Respondents wanted accurate ante-natal lists with defaulters indicated, early knowledge of hospital admissions, especially from casualty, transfers in and out constantly updated, and accurate relevant information from G.P.’s. Concerning nurseries, respondents wanted to know when children were attending nursery and when they had been seen by the school nurse, feedback, from the primary health care team, particularly when other members were seeing the same family as the health visitor, a message leaving service, and feedback from post-natal and family planning clinics was felt would be helpful. Respondents wanted to know when children were attending the G.P. frequently, especially when nothing much was wrong, children attending day care and childminders and children being fostered. Good liaison with the Hallamshire Hospital and feedback from the eye surgeons was requested. Some respondents sought earlier feedback, for example:
"Sometimes information is late coming through, it comes through so many hands." T.C.
"We get very little feedback from the Educational nurseries. I suppose looking at mums it would be nice to have information about what happens at family planning at the G.P.s, post-natals, etc if we got information about transfers in, or maybe all people coming into the area, a register at the G.P.s would be good." B.D.
"You get to know information, e.g. hospital admissions, too late." I.T.
MISCELLANEOUS
Respondents asked for an array of other information for example an update of local amenities you could give out to families, what was happening in the area, more statistics, leaflets when you need them, not a two week wait, a profile of the area.
"I’d like a much better in depth profile of whats in the area so that the work would be a bit more meaningful." Q. Y.
One respondent asked for "what management expect of us", and then asked "how effective is visiting by appointment in a deprived area?". One felt a necessary tool was a list from the previous health visitor of all the families needing support. Respondents wanted access to welfare rights information, to know when mothers would be out, to know what can be prevented, the "health needs of the people I don’t see", what people would like, any major family shake up and finally what goes on behind the doors.
"Health needs of the people I don’t see. What would people actually like - the ones you recognise health needs in." K.N.
21. DO YOU USE YOUR G.P.s AGE SEX REGISTER? WHAT DO YOU USE IT FOR? All of the respondents had access to an age sex register but half of them replied that they never used it. Of the remainder it was used for elderly screening, tracing people, checking immunisations and estimating population. One respondent mentioned that work was planned, another had traced back the family of a deaf child to see if any genetic component could be found.
Others had used it to print out ante-natal patients, give a breakdown of ages in the 0-5 range, for transfers in and for a disease and conditions register, which sounded the most promising use.
The variety of responses is illustrated by the following quotations, "I haven’t no, there is one." B.T.
"No. Its not geared to prevention." S.T. "No." M.M.
"Use it for elderly screening clinic. Screen all over 65. Apart from that I don’t use it." K.N.
"I do. For checking, to check if registered here. For tracing kids. Here they have a disease register e.g. diabetics, blood pressure screening, smears. They stick a dot on. We have a computer here. You can pick out all the children who have not been immunised. They are very good at sending out letters. The G.P.s have a baby clinic. I like to think that I run it. I used the age-sex register when I very first came and started to count through how many people there were. I gave up at about 6000 and something. To see what sort of people and age groups. Can’t pull of age bands yet but that what he’s working on now. Can pull out cervical smears, blood pressures, repeat prescriptions, things like that." M.I.
22. IF YOU VIEWED YOUR CASELOAD AS THE WHOLE POPULATION ON YOUR G.P.s AGE-SEX REGISTER WHAT INFORMATION WOULD YOU WANT FROM IT?
The answers to this question bore a great resemblance to the answers to question20. In a similar way the responses can be divided into screening and lifestyle, conditions and illnesses and miscellaneous.
SCREENING AND LIFESTYLE
Respondents particularly wanted information about age ranges and groups in the practice, numbers of unemployed, elderly, and immunisation feedback. Particular sections of the population included the pre-retirement group, men aged between 35 and 60 years, people living
alone, menopausal women and one parent families. Again incidence of smoking, drinking alcohol, obesity and drug addiction were requested. In addition marital and educational status, diet, use of the contraceptive pill and literacy levels were sought as well as ability to communicate in English. Individual respondents mentioned numbers of widows and widowers suffering bereavement, people needing chiropody, people taking early retirement, those with anxiety and personal problems, the mental health of young men and those taking tranquilizers. Couples thinking of starting families were identified for pre-conceptual work, breast feeding rates, hearing test and assessments due were all considered useful. Others mentioned identifying positive health, kinds of employment and linking motorbike accidents with age groups.
Examples in this section include,
"I’d like to see smoking or not then we’d know where we were targetting. Whether they are unemployed or not - that has a lot of bearing on what people eat. Whether a women has been sterilized, had a hysterectomy things like that." W.Y.
"How many single parents .... mental health of young men, depression, use of tranquillizers, psychiatric admissions." T.G.