The Scottish Child Health Programme: Guidance on the 27-30 month child health review

Guidance on the core issues which should be addressed and recorded at the 27-30 month review, and standardised methods of assessment to ensure consistency of practice across Scotland.


1. The Scottish Child Health Programme provides proactive care and support to all children to help them attain their health and development potential. The universal child health reviews are a core element of the overall programme. The reviews provide an opportunity to work with parents to assess children's wellbeing, provide age appropriate health promotion advice, build parenting capacity, identify needs for support, and facilitate early access to effective interventions.

2. Policy on the content and delivery of the Child Health Programme was set out in 2005 in Health for All Children 4: Guidance on Implementation in Scotland1. This policy was supplemented in 2010 by a Chief Executives' letter2 and, following extensive consultation, in 2011 by the policy update A New Look at Hall 4 - the Early Years - Good Health for Every Child3. The letter and policy update recommended that a universal review for children aged 24-30 months ('the review') should be added to the Child Health Programme.

3. The 2011 policy outlined the key issues to be addressed at the 24-30 month review (specifically speech, language and communication skills; personal, social and emotional development (including behavioural issues); nutrition, growth and weight; immunisations; parental concerns and issues; vision, hearing and oral health; and physical activity and play) but did not provide further detail3.

4. In October 2011 the Scottish Government therefore established a short life working group ('the group') to produce detailed guidance on the content and delivery of the review. The group's aims were:

  • To identify the core issues which should be addressed at the universal 24-30 month review in all NHS Board areas,
  • To achieve consensus regarding the use of standardised methods of assessment, and
  • To improve national data collection from the review and hence facilitate the production of robust, reliable statistics that can inform child health policy and service delivery.

5. The group met four times between December 2011 and April 2012. The group was concerned to base the guidance on the best available evidence, to encourage and incorporate comments from stakeholders across Scotland, and to seek consensus wherever possible. To facilitate this, all members (see Appendix 1) were invited on to the group to represent their relevant professional groups and organisations and were asked to discuss the work of the group with them. A briefing note was produced after each meeting which documented the progress of the group and the development of the draft guidance and these were widely circulated. Specific input was also sought from key individuals, for example academics with relevant areas of expertise.

6. Consideration was given on the best age to carry out the review. The Group agreed, based on comments received, that the review should be carried out between 27 and 30 months, rather than 24-30 months, therefore the review will now be known as the 27-30 month review. NHS Boards should aim to ensure that reviews are completed by the time children attain 30 months.

7. The group was also concerned to ensure that this guidance is congruent with other policy, in particular the Getting it right for every child approach4 and the Early Years Framework5.

8. The aim of this guidance is therefore to facilitate the implementation of an effective 27-30 month review for all children in Scotland. The guidance is primarily aimed at front line health staff involved in delivery of the review, in particular Public Health Nurses - Health Visitors (PHN-HVs), and their managers. The guidance will also be of wider interest to General Practitioners and colleagues involved in early learning and childcare and the wider care and support of young children.


Email: Mary Sloan

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