run there is greater benefit to both patients and doctors. In the same way there is a danger that the