Health Appraisals and Medical Examinations for Children in Special Schools and Learning Centres

Health Appraisals and Medical Examinations for Children in Special Schools and Learning Centres Reference Number: NHSCT/09/229 Responsible Directorate: Children s Services Replaces (if appropriate): N/A Policy Author/Team: Dr. Clare Bailey Mrs. Loraine Calvert, School Nurse Team Leader Mrs. Rosaleen Devlin, School Nurse Team Leader Approved by: John Fenton Assistant Director Child Care Type of document: Departmental Protocol Date Policy disseminated by the Policy Unit: 17 November 2009 Date Approved: 29 September 2009 NHSCT Mission Statement To provide for all the quality of services we would expect for our families and ourselves 1

PROTOCOLS for HEALTH APPRAISALS & MEDICAL EXAMINATIONS for CHILDREN in SPECIAL SCHOOLS & LEARNING SUPPORT CENTRES 2

CONSULTANT PAEDIATRICIANS/SCMOS - NORTHERN IRELAND NORTHERN TRUST Dr Alison Livingstone Consultant Paediatrician Tel: 028 9441 5729 CDC Ferrard Site Fax: 028 9441 5726 ANTRIM Email: alison.livingstone@northerntrust.hscni.net Dr Kim Troughton Tel: 028 9441 5735 Consultant Paediatirican CDC Fax: 028 9441 5726 Ferrard Site ANTRIM Email: kim.troughton@northerntrust.hscni.net Dr M Clare Bailey Tel: 028 9034 1572 Associate Specialist Ferguson House Fax: 028 9034 1578 57-59 Manse Road NEWTOWNABBEY Email: clare.bailey@northerntrust.hscni.net Dr Pauline Kennedy Associate Specialist Tel: 028 2563 5649 Health Office Slemish Community Services Centre Fax: 028 2563 5686 BALLYMENA Email: pauline.kennedy@northerntrust.hscni.net Dr Yvonne Doherty Associate Specialist Tel: 028 7963 4831 ext 201 Health Office 44 King Street Fax: 028 7930 0401 MAGHERAFELT Email: yvonne.doherty@northerntrust.hscni.net Dr Deirdre Walsh Tel: 028 7032 7032 Consultant Community Paediatrician 4 Newbridge Road Fax: 028 7035 0000 COLERAINE Email: deirdre.walsh@northerntrust.hscni.net Dr J Nicholson Tel: 028 9442 4504 Consultant Paediatrician Antrim Hospital Fax: 082 9442 4294 ANTRIM Email: john.nicholson@northerntrust.hscni.net 3

WESTERN HEALTH & SOCIAL CARE TRUST Dr Sandi Hutton Consultant Community Paediatrican Tel: 028 7186 0056 Foyle Health & Social Services Trust Bridgeview House Fax: Gransha Park Clooney Road LONDONDERRY Email: sandi.hutton@westerntrust.hscni.net Dr Vivien Dale Associate Specialist Tel: 028 7132 1709 Waterside Health & Social Care Centre 127-145 Spencer Road Fax: LONDONDERRY BT47 6AQ Email: vivien.dale@westerntrust.hscni.net Dr Erin Knowles Community Paediatrician Tel: 028 7136 5177 Great James Street Health Centre Great James Street Fax: 028 7226 8511 LONDONDERRY Email: erin.knowles@westerntrust.hscni.net Dr K Sharma Consultant Community Paediatrician Tel: 028 8224 3521 Mountjoy Road Email: Health Centre Fax: 028 8225 1202 OMAGH 4

SOUTHERN HEALTH & SOCIAL CARE TRUST Dr James Hughes Consultant Paediatrician Tel: 028 3083 4200 John Mitchell Place NEWRY Fax: 028 3083 4384 Email: james.hughes@southerntrust.hscni.net 5

