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'Health assessment' at school entry: performance of a system based on school nurse interviews
1Lambeth Community Care Trust, Mary Sheridan Centre for Child Health, London, UK.
Objectives:
To describe the performance of a school entry 'health assessment' based on school nurse interviews.
Background:
Universal medical examination at school entry has largely been replaced by a 'health assessment' led by the school nurse, based on screening tests, a health interview, eliciting parental and professional concern and past history. As a result children with possible problems are selected for school medicals, reviewed in school or referred to a range of health professionals and other agencies.
Setting:
Inner city south-east London.
Subjects:
Children born between 1/3/89 and 31/8/89 who were on the class lists of 21 randomly selected primary schools.
Data Collection:
A form for each subject was distributed to the school nurse and completed as children were invited for screening, school health interviews and medical examinations.
Main Outcome Measures:
Proportion of subjects attending, patterns and proportions of reviews and referrals.
Results:
426 children were eligible for inclusion and 419 (98%) forms were returned. 232 children were seen for a health interview and a further 50 were screened for vision, hearing and growth problems only. 124 had no contact with the school nurse or doctor. Following health interview or screening, 180 children were reviewed and/or discussed with other health professionals. 71 external referrals were made.
Conclusion:
Adequate coverage at school entry is difficult to obtain. The objectives of school entry health assessment and the relationship between selection criteria and health needs require clarification.