Procedure for school entrant health review
21st May 2008
Version Control. Document Title
Procedure for school entrant health review
See section 15 - stakeholders
Date of Production
for School nurse team leader
Primary Circulation List Web address Restrictions
Standard for Better Health Map. Domain
First domain: Safety Third domain: Clinical & cost effectiveness Fourth domain: Patient focused
Core Standard Reference
Core Standard C2, C3, C5, C13
1. To offer a school entry health review to all children in mainstream education. 2. To achieve a minimum of 91% of height and weight measurements at school entry for the national childhood monitoring programme (NCMP).
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Associated Policies and Procedures
Aims & Objectives
Scope of the Policy / Procedure
Accountabilities & Responsibilities
Preparation prior to screening
Selection Criteria for School Nurse Health Interview:
Parental questionnaire follow up guidance
Equality Impact Assessment Tool
Training Needs Analysis
Monitoring compliance with this policy/procedure
Appendices â€“ pages 11-13 A
Parent information letter 1
Parent information letter 2
Parent feedback letter (following the screening)
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Policy Statement Kirklees PCT is committed to meeting the standards set out in the National Service Framework for children and young people (2004) and the Every child Matters agenda (2003). The NSF sets out a clear child health promotion programme that aims to promote the health and well-being of children and identify needs and intervene early these principles are supported within the Every child matters agenda which aims to place children centrally to optimise positive outcomes for children and break down organisational barriers that can prevent this from occurring. Part of this programme includes a review of children’s health at school entry to include measurement of height, weight, vision and hearing, which will be undertaken by the School Nursing service in schools, working in partnership with school staff and parents. The School Nursing Service will address any specific unmet health needs identified at this stage. The school nursing service is expected to work collaboratively with other agencies to promote health and well-being to school age children and adhere to agreed policies and procedures as laid out by the PCT.
The document provides guidance for School Nursing teams using a negative consent system when undertaking screening in reception children as part of the School Entry Health Review. This approach ensures a universal system that encompasses all children having a school health review allowing any potential health concerns that may impact on the child’s education and well-being to be captured and addressed early as recommended within the children’s NSF and preventing children from ‘falling through the net’. The review also supports the department of health’s National Childhood Monitoring Programme (NCMP) where data is collected on a national basis on the height and weight of children in reception and year 6. This programme advocates a negative consent approach towards monitoring children in schools. Children are screened in school for height, weight, vision and hearing in reception year once they have been in school for at least one whole term. Birth date
1st Sep – 29th Feb
1st March – 31st After Easter August NB in cases where the number of pupils eligible for screening is very small all screening can be undertaken in the summer term (after Easter).
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Health reviews for the whole year group must be completed by no later than the end of the summer term. During this process it is important that each school nurse is involved in the new parents meeting/ evening in school to raise awareness of the school nursing service and the school entrant health review.
Associated Policies and Procedures.
This Policy / procedure should be read in accordance with the following PCT policies, procedures and guidance. • • • • • • •
PCT consent policy Record keeping policy School nurse height and weight procedure School nurse audio procedure School nurse vision procedure School nurse enuresis procedure Kirklees PCT child protection policy
Aims and Objectives.
AIM All school entrant children will be offered a health review once they start school. All parents will have the opportunity to inform the school nurse of any health needs their child may have. Opportunity will also be given for school to highlight any concerns/ issues. OBJECTIVES: •
Each child will be screened for height, weight, vision and hearing.
Parental information will be gathered on health issues from the parental questionnaire.
Health related information will be obtained from school.
Any prior health issues will be passed on to the school nurse from the health visiting service.
Identify any children that need any further intervention.
EXPECTED OUTCOME: •
Each child will have been offered appropriate surveillance.
Each parent will be given the opportunity to share any health related information with the school nurse.
School will be given the opportunity to share any health related information on children with the school nurse.
Referred as necessary to an appropriate agency. Page 4 of 14
The parent/ carer will be aware who their school nurse is, what services they provide and how to contact them.
Scope of the Policy / Procedure
These procedures must be followed by all PCT employees and staff involved in the school entry health review including those on temporary or honorary contracts as well as pool staff and students.