BELFAST HEALTH & SOCIAL CARE TRUST Dr Anne Armstrong Consultant Paediatrician Tel: 028 9056 3373 The Arches Centre Westminster Avenue North Fax: 028 9065 3846 BELFAST BT4 1NS Email: anne.armstrong1@belfasttrust.hscni.net Dr Moira Stewart Consultant Community Paediatrician Tel: 08453006650 Carlisle Centre Email: 40 Antrim Road Fax: 028 9016 3550 BELFAST BT15 2AX Dr Alan McMillan Associate Specialist Tel: 08453006650 Carlisle Centre Email: 40 Antrim Road Fax: 028 9016 3550 BELFAST BT15 2AX Dr Nan Hill Consultant Paediatrician Tel: 028 9056 3373 RBHSC Email: Falls Road Fax: 028 9065 3846 BELFAST Dr Daphne Primrose Tel: 028 9056 3373 Consultant Paediatrician Email: The Arches Centre Fax: 028 9065 3846 Westminster Avenue North BELFAST BT4 1NS Dr Margaret Stanfield Senior Clinical Medical Officer Tel: 028 9266 5181 Lisburn Health Centre Email: Linenhall Street Fax: 028 9267 6026 LISBURN 6

Protocol for Health Appraisals and Medical Examinations in Special S Schools and Beechgrove 1 Special S Schools Sandalford Coleraine Kilronan Magherafelt Loughan - Castle Tower Campus, Ballymena Riverside Antrim Roddensvale Larne Hillcroft Newtownabbey Beechgrove is a school for children of primary school age who have a physical disability and is a campus within Castle Tower. General Comments 1. All health appraisals and medical examinations will be undertaken jointly with school nurse and community paediatrician 2. The CHS 24R should not be issued to pupils at these schools. Clerical staff should issue relevant questionnaire either Special S School questionnaire or Beechgrove questionnaire together with Invitation to Medical 3. Provided consent is obtained, health appraisal and examination will take place, even in the absence of a parent (Homefirst legacy only) a. Children may travel some distance to attend their specialist education provision and therefore parents may have difficulty attending appointments in school b. Paediatricians will exert their own professional judgement as to whether or not a local clinic appointment will also be necessary 4. Where an appointment has been cancelled, this will be rescheduled as soon as possible 5. In the event of a pupil being absent or consent not having been obtained, one further appointment will be offered the following school year only. In the event of a joint examination still not taking place despite two invitations consideration must be given to the most appropriate action necessary. 6. In the event of a carer not being present for the appointment, information will be shared using the standard letter Health Appraisal Outcome Special Schools and LSC 1 Beechgrove now forms part of the Castle Tower Campus and it is not clear how easy it will be, in the future, to ascertain which pupil is assigned to which campus 7

7. CHS 18R is completed jointly by school nurse and paediatrician and returned to clerical staff for entry onto CHS. Clerical staff will record height, weight, vision and hearing as school nurse activity and any other information will be recorded against the paediatrician. 8. Paediatrician will make a handwritten record of the consultation 9. The paediatrician will forward information to the GP decision to be reached options include: a. Copy CHS18R b. Standard letter issued or c. Copy of file note (handwritten) New Entrants 1. All new entrants regardless of age will be offered a health appraisal and medical examination Reviews 1. It is the responsibility of the community paediatrician to identify those children that require to be reviewed in any one school year a. A child who is currently attending a consultant community paediatrician within the Trust should have the CHS 18R completed as examination not required but the child should be recalled for 12 months to ascertain whether or not the child continues to be followed up by a consultant 2. Review appointments will be offered on those pupils not currently attending a consultant community paediatrician within Northern HSC Trust a. Timing of subsequent reviews will be determined at medical appointment by the paediatrician and will be offered no less frequently than every 2 years. This will be recorded on CHS18R. b. All young people in their final full year at school (age 18 at special S schools) should have a final medical examination. The paediatrician will share the outcome with the General Practitioner this should include reference to condition specific guidelines where available. 8

