Audit of school entry health assessments: to maximise efficient use of health personnel at school entry assessments at 5 years.

During the last 3 years in which doctors saw all school entrants, the decisions made about each child on examination were recorded and a protocol about decision-making to support children with health needs was drawn up. In September 1994, school entry health care assessments by the school nurses were introduced. Having previously recorded the numbers in each school who required medical interest and support, it was possible to rationalise which schools should be the primary responsibility of the nurses, which should retain medical contact for all children and in which schools assessments should be shared. The outcomes in decision making after introducing nurse assessments were recorded in the same format as used by the doctors, so that the effect of passing responsibility to nurse colleagues could be assessed. The findings suggested that an equivalent number of children were referred to other services or selected for continuing review. However, the proportion of children whose needs were discussed with the headteacher without the children being selected for review was reduced. Issues to take forward were identified.