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There is no group attachment scheme of Council midwives to general practitioner surgeries. Midwives
continue to hold their own ante-natal sessions, but close liaison with general practitioners, obstetricians
and hospitals is observed. Ante-natal care includes instruction in the use of analgesics i.e. Trilene and Entonox.
Sterilised maternity outfits are provided for all mothers who have their babies at home.
Refresher Courses
Six midwives attended refresher courses during the year to comply with Section G.l. of the Rules of
the Central Midwives Board which requires every practising midwife to attend a residential refresher course
every 5 years.
Pupil Midwives
A total of 24 pupil midwives were accepted for Part II District Training from Hillingdon, Bushey,
Paddington and Central Middlesex Hospitals. The continued reduction in domiciliary bookings is having an
adverse effect on the number of pupils who can be accepted for Part II training.
The Council's midwives have also given facilities for nurses in general training to accompany them
on their rounds and to attend ante-natal sessions.
48 Hour Discharges
There was a marked increase in the number of early discharges, the majority of which were planned
for early discharge, others were accepted on account of emotional disturbances and domestic difficulties. Four
part-time midwives are employed for the nursing of early discharges.
HEALTH VISITING

The noticeable decrease in the total effective home visits (5,455) is offset by the amount of time
required in helping newcomers to the Borough settle into unfamiliar surroundings, dealing with the many
problems which arise, and to a lesser extent by the fall in the birthrate and the shortage of Health Visitors.
Liaison
Frequent contact is made with the Medical Social Workers in hospitals. An invitation to attend discussion
groups with the Geriatric Department of Edgware General Hospital was extended to the Health Visitors
working in the Kingsbury area. One Health Visitor continued her weekly visit to the surgery of a group
practice. Closer liaison will be made when the Chalkhill Health Centre opens next year.
Refresher Courses
The Superintendent Health Visitor attended a weeks' refresher course on top line management at
Liverpool; two Health Visitors attended a two weeks' refresher course at Liverpool; three attended a two
weeks' non-residential course in London; and two attended a half day per week release course for ten weeks in
London.
Student Health Visitors
Five sponsored students are attending the current course, leading to the Health Visitor's Certificate.
DISTRICT NURSING
Under Section 25 of the National Health Service Act 1946, it is the duty of every local authority to
provide nurses for persons who require nursing in their own homes. The full establishment of nurses (46 plus
2 state enrolled nurses) was maintained during the year. Four part-time bathing attendants are employed and
they work under the supervision of the trained staff. The nurses work in close liaison with general practitioners
and hospital staff to ensure comprehensive nursing care for patients.
2,544 new patients were referred during the year, and the nurses paid a total number of 126,607 visits
to all patients. At the end of the year 1,212 cases were on the register. 3,184 treatments were given in general
practitioners' surgeries under the group attachment scheme. 1,767 visits were paid by bathing attendants.
General Practitioner Attachments
There are now five District Nursing Sisters attached to group practices. The scheme works well to the
benefit of the patient and to the satisfaction of the doctors and the nurses.
Training and Refresher Courses
Four nurses attended the District Nurse Training Course at Chiswick Polytechnic. They were all
successful and obtained the National Certificate of the Ministry of Health.
Four nurses attended refresher courses to comply with the Ministry of Health's recommendation that
all home nurses should attend refresher courses every 5 years.
One bathing attendant attended a two weeks' course for nursing attendants arranged by the London
Borough of Newham.