School Health Service Beechgrove Questionnaire Name Address Date of Birth School GP 1. Is your child in good health at present?.. If "no" please give details:......... 2. Is your child on regular medication/treatment?... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 3. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 4. Do you suspect poor hearing?. If yes please give details: 5. Do you suspect poor vision? If yes please give details: continued overleaf 9

6. Does your child have epilepsy?. If "yes", please give brief description of seizures (including how often) 7. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam? If yes has it been prescribed for emergency use in school? 8. Does your child have a bedwetting problem?.i Is this a new problem? Is your child dry by day?. 9. Does your child have any bowel problems? If yes please give details... 10. Does your child have behaviour problems?... If "yes" please give details:......... 11. Does your child have any known allergies?. If yes please give details and state if any emergency medication is required?.. 12. Do you have any particular worries about your child? If "yes" please give details:.......... Do you intend to be at the medical appointment?. If no do you still want your child to be seen and examined?... If you are unable to attend and you want your child to be seen can s/he be accompanied by teacher/classroom assistant, if necessary?..... Are you happy for the doctor/nurse to talk to the teacher about your child, if necessary? Do you consent to the doctor providing a relevant report to the Education & Library Board for the annual review of statement, if necessary?. Please state your current address if different from overleaf: Please state your contact telephone number(s).... Signature of Person with Parental Responsibility Date. 10

Name School Health Service Special S Schools Questionnaire Address Date of Birth School GP 1. Is your child in good health at present?.. If "no" please give details:......... 2. Is your child on regular medication/treatment?... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 3. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 4. Do you suspect poor hearing?. If yes please give details: 5. Do you suspect poor vision? If yes please give details: continued overleaf 6. Does your child have epilepsy?. 11

If "yes", please give brief description of seizures (including how often) 7. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam? If yes has it been prescribed for emergency use in school? 8. Does your child have a bedwetting problem?. Is this a new problem? Is your child dry by day?. 9. Does your child have any bowel problems? If yes please give details... 10. Does your child have behaviour problems?... If "yes" please give details:......... 11. Does your child have any known allergies?. If yes please give details and state if any emergency medication is required?.. 12. Do you have any particular worries about your child? If "yes" please give details:.......... Do you intend to be at the medical appointment?. If no do you still want your child to be seen and examined?... If you are unable to attend and you want your child to be seen can s/he be accompanied by teacher/classroom assistant, if necessary?..... Are you happy for the doctor/nurse to talk to the teacher about your child, if necessary? Do you consent to the doctor providing a relevant report to the Education & Library Board for the annual review of statement, if necessary?. Please state your current address if different from overleaf: Please state your contact telephone number(s).... Signature of Person with Parental Responsibility Date. 12

School Health Service Invitation to Medical Children s Services Directorate Recipient s Name Recipient's Address 1 Recipient's Address 2 Recipient's Address 3 Recipient's Address 4 Recipient's Postcode Date: To: The Person with Parental Responsibility You and your child are invited to attend an appointment with the school nurse and community paediatrician: In: School On: At: Your attendance would be greatly appreciated. Please complete the attached questionnaire and return it to school before the appointment. Yours faithfully, 13

Protocol for Health Appraisals and Medical Examinations in Special M Schools and Learning Support Centres Special M Schools Dunfane Castle Tower Campus, Ballymena Rosstulla Jordanstown Learning Support Centres Moyle Primary School, Larne Larne High School, Larne Holy Trinity Primary School, Cookstown Cookstown Primary School, Cookstown Glenview Primary School, Maghera Rathenraw Primary School, Antrim Ballymoney Model, Ballmoney Ballysally Primary School, Coleraine Christie Primary School, Coleraine Harpur s Hill, Coleraine St Brigid s Primary School, Ballymoney General Comments 1. Children attending special M schools will have their health appraisal undertaken by the school nurse in advance of any medical examination as for children in mainstream schools 2. Children attending special M schools and learning support units may have an isolated learning disability or it may be part of a wider medical condition 3. Children may not be attending any specialist services 4. Provided consent is obtained, health appraisal by the nurse will take place in the school even in the absence of a parent 5. In the event of a carer not being present for the appointment, information will be shared using the standard letter Health Appraisal Outcome Special Schools and LSC 6. The location of any subsequent medical examination (if required) will be determined jointly by the paediatrician and the child s carer given that children may travel some distance to attend their specialist education provision and therefore carers may have difficulty attending appointments in school. 7. Where an appointment has been cancelled, this will be rescheduled as soon as possible 14

