'Health assessment' at school entry: performance of a system based on school nurse interviews.
OBJECTIVE
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Universal medical examination at school entry has largely been replaced by a 'health assessment' led by the school nurse, based on screening tests, a health interview, eliciting parental and professional concern and past history.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.


METHODS
Inner city south-east London.


METHODS
Children born between 1/3/89 and 31/8/89 who were on the class lists of 21 randomly selected primary schools.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Laing
G J
GJ
Lambeth Community Care Trust, Mary Sheridan Centre for Child Health, London, UK.
Rossor
E B
EB
D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare; D006304:Health Status; D006801:Humans; D009726:Nurses; D012574:Schools; D013334:Students; D006113:United Kingdom