Accountabilities & Responsibilities
The Director of Provider Services is lead director with board level responsibility for school nursing services. Overall day to day responsibility for all aspects of the school nursing service lye with the School Nurse Team Leaders. School nurses are professionally accountable to the Director of Nursing Care and Professions 5.2
The Governance Committee is the overarching group that will have responsibility for this policy, it’s ratification and review
Preparation prior to screening •
Send letter to head teacher/ class teacher informing them of the process (SCH1).
The named school nurse should arrange an appointment with the class teacher or school representative where possible to discuss any health concerns regarding the children eligible for screening (blank SCH2 forms should be provided to the teacher).
Documentation to support this process should be completed for each child (SCH2) only where the teacher has identified concerns.
Where there are concerns highlighted details should be provided on the form. It is the responsibility of the teachers/ school staff to have shared any identified concerns with parents.
Obtain parent questionnaires from public health department (SCH4) and send them to parents with accompanying letter (SCH3) and envelope.
Allow 7 days
Pick up returned questionnaires from school
Send non-return letter (SCH5) to non-returned questionnaires.
Allow a minimum of 7 days.
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Prepare summary forms (SCH7) if required, attach to SMEF’s and copy of returned questionnaire (if available).
7. Procedure EQUIPMENT: •
School nurse equipment bag
Class list and SMEF’s..
Vision testing equipment (see vision procedure)
Audio testing equipment (see audio procedure)
Centile charts – male, female and BMI.
Method Complete screening – height, weight, vision and hearing as per procedures to identify any concerns. 1. Record screening information and any concerns/ further actions on summary form (if required - SCH7) and SMEF. 2. If no problems are identified from the screening send the completed SMEF to school health and feedback letter to parents (SCH6SE). 3. Completed questionnaires need to be returned to public health department for collation in school batches. 4. If no concerns are identified – shred paperwork. 5. Where there are identified concerns open a package of care and school nurse record and attach paperwork and a copy of the parent/ teacher questionnaire (where available) and inform parents using as per associated procedures.
8. Selection Criteria for School Nurse Health Interview:
Further input would be decided upon the discretion of the School Nurse and the level/ nature of the concern identified. A telephone call may be sufficient or in other incidences a health interview in school, health centre or at home could be more appropriate.
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Issue Screening concern
Health Visitor concern
Identified concern •
Vision (refer to Optician)
Concern from any member of school staff.
From School Nurse / Health Visitor liaison
Local options coding ~ any B, C category
On Child Protection register / cause for concern.
Any other concerns (eg: A&E Liaison)
School Nurse involvement as part of care plan.
9. Parental questionnaire follow up guidance
The following information is to provide guidance when responding to issues highlighted on the completed parental questionnaire for school entry health review. It is necessary for you to use your professional judgement on following up identified issues. However, the recommended action is required on the following issues: Dentist Has your child visited the dentist in the last year? If ‘No’ - send dentist information card. Record ‘I’ in the local options box on the SMEF. No other action required.
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Accidents & Safety Responses are for public health statistics – no action required Diet & Exercise Does your child eat breakfast everyday? Responses are for public health statistics – no action required. Number of helpings of fruit and vegetables each day? Responses are for public health statistics – no action required. Physically active for 1 hour per day? Responses are for public health statistics – no action required Do you think your child’s weight is: about right, underweight, overweight? To be used in conjunction with screening results. No action required if screening is satisfactory. Enuresis Where a parent is identifying night time wetting as an issue all/ most of the time, but the parent is stating they do not require support from the school nurse the school nurse should contact the parent by telephone informing them of the enuretic referral process and offering advice of leaflets. For other issues relating to night time wetting refer to the School nurse enuresis procedure. Leaflets Where information leaflets are sent to parents (and no record is opened) this should be recorded on the SMEF in the local options box as ‘I’ for information.
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10. Equality Impact Assessment.
All public bodies have a statutory duty under the Race Relation (Amendment) Act 2000 to “set out arrangements to assess and consult on how their policies and functions impact on race equality.” This obligation has been increased to include equality and human rights with regard to disability age and gender. The PCT aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others.
