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12
Pupil Midwives
A total of 23 pupil midwives were accepted for Part II District Training from Paddington, Hillingdon,
Bushey and Central Middlesex Hospitals.
As a result of the continuing decline in domiciliary bookings with its adverse effect on the training of
pupil midwives, i.e. insufficient cases to meet the requirements of the Central Midwives' Board, a revised
scheme of training was approved by the Board for pupil midwives accepted from St. Mary's Hospital, Harrow
Road, W.9 (formerly Paddington General Hospital) and Central Middlesex Hospital. As from 1st November,
1968, the number of cases delivered by pupil midwives was reduced from ten to six. An additional four
patients to be delivered within the hospital during the intern part of the training. In addition to complying with
the Rules of the Board, a programme of talks and visits was arranged extending over the 13 week period of
domiciliary training. At the request of the Board the programme was planned to give pupils a broad outline
of community care, with a composite picture of the work of the Local Authority as it affects community care
generally and the maternity services in particular.
48 Hour Discharges
487 patients were discharged from hospital before the 10th day. The majority were planned for early
discharge, others were accepted on account of emotional disturbances and domestic difficulties, and a number
took their own discharge. Three part-time midwives are employed for the nursing of early discharges.
HEALTH VISITING
At the end of 1968, there were 35 health visitors in post to cover 43 areas. This shortage is liable to
have adverse effects through the wide range of medico-social services in which the health visitors are engaged.
It is fortunate that a good basic core of health visitors exist, but their work is of necessity becoming more and more selective.

Liaison
Health visitor liaison with general practitioners was extended from one to four practices, and frequent
contact between hospitals and the staff continues. Closer liaison with hospital personnel has been encouraged
and the result is rewarding. The attachment of a health visitor to the Diabetic Clinic at Central Middlesex
Hospital is well established. A new attachment to the Geriatric Unit at Central Middlesex Hospital is proving
most satisfactory for both Borough and hospital services. A member of staff attended Study Days arranged
by the Geriatric Department of Edgware General Hospital and the National Diabetic Association respectively.
An assistant medical officer and a health visitor attended St. Mary's Hospital Maternity Unit to discuss and
instruct on psychoprophylaxis.
Refresher Courses
Four health visitors attended a two weeks' non-residential Refresher Course in London, two attended
a two weeks' residential course at Canterbury, and two attended a course at Oxford.
Fieldwork Instructor's Course
Two health visitors completed a two weeks' Fieldwork Instructor's Course at Chiswick Polytechnic
qualifying them to instruct student health visitors in practical work.
Student Health Visitors
Five sponsored students successfully completed a course of training and obtained the Health Visitor's
Certificate, and five are attending the current course.
DISTRICT NURSING
Under Seotion 25 of the National Health Service Act, 1946, it is the duty of every local health
authority to provide nurses for persons who require nursing in their own homes. The establishment of nurses
(46 plus two State Enrolled Nurses) was increased by two full-time officers to cover maternity and sick leave.
The nurses work in close liaison with general practitioners and hospital staff. Facilities have been given for
senior student nurses in general training to accompany the Council's nurses on their rounds.
Seven part-time bathing attendants are employed. They work under the close supervision of the
trained nurses, and attend the elderly and infirm patients who require semi-nursing care over a long period,
thus allowing the trained nurses to give more time to the acutely ill and surgical patients.
2,143 new patients were referred during the year, and the nurses paid a total of 123,840 visits to all
patients. 5,012 visits were paid by bathing attendants. At the end of the year, 1,284 cases were on the register.
General Practitioner Attachments
Three new attachments were started during the year making a total of seven operating in the Borough.
The scheme works well to the satisfaction of the doctors and nurses, resulting in better community care for the
patients. 2,021 treatments were given in general practitioners' surgeries under the group attachment schemes.