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.


National minimum dataset

118. The national minimum dataset to be returned on all completed 27-30 month reviews is included below. Response options or full code lists are provided as required along with comments to promote consistent interpretation and recording and hence facilitate comparative analyses over time or across areas. Pre-printed items are those potentially already held on the CHSP-PS system which can therefore be pre-printed onto a child's 27-30 month review form to minimise data entry required at the review. The PHN-HV can amend this information if required and then CHSP-PS can be updated accordingly.

Data item

Pre-printed on CHSP-PS form?

Response options

Comments

Demographic data

First name

Y

Surname / family name

Y

Home postcode

Y

Full postcode

Gender

Y

CHI

Y

Ethnicity

See code list at end

If ethnicity, main home language, and bilingual status were added to other CHSP-PS forms, these could also then be pre-printed on the 27-30 month form.

Main home language

English, other than English, unknown

Is English the main language spoken at home?

Bilingual/multilingual

Yes, no, unknown

Is the child routinely exposed to more than one spoken language in their home and/or care environment?

Looked after status

See code list at end

Is the child currently looked after by the Local Authority for any reason?

Professional identifiers

Health visitor identifier

Y

Clinic identifier

Y

GP practice identifier

Y

Information about review

Date of review

If reviews are conducted over more than one appointment, please include the date the review was completed

Place of review

Home, GP practice, community clinic, other

Tick all that apply if review conducted over multiple appointments

Professionals directly involved in delivering review

Health visitor, staff nurse, GP, paediatrician, other

Tick all that apply

Family members present with child at review

Primary carer, additional carer, other

Tick all that apply. Primary carer refers to the adult living (at least most of the time) with the child who provides most day to day care. Additional carer refers to a second adult (living with the child or not) who contributes to their day to day care. In most but not all cases, the primary and additional carers will be the child's mother and father.

Development

Social

No concerns, concern newly suspected, concern/disorder previously identified

A concern about a child's development may be newly identified during their 27-30 month review through a combination of structured discussion with the child's carers and elicitation of any concerns parents have, observation of the child, and the use of validated developmental assessment tools. If concerns are newly identified, action would be expected to follow such as arrangement for early review, more detailed assessment, and/or wider parenting support. Some children with developmental concerns at this stage will ultimately follow 'normal' developmental trajectories.

Developmental concerns, or specific disorders such as cerebral palsy, congenital deafness, etc, may have been identified prior to the 27-30 month review.

Newly suspected concerns and previously identified concerns/disorders should be recorded separately to allow the yield of the 27-30 month review to be monitored.

Emotional

Behavioural

Attention

Speech and language

Gross motor

Fine motor

Vision

Hearing

Tools used during the review to support developmental assessment

PEDS, PEDS:DM, ASQ3, SOGS II, SDQ, ASQ:SE, SSLM, M-CHAT, ECBI, other

Tick all that apply

Growth

Weight

Weight in kg to one decimal place

Height

Height in cm to one decimal place

Date measured

Complete if different to date of review. Only measurements taken within four weeks of the date the 27-30 month review was completed should be entered.

Second hand smoke

Primary carer current smoker?

Yes, no, unknown

Is the child's primary carer a current smoker? Primary carer refers to the adult living (at least most of the time) with the child who provides most day to day care.

Exposed to second hand smoke?

Yes, no, unknown

Is child regularly exposed to second hand smoke within their home, car, and/or care environment from any source? Exposure in the home means anyone smoking anywhere inside the house or on the doorstep with the door open. Regularly means once a week or more frequently.

Dental health

Childsmile referral status at 6-8 weeks

Y

Yes, no, refused, incomplete

Was the child referred to Childsmile following their 6-8 week child health review? Incomplete means either that the child is too young to have had the opportunity to be referred to Childsmile at their 6-8 week review (referral option added in July 2011) or that no definitive response (yes, no, refused) was indicated by the PHN-HV at their 6-8 week review.

Registered with dentist

Y (if available as part of the national Childsmile data linkage project - otherwise PHN-HVs to complete)

Yes, no, unknown

Is the child currently registered with a dentist?

Attended dentist in last 12 months

Yes, no, unknown

Has the child attended a dentist within the last 12 months?

Diagnoses/needs

Diagnoses/needs

Y

Free text subsequently Read coded

Known specific diagnoses and wider social needs should be recorded here using the GIRFEC My World Triangle as a guide.

How I grow and develop

All medical diagnoses (including congenital conditions) that are likely to be relevant to the continuing health and development of the child should be noted. Note that these could have been diagnosed by any health professional and the PHN-HV and associated skill mix team do not need to be involved in managing the condition for it to be included here. The CHSP-PS NUG, with support from ISD, should provide PHN-HVs and child health departments with regularly updated lists of Read codes for common problems to minimise the administrative resource required locally for Read coding and improve the accessibility of the information recorded for analytical purposes.