11. Training Needs Analysis. Comprehensive training will be provided to all new staff in the service as part of their induction package. Ongoing training will be provided to all School Nurses and School Nurse assistants where any changes in practice occur. 12. Monitoring Compliance with this Policy / Procedure. It is the responsibility of the health care practitioner employed by the PCT & working in the School Nursing Service to refer to the key performance indicators outlined in this policy & to monitor its content on an annual basis or sooner if necessary. The key aspects to be observed will be to ensure that all children in mainstream education are offered a school entry health review and a minimum of 91% of school entrants’ height and weight is measured to support the national childhood monitoring programme (NCMP). The safeguarding of young people be observed at all times and action taken if necessary, following guidelines set out by the Kirklees Safeguarding Children’s Board. The process of reviewing results will entail using data from the comcare department on a quarterly basis and data from child health systems on an annual basis in terms of numbers screened. School Nurse Team leaders will review this data and any action will be initiated should it be required. Results from the NCMP will be available from the public health department on an annual basis which will also be reviewed by school nurse team leaders. 13. References Department of Health (2004) National Service Framework for children and Young People – core standards. DH, London. The Stationary Office (2003) Every Child Matters. TSO, London Department of Health (2008) (NCMP). DH, London.
The national childhood monitoring programme
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14. Definitions SMEF – School medical examination form.
15. Key Stakeholders policy/procedure.
Kirklees PCT clinical governance department
Kirklees Education department
Kirklees PCT public health department
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Parent information letter (SCH 3) Address
Date Dear Parent / Carer
The School Nursing Service is part of the local NHS Primary Care Trust and is available to all school aged children in Kirklees. As part of the school nursing service your child’s hearing, vision, height and weight will be screened in school by a health professional. This will take place in school once your child has been in school for one whole term.
Please find enclosed a health questionnaire, which we would ask you to complete. It asks about your child's health, and gives you the opportunity of letting us know of any worries or concerns that you may have about any aspects of your child's health. As part of the process your child’s teacher will be asked if there are any health concerns about your child in school.
If any concerns are raised by yourselves, the screening results, your health visitor or your child’s school, your school nurse will contact you to discuss them further.
If you do not wish for your child to be screened in school please inform your school nurse on the above telephone number within the next two weeks.
Yours sincerely School Nurse Team Leader
It is important that this form is completed and returned to school in the envelope provided within the next 7 working days. Please take care not to fold the questionnaire.
Enc: Health questionnaire & return envelope.
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Parent information letter (SCH 5) Address
Date Dear Parent/Carer
We recently sent you a questionnaire regarding your childâ€™s health. We have not received your completed questionnaire. If you would like to you can complete and return your questionnaire however, if we do not receive your completed questionnaire we will assume that you have no health concerns about your childâ€™s health.
Your child will be screened in school by the School Nursing service. If you do not wish for your child to be screened in school please inform your school nurse on the above telephone number as soon as possible.
Should any health concerns be raised by school, your health visitor or from screening your School Nurse will contact you to discuss further.
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APPENDIX C Parent feedback letter (following the screening – SCH 6SE) Address
Date: Dear Parent/Carer .............................................................has been screened in school. The vision was tested and the result is: Satisfactory A referral is necessary, please see the enclosed letter, your school nurse will contact you to discuss this further. The hearing was tested and the result is: Satisfactory A repeat check is required in approximately 4 weeks (this will be undertaken in school and you will be informed of the result). A referral is necessary, please see the enclosed letter, your school nurse will contact you to discuss this further. The height recording is ......................cm. Satisfactory Suggests a repeat check in ……….. months. Your school nurse will contact you to discuss this further. The weight recording is ......................kg. Satisfactory Suggests a repeat check in ……….. months. Your school nurse will contact you to discuss this further. If yourself, your child’s school or your Health Visitor identifies any other health issues I may contact you to discuss them. If you would like to discuss the above screening results or any other health concerns regarding your child please contact me on the number above.
Yours sincerely School Nurse
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