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such a register. Only then is the mother invited to bring her
infant up to the nearest infant welfare clinic (by appointment)
when a thorough history is taken and a physical and developmental
examination is carried out by the medical officer at the
clinic. Urinary investigation is noted and additional visual or
auditory testing is effected by means of the Stycar systems
appropriate to the age of the infant.
This routine examination is repeated at intervals as the
infant reaches the age of approximately 6 months, 9 months,
12 months, 18 months and 2 years.
In the event of a handicap or abnormality being detected,
the appropriate action is taken with the agreement of the
infant's general practitioner, and subsequently the infant may
either be further observed or be transferred to the Physically
Handicapped Register,
If by the age of 2 years no abnormality has been detected
the infant's name will be removed from the register, but it is
intended that the health visitor and medical officer will continue
an unofficial follow up through the toddlers clinics at
yearly intervals and thereafter the child will be seen at the
routine school medical examinations. The school record card
of the child concerned will be marked by a purple adhesive
label to show the examining medical officer that the child has
at some point been on the observation register.
For record purposes in the infant welfare centres the
consultation record form (0—4 years—MCW 46 revised) is in
use, and this is distributed to any general practitioner also if
he prefers to follow up his own patients.
Certain minor problems are being met—inevitable in the
launching of any new scheme: these are being dealt with as
they arise.
Arising from experience so far, I strongly recommend the
standardisation of all hospital discharge forms. This could
well commence in the Redbridge Health Area. As the "At Risk"
Register (at present voluntary) becomes a nationwide concern,
the possibility of a national standard hospital discharge form
could eventually be considered. This would ensure that all
relevant and necessary information concerning the infant is
available quickly and efficiently, thus saving a lot of hospital
and local authority clerical time.
It was estimated in the London Borough of Redbridge that
approximately 20—25% of all live births would be considered