Child Health Systems Programme Pre-School (CHSP Pre-School)
The CHSP Pre-School system supports the delivery of the child health programme by facilitating the automated call and recall of children for the agreed schedule of child health reviews for pre-school children. Child health reviews incorporate assessment of children's health, development, and wider wellbeing alongside provision of health promotion advice and parenting support. The CHSP Pre-School system also allows consistent recording of the findings and outcomes of child health reviews.
- Pre-School Screening and Reviews
- Users of CHSP Pre-School
- NHS Board CHSP Pre-School Implementation Dates
- Analyses Available
- Clinical guidelines [1700Kb] are available for health professionals who use the CHSP Pre-School system
- Guidance [41Kb] on recording a summary list of issues affecting children’s health, development and well-being through the CHSP-Pre-School and School systems is available along with associated Read code lists [78Kb] (full Read code list, quick list for Health Visitors/School Nurses [31Kb], quick list for administrative staff [43Kb])
- Report on CHSP Pre-School data quality [76Kb] and related general article
- Paper on use of developmental assessment questionnaires within 27 month child health reviews. [319Kb] Please note that figures quoted in this paper differ slightly to those published in the official statistics publication. This is because the publication is based on a more recent analysis file.
Pre-School Screening and Reviews
Professional guidance on the content and delivery of the Child Health Programme has been provided at regular intervals by the Royal College of Paediatrics and Child Health (RCPCH). The most recent RCPCH guidance was published as the fourth edition of Health for All Children (Hall 4) in 2003.
Scottish Government policy on the delivery of the child health programme is set out in Health for all children 4: guidance on implementation in Scotland (published April 2005) and A new look at Hall 4. The early years: good health for every child (published January 2011); and The Scottish Child Health Programme: Guidance on the 27-30 month child health review(published December 2012) and Universal Health Visiting Pathway in Scotland - Pre-Birth to Pre-School (published October 2015). Together these policies set out the core programme of child health reviews and screening activities that are offered to every child. Beyond the universal programme of contacts, the health visitor uses their professional judgement to decide on the nature and frequency of further contacts with the family. Implementation of the programme of child health reviews specified in the 2005 policy was phased across Scotland from October 2005. In response to the 2011 and 2012 policy updates, the review for selected children at two years was replaced with a review for all children at 27 to 30 months from April 2013 in all NHS Board areas. The forms for all existing reviews were updated in 2015, with new forms implemented in February 2016.
Universal Programme of Reviews and Screening Activities
Neonatal hearing screening
From 2005 all newborn babies are tested for hearing impairment problems, normally prior to hospital discharge. The results are recorded on a neonatal hearing screening form [147Kb].
Health Visitor First Visit
The Health Visitor First Visit form [275 Kb] is generally completed at around 10 days after the birth of the child. This begins the child's electronic surveillance record and gathers basic identification, family and social data. Examples of information collected include: mother's age; smokers in household and infant feeding (at birth, hospital discharge and current method). Identification data such as name, address, GP etc are also checked and updated.
6-8 Week Review
The 6-8 week review form [310 Kb] is generally completed at around 6-8 weeks after the birth of the child and is often a health visitor and GP combined review. Examples of information collected include: feeding of baby (breast, bottle or both); parental concerns (feeding, appearance; behaviour; hearing; eyes; sleeping; movement; illness; crying; weight gain and other); development (gross motor, hearing & communication, vision & social awareness); physical (length, weight, heart, hips, testes, genitalia, femoral pulses and eyes); diagnoses/concerns (Read coded); sleeping position (prone, supine and side). Identification data such as name, address, GP etc. are also checked and updated.
27 - 30 Month Review
The 27-30 month review form [295 Kb] is completed at around 27-30 months of age and is carried out by a health visitor. This review started in April 2013 and is offered to all children (previously only children requiring structured additional or intensive support were invited for a review at this stage). Examples of information collected include: development (social, behavioural, communication, gross motor, vision, hearing), physical measurements (height and weight) and diagnoses / issues (Read coded). Identification data such as name, address, GP etc. are also checked and updated.
