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Co-ordination and co-operation of health
department services with the hospital and
family doctor services
Co-ordination and co-operation of the local health
authority's services with the hospital and family
doctor services continued to improve. Frequent
discussions took place with groups of family
doctors who are practising from health centres and
with those who were interested in working from
such centres. There was consultation between the
three services at maternity liaison committees.
Social workers and health visitors provide home
reports when they are asked to do so by family
doctors and hospital staff.
The ways in which domiciliary staff co-operate
with the other two branches of the health service
are described in the paragraphs on particular
services.
Midwifery Section 23
The general arrangements for the domiciliary care
of maternity cases remain the same as for previous
years, Heston, Isleworth and Feltham districts
being covered by the Council's midwives,
Brentford and Chiswick cases undertaken by
Queen Charlotte's Hospital midwives and planned
forty-eight-hour discharges in Brentford and
Chiswick being attended by a midwife operating
on our behalf from the London Borough of Ealing.
Five hundred and eighteen domiciliary confinements
were attended by the Council's midwives
during the year compared with 619 during 1966,
but the reduction was more than compensated by
the 964 early hospital discharge cases compared
with 694 in the previous year. Midwives employed
by Queen Charlotte's Hospital attended 60
domiciliary confinements and also the 72 patients
discharged from that hospital after forty-eight
hours and before the tenth day of the puerperium.
Domiciliary midwives took over the care of
premature babies when necessary after discharge
from hospital until the babies were sufficiently
mature for the mother to care for them and to
attend infant welfare clinics with them. Equipment
is available on loan to any mother of a premature
baby born at home and considered safe to be
nursed at home. If it is necessary to transfer a
premature infant to hospital the ambulance depot
supply the oxygenated incubator kept for this
purpose.
A full establishment of midwives was maintained
until October, and for the remainder of the year
it was not found necessary to replace the one
midwife who had resigned. Fifteen pupil midwives
came on to the district for training. Of these
8 were from Hillingdon Hospital and 7 from
West Middlesex Hospital training schools.
Four midwives attended compulsory refresher
courses conducted by the Central Midwives Board.
Three midwives attended day courses of study.
Co-operation with Family Doctors
The majority of the midwives attended ante-natal
clinics provided by family doctors at their own
surgeries, and liaison in this field continues to be
very good and will facilitate the implementation of
attachment schemes when these are eventually
put into operation.
Emergency Obstetric Units
Units are situated at Hillingdon and West
Middlesex Hospitals. Their services were required
on one occasion during 1967.
Analgesic Apparatus
Another Entonox analgesic machine was
purchased during 1967. This is considered to be
the safest type of analgesia for midwifery purposes
as the mixture of gas is 50% nitrous oxide and
50% oxygen. These machines proved very useful
to patients with maternal or foetal distress.
Maternity Medical Services Co-operation Card
The main purpose of this card is to ensure that
each member of the obstetric team is aware of the
attention given to patients by other members.
It is now becoming more widely used between
hospital and local authority clinics, also between
the general practitioners and midwives on
domiciliary work.
Maternity Services Liaison Committee
The Committee, which consists of members
representing the Regional Hospital Board, the
South-West Middlesex Hospital Management
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