8. In the event of a pupil being absent or consent not having been obtained (for health appraisal), one further appointment will be offered the following school year only. In the event of a health appraisal not taking place despite two invitations, the situation must be discussed with the paediatrician. P1 Pupils and New Entrants School Nurse Health Appraisal 1. All P1 pupils and all new entrants who have not had a previous P1 health appraisal, will be offered an appraisal with the school nurse (universal school entrant health appraisal). 2. The CHS 24R will not be issued to pupils at these schools. Clerical staff should issue relevant questionnaire Special Needs Health Questionnaire Children with Statements together with CHS letter of invitation 3. School Nurse will discuss all children with the paediatrician for the school to determine the outcome of the health appraisal: c. There may be no indication for the child to be seen for long term review d. The child may require to be seen either at a local clinic or by the paediatrician in their area of residence. e. Where the paediatrican determines that a child requires an appointment he/she will be responsible for ensuring that an appointment is arranged/referral made to the child s area of residence 4. CHS 18R is completed by the nurse and returned to clerical staff for input onto CHS The role of the Paediatrician 2009/10 only 1. The principal will be notified of the change in procedure and invited to refer any medical concerns at any time provided consent has been obtained 2. All children who are currently in the school will have their files reviewed in 2009/10 by the paediatrician to ascertain whether or not they require medical follow up a. Parents of those who do not require follow up will be informed (standard letter to be written) and invited to contact the paediatrician in the event of future concerns (service leaflet to be written). These children will be managed as for children in mainstream. CHS18R will be completed by the paediatrician and forwarded to the relevant CHS clerical officer for input onto CHS b. Those who do require a medical appointment will have this arranged by the paediatrician this may be undertaken in school without the presence of the school nurse or alternatively in a local clinic. Subsequent reviews will be arranged in accordance with condition specific guidelines or in line with professional judgment/parental request. CHS18R will be completed at the time of the medical appointment and forwarded to the relevant CHS clerical officer for input onto the CHS 15

Where a medical appointment is required 1. Paediatrician will be responsible for organising the appointment at the most appropriate location this may require an appointment with a paediatrician in another locality 2. Paediatrician will make a handwritten record of the consultation and complete the CHS18R, ensuring it is returned to the relevant CHS clerical officer 3. Paediatrician will determine the need for further review and the frequency of same. 4. Information will be shared with the child s GP the exact format is yet to be determined - options include: a. Copy CHS18R b. Standard letter issued or c. Copy of file note (handwritten) 16

School Health Service Special Needs Health Questionnaire Children with Statements Name... Address...... School Date of Birth... GP... 1. Does your child have any medical conditions? If yes, please give details. 2. Is your child in good health at present?.. If "no" please give details:......... 3. Is your child on regular medication/treatment?... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 4. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 5. Do you suspect poor hearing?. If yes please give details: continued overleaf 6. Do you suspect poor vision? 17

If yes please give details: 7. Does your child have epilepsy?. If "yes", please give brief description of seizures (including how often) 8. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam? If yes has it been prescribed for emergency use in school? 9. Does your child have a bedwetting problem?. Is this a new problem? Is your child dry by day?. 10. Does your child have any bowel problems? If yes please give details... 11. Does your child have behaviour problems?... If "yes" please give details:......... 12. Does your child have any known allergies?. If yes please give details and state if any emergency medication is required?.. 13. Do you have any particular worries about your child? If "yes" please give details:.......... Has your child previously attended another school? If yes please give details. Please state your current address if different from overleaf: Consent: I have read and understood the information accompanying this form and, on this basis (Please delete as appropriate) I agree/do not agree to the child named overleaf receiving the health checks, as described, from the school health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: 18

