View report page

Co-crdination 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 are interested in working from such
centres There was consultation between the
three services at maternity geriatric and
psychiatric 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 cooperate
with the other two branches of the
health service including the attachment of
home nurses to general medical practitioners
are described in the paragraphs on particular
services
Midwifery - Section 23
Domiciliary midwives employed by the council
attend cases in the former Borough of Heston
and isleworth and Urban district of Feltham.
whilst in accordance with a long standing
agreement the domiciliary cases in Brentford
and Chiswick are attended by midwives
employed by Queen Charlotte s Hospital
who also attend the antenatal clinic conducted
by the hospital at Brentford Health Centre
or the antenatal clinics held in the general
practitioners own surgeries The midwives
employed by the borough are increasingly
involved with antenatal clinics conducted by
general practitioners and also conduct their
own clinics on local authority premises in
addition to their attendance at the antenatal
clinics run by the council s medical officers
As in urban areas in England and Wales
generally there has been a substantial
growth of institutional midwifery though many
cases are admitted to hospital for 48 hours
only and discharged thereafter to the care of
domiciliary midwives where there are no
contra-indications to this obstetrically or
socially
Council midwives attended 413 domiciliary
confinements during the year compared with
518 during 1967 The cases discharged early
23
from hospital numbered 970 six more than last
year Midwives employed by Queen Charlotte s
Hospital sttended 21 domiciliary confinements
and 141 patients discharged from the hospital
after 48 hours and before the tenth day of the
puerperium Domiciliary midwives assisted in
the care of premature babies where necessary
after discharge from hospital until the babies were
sufficiently mature for the mothers to care fully
for them and to take them to infant welfare clinics
Equipment is available for loan to any mother of
a premature baby where nursing can sa:ely be
arranged at home If it is necessary to transfer a
premature infant to hospital the ambulance depot
supply the oxygenated incubator kept for this
purpose Domiciliary midwives in the borough
numbered 14. Twenty-one pupil midwives came on
to the district for training Of these 9 were from
Hi11ingdon Hospital and 12 from West Middlesex
Hospital training schools As in previous years
Dr E N Christie gave the social service lectures
to two new groups of second part pupil midwives
in West Middlesex Hospital Two midwives
attended day release courses The principal
nursing officer for midwives and home nurses
also attended a refresher course this year
Emergency obstetric units
Units are situated at Hillingdon and West Middlesex
Hospitals, the former being used mainly for
patients in the Cranford and Southall areas The
units were required on two occasions during 1968
Emergency admissions to hospital were secured
for 6 babies who showed some form of distress
or congenital deformity soon after birth
Analgesic apparatus
All midwives now have both Entonox and Trilene
analgesic machines which prove very useful in
alleviating maternal distress The machines are
regularly serviced to ensure the greatest possible
safety in their use
Maternity medical services co-operation card
This standard co operation card is used to ensure
that each member of the obstetrics team is aware
of the attention given and observations made by
the other members of the team The card is kept
by the patient until the final post-natal examination
when it should be passed to her family
doctor and kept with her medical record