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 examination, and recording the results of examinations, which monitor the health and development of children, from shortly after birth until school entry. The system can also record referrals and outcomes of referrals pertaining to a child's problems.
- Pre-School Screening and Reviews
- Users of CHSP Pre-School
- NHS Board CHSP Pre-School Implementation Dates
- Analyses Available
- Clinical guidelines
[749kb] are available for health professionals who use the CHSP Pre-School system - Report on CHSP Pre-School data quality [76kb] and related general article
Pre-School Screening and Reviews
Child health surveillance is reviewed at regular intervals by the Royal College of Paediatrics and Child Health (RCPCH). The most recent RCPCH review of child health screening and surveillance programmes was published as the fourth edition of Health for All Children (Hall 4).
Current 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). This is commonly referred to as the Hall 4 programme. Under the Hall 4 programme a core programme of universal reviews and screening activities are offered to every child. Beyond the universal programme of contacts the public health nurse - health visitor uses their professional judgement to decide on the nature and frequency of further contacts with the family for review of child development. Implementation of Hall4 was phased across Scotland from October 2005.
Universal Programme of Reviews and Screening Activities
Neonatal hearing screening
Public Health Nurse First Visit
6-8 Week Review
Orthoptist vision screening (4-5 years)
Non-Universal Reviews
Birth Details
2-Year Review *
Recall Review
Unscheduled Review
* In January 2011 A New Look at Hall 4 - the early years: good health for every child set out guidance for a 24-30 month review to be carried out for all children (currently only children requiring structured additional or intensive support are invited for a review at this stage). Changes to the pre-school system and paper review forms are planned to facilitate the implementation of this guidance and once adopted will be incorporated into these web pages.
Information is also available on the programme of pre-school screening and reviews prior to Hall4 implementation.
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].
Public Health Nurse First Visit
The public health nurse - health visitor First Visit form [1.2mb] 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 [363kb] is generally completed at around 6-8 weeks after the birth of the child and is often a Public Health Nurse - 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.
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 [1.93mb]. In some areas pre-school orthoptist vision screening has not been implemented as yet and children are screened on school entry.
Birth Details
The birth details form [1.45mb] is completed in the maternity unit before postnatal discharge. This form gathers information about the birth which may effect 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 some NHS Boards.
2-Year Review
The 2-year review form [1.79mb] is completed at around 2 years of age for children who require structured additional or intensive support. This can include a full developmental examination where appropriate. Families of children on the core programme receive written information about child development at this age. They are invited to contact a designated person in the primary care team if they have any concerns about the child.
Recall Review
A recall review form [1.72mb] 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.
Unscheduled Review
An unscheduled review form [1.9mb] 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 may wish to discuss.
Users of CHSP Pre-School
The two principal groups of users are pre-school health professionals (such as public health nurse - health visitors, GPs, and community paediatricians) and staff responsible for pre-school health administration within an NHS Board.
Through discussion with the parent/guardian, the pre-school health professional records information on the relevant age related paper examination form. The review forms are designed to lead the health professional through the age appropriate assessment and examination of the child. They give the health professional a complete record of their discussion as well as findings and actions required, and the opportunity to recall the child if required. A copy is then given to the parent/guardian and held by the GP/public health nurse - health visitor. After the clinical contact has taken place the examination details are 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 implementation date | Hall4 Implementation Date on CHSP Pre-School1 |
|---|---|---|
| Ayrshire & Arran | 1993 | October 2006 |
| Borders | 1995 | October 2005 |
| Dumfries & Galloway | Dec 2000 | April 2006 |
| Fife | 1994 | April 2006 |
| Forth Valley | Dec 1997 | April 2006 |
| Grampian | June 2010 | June 2010 |
| Greater Glasgow & Clyde: Argyll & Clyde * Greater Glasgow |
1991 1995 |
February 2006 April 2006 |
| Highland: Argyll & Clyde * Highland |
1991 May 2007 |
February 2006 May 2007 |
| Lanarkshire | 1992 | December 2006 |
| Lothian | 1994 | October 2005 |
| Orkney | July 2010 | July 2010 |
| Shetland | May 2008 | May 2008 |
| Tayside | 1995 | January 2007 |
| 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.
1. The date when Boards started recording Hall4 compliant data on CHSP Pre-School.
Analyses available
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 childhood Body Mass Index (BMI) (pre Hall 4).
Analyses are available at various levels, for example by NHS Board (residence or examination), Council Area and Community Health Partnership.
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.