Orthoptist vision screening (4-5 years)
Vision screening is carried out by an orthoptist prior to school entry at 4-5 years of age. The results are recorded on a vision screening form [855 Kb] and if required, a vision screening recall form [1 Mb].
The birth details form [1.45 Mb] is completed in the maternity unit before postnatal discharge. This form gathers information about the birth which may affect a child's subsequent health and development. Examples of information collected include: name; address; date of birth; sex; Apgar score; problems during birth; method of delivery; birth weight and height. The birth details form is only used in a few NHS Boards.
A recall review form [305 Kb] is generated by the system when a recall has been requested by a health care professional at a previous examination. A child may be recalled for an additional review if the examiner has any concerns regarding the child. For example, if the examiner has concerns about the child at 6-8 weeks they can request an additional review at a later date, which they specify.
An unscheduled review form [278 Kb] can be used when a child is outwith the normal age range as indicated at each age-related review. A child may receive an unscheduled review if they missed the routine scheduled examination or if a parent has any concerns/issues they wish to discuss.
2-Year Review (no longer carried out - replaced by 27-30 month review from 1 April 2013)
Following implementation of the 2005 policy and prior to 1 April 2013, the 2-year review form [1.79Mb] was completed at around 2 years of age for children who required structured additional or intensive support. This included a full developmental examination where appropriate. At this time, families of children on the core programme received written information about child development at this age and were invited to contact a designated person in the primary care team if they had any concerns about the child.
Changes were made to some of the preschool forms in February 2016 to better align them. The forms used for reviews carried out between 2005 and 2015 are also available for historic monitoring purposes.
Information is also available on the programme of pre-school screening and reviews offered prior to implementation of the 2005 policy.
Users of CHSP Pre-School
The two principal groups of users are pre-school health professionals (such as health visitors, GPs, and community paediatricians) and staff responsible for pre-school health administration within an NHS Board.
When a child is due for a child health review, the CHSP Pre-School system sends an invitation to the family and sends the relevant review form (in triplicate) to the health visitor. During the child's review, the pre-school health professional completes the form which then provides a summary record of their discussion with the family as well as findings and actions required. One copy of the completed form is given to the parent/guardian, one is retained in the health visitor's notes, and one is returned to the local child health department where the information contained is keyed into the system by administrative staff. Identified problems are also Read coded at this stage. This allows any problems to be followed up and further reviews scheduled if necessary.
NHS Board CHSP Pre-School Implementation Dates
The CHSP Pre-School system was established in 1991 with Argyll and Clyde being the first NHS Board to adopt the system. All NHS Boards in Scotland now use the system.
|NHS Board||CHSP Pre-School system implementation date||Implementation date for revised schedule of child health reviews as specified in 2005 policy|
|Ayrshire & Arran||1993||October 2006|
|Dumfries & Galloway||Dec 2000||April 2006|
|Forth Valley||Dec 1997||April 2006|
|Grampian||June 2010||June 2010|
|Greater Glasgow & Clyde:
Argyll & Clyde *
Argyll & Clyde *
|Orkney||July 2010||July 2010|
|Shetland||May 2008||May 2008|
|Western Isles||May 2006||May 2006|
|* Argyll and Clyde ceased to exist on 31st March 2006 and the administration area was split into two sub-areas that now fall under the administration of NHS Greater Glasgow and Clyde and NHS Highland respectively.|
A variety of routine outputs are available to users of CHSP Pre-School, which can be used for local purposes. Data recorded have also been used in a range of different analyses and have been published on the ISD Scotland website. These include statistics on: breastfeeding; maternal smoking and, prior to implementation of the 2005 policy, childhood Body Mass Index (BMI).
Analyses are available at various levels, for example by NHS Board (residence or examination and Local Authority).
Please note that in some NHS Boards a phased implementation occurred after the system was adopted. Therefore, caution should be taken when interpreting data around the implementation period. In addition many data items are not mandatory and recording practices vary between NHS Boards and individual health professionals. Therefore not all data items on the review forms can be used for analysis.
If you would like to request specific analyses please refer to the contacts page for details.