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made 8,773 home visits to aged and infirm patients who
were unable to attend the clinics. The number of patients
requiring domiciliary treatment increased from 1,249 to
1,506.
Owing to the inability of the Heston and Isleworth Old
People's Welfare Committee to engage qualified chiropodists
that organisation was able to provide a very limited
service during 1972. As a result 121 domiciliary patients
received a total of only 189 visit and 77 patients made only
115 attendances at specially arranged sessions during the
year. Due to these continuing difficulties the arrangements
whereby this voluntary organisation provided a chiropody
service on the council's behalf have since been formally
terminated. The council has expressed its appreciation of
the chiropody services previously rendered, not only during
the formative years of the chiropody service in the borough,
but also as an invaluable adjunct to the local authority's
directly-provided service in general. The majority of both
clinic and domiciliary patients previously provided with
chriopody treatment by the Heston and Isleworth Old
People's Welfare Committee have since been absorbed into
the council's directly-provided service.

Problem families
Health Education
There is a small proportion of families which make
exceptional demands on the resources of the department
because of the multiplicity of their presenting problems. A
central file containing all known information about such
families is maintained in order to provide easier
communication and liaison with members of the Social
Services Department and voluntary agencies such as the
N S P C C who are often also involved with these families.
As a matter of routine, health visitors now bring forward
families about whom they are especially concerned and
these are discussed in detail with the Area nursing officer.
All staff are well aware of the desirability of prevention
rather than cure but where primary prevention has been
impossible the procedure aims at
(a) Identifying needs and difficulties and then considering
them in the context of the whole family.
(b) Effection use and organisation of resources.
(c) Early referral, where necessary, to other departments
or agencies.
(d) Adequate support to the worker most closely involved
and improved communications between all the
agencies concerned.
There has been a considerable increase in the number of
talks, supported by films, given to organisations throughout
the borough. The health education service has been well
served by local press publicity and there has been a most
satisfactory response evidenced by the large number of
citizens who have personally visited the Department to
collect literature on various aspects of health.
Posters concerned with health subjects were regularly
displayed in schools, health centres, clinics, dental surgeries
and factories as well as public notice boards. About 25,000
pamphlets covering a wide variety of health topics were
distributed.
Doctors from twenty three countries visited the health
education service during the year and were informed on
our techniques of planning, research and evaluation.
Students from colleges within the borough, student
nurses from general and mental hospitals, others of various
disciplines and groups of senior school girls who visited
health centres, clinics and other departmental
establishments were given lectures and shown films.
A description of the service provided for school
children appears on Page 46 of the report.
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