Diagnoses/needs (con))

Y

Free text subsequently Read coded

What I need from people who look after me, and My wider world

Social and wider environmental issues likely to be relevant to the continuing health and development of the child should also be noted. Again, the CHSP-PS NUG, with support from ISD, should provide regularly updated suggested standard wording and associated Read codes for common and/or serious problems. The standard wording should aim to balance the requirement to accurately record children's needs with considerations about confidentiality and maintaining parental engagement with services and consent for data sharing. Additional detailed information on family circumstances can be recorded in local notes and does not need to be included in the national minimum dataset.

Health plan indicator

Current HPI

Y

Core, additional (will also include some intensive until this code no longer used and possibly some unknown eg children new to area)

This is last HPI entered into CHSP-PS prior to the 27-30 month review

Updated HPI

Core, additional

This is the HPI assigned on completion of the 27-30 month review.

An additional HPI indicates that the child requires sustained (>3 months) additional input from professional services to help them attain their health or development potential. Any services may be required such as additional PHN-HV support, parenting support, enhanced early learning and childcare, specialist medical input, etc.

Future action

Recall to PHN-HV

Interval to next appointment in weeks if child to be reviewed by PHN-HV

GP

Provide, signposted to, discuss with, refer to/request assistance from, refused

Provide indicates that the PHN-HV and/or associated skill mix team will directly provide the specified additional support e.g. parenting support (only relevant for some options).

Signposted to indicates that parents have been given details of specified local services and how to access them.

Discuss with indicates that the PHN-HV will formally discuss the child/family with the specified service to inform future management plans.

Refer to/request assistance from indicates that the PHN-HV will formally refer the child/family to the specified service, whilst retaining responsibility for overall monitoring of the child's wellbeing and outcomes as their GIRFEC Named Person.

Refused indicates that the carer has been offered provision/ signposting/ discussion/ referral to the specified service but has refused this.

Parenting support

Audiology

Speech and Language Therapy

Community paediatrics

Child and adolescent mental health service

Childsmile dental health support worker

Smoking cessation/smoke free homes service

Child healthy weight intervention

Early learning and childcare

Financial advice services

Social work

Other service

Specify

Support Needs Status

Y

Not active on SNS, active - not yet notified to doctor, active - not yet assessed, active - being assessed, previously on SNS

Data sharing

Consent to share review findings with early learning and childcare

Provided, refused, not sought

Ethnicity code list

Group A - White

1A Scottish
1B Other British
1C Irish
1K Gypsy/ Traveller
1L Polish
1Z Other white ethnic group

Group B - Mixed or multiple ethnic groups

2A Any mixed or multiple ethnic groups

Group C - Asian, Asian Scottish or Asian British

3F Pakistani, Pakistani Scottish or Pakistani British
3G Indian, Indian Scottish or Indian British
3H Bangladeshi, Bangladeshi Scottish or Bangladeshi British
3J Chinese, Chinese Scottish or Chinese British
3Z Other Asian, Asian Scottish or Asian British

Group D - African

4D African, African Scottish or African British
4Y Other African

Group E - Caribbean or Black

5C Caribbean, Caribbean Scottish or Caribbean British
5D Black, Black Scottish or Black British
5Y Other Caribbean or Black

Group F - Other ethnic group

6A Arab, Arab Scottish or Arab British
6Z Other ethnic group

Group G - Refused/Not provided by patient

98 Refused/Not provided by patient

Group H - Not Known

99 Not Known

Please note that this code list is the one developed for the 2011 census. It is used on other NHS Scotland datasets such as SMR01 returns. Alternative code lists should not be used.

Code 99 indicates that the individual was not asked to give their identity. If they are asked but decline to answer, code 98 should be used.

Looked after status code list

01 No, not currently looked after by local authority

02 Yes, looked after at home

03 Yes, looked after with friends/relatives (placed with friends or relatives who are not approved foster carers)

04 Yes, looked after with foster carers (placed with approved foster carers provided by or purchased by the local authority)

05 Yes, looked after with prospective adopters

06 Yes, looked after in other community placement (e.g. supported accommodation, hospital)

07 Yes, looked after in residential care (any form of residential care e.g. local authority or voluntary children's home or crisis care refuge)

Please note that this code list is a shortened version of that used by the Scottish Government to collect looked after children data from local authorities. Overall numbers of looked after children in Scotland are reported by the Government in the Children's Social Work Statistics Scotland publications (see http://www.scotland.gov.uk/Topics/Statistics/Browse/Children/TrendLookedAfter).

Contact

Email: Mary Sloan

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