Protocol for Health Appraisals and Medical Examinations in Jordanstown Special Schools General Comments 1. Children attending Jordanstown have either a visual or a hearing impairment occasionally both, this may be an isolated condition or a symptom of a wider clinical condition 2. Children usually attend a relevant specialist in relation to their primary impairment and may also attend other specialist consultants 3. Children travel from across the Province and across the island of Ireland to attend the school (boarding facilities exist) 4. All NI resident children will have had a statement of educational need written and one of the components of this is the medical examination 5. Provided consent is obtained, health appraisal by the nurse will take place in the school even in the absence of a parent 6. In the event of a carer not being present for the appointment, information will be shared using the standard letter Health Appraisal Outcome Special Schools and LSC 7. The location of any subsequent medical examination (if required) will be determined jointly by the paediatrician and the child s carer given that children may travel some distance to attend their specialist education provision and therefore carers may have difficulty attending appointments in school. 8. Where an appointment has been cancelled, this will be rescheduled as soon as possible 9. In the event of a pupil being absent or consent not having been obtained (for health appraisal), one further appointment will be offered the following school year only. In the event of a health appraisal not taking place despite two invitations, the situation must be discussed with the paediatrician. P1 Pupils and New Entrants School Nurse Health Appraisal 1. All P1 pupils and all new entrants who have not had a previous P1 health appraisal, will be offered an appraisal with the school nurse (universal school entrant health appraisal) 19

2. The CHS24R will not be issued but the school nurse will review the list of all relevant new entrants, against their medical condition, to determine which questionnaire will be issued either Special School Questionnaire for Pupils with Visual Impairment or Specials Schools Questionnaire for Pupils with Hearing Impairment. CHS letter of invitation will also be issued 3. School Nurse will discuss all children with the paediatrician for the school to determine the outcome of the health appraisal: a. There may be no indication for the child to be seen for long term review b. The child may require to be seen either at a local clinic or by the paediatrician in their area of residence. c. Where the paediatrican determines that a child requires an appointment he/she will be responsible for ensuring that an appointment is arranged/referral made to the child s area of residence (the paediatrician will have a list of colleagues across the province to whom they can make referrals where indicated) 4. The CHS18R is completed by the nurse and returned to clerical staff for input onto CHS The role of the Paediatrician 2009/10 only 1. The principal will be notified of the change in procedure and invited to refer any medical concerns at any time provided consent has been obtained 2. All children who are currently in the school will have their files reviewed in 2009/10 by the paediatrician to ascertain whether or not they require medical follow up c. Parents of those who do not require follow up will be informed (standard letter to be written) and invited to contact the paediatrician in the event of future concerns (service leaflet to be written). These children will be managed as for children in mainstream. CHS18R will be completed by the paediatrician and forwarded to the relevant CHS clerical officer for input onto CHS d. Those who do require a medical appointment will have this arranged by the paediatrician this may be undertaken in school without the presence of the school nurse or alternatively in a local clinic. Subsequent reviews will be arranged in accordance with condition specific guidelines or in line with professional judgment/parental request. CHS18R will be completed at the time of the medical appointment and forwarded to the relevant CHS clerical officer for input onto the CHS Where a medical appointment is required 1. Paediatrician will be responsible for organising the appointment at the most appropriate location this may require an appointment with a paediatrician in another locality 20

2. Paediatrician will make a handwritten record of the consultation and complete the CHS18R, ensuring it is returned to the relevant CHS clerical officer 3. Paediatrician will determine the need for further review and the frequency of same. 4. Information will be shared with the child s GP the exact format is yet to be determined - options include: a. Copy CHS18R b. Standard letter issued or c. Copy of file note (handwritten) 21

Name... School Health Service Special School Questionnaire For Pupils with Visual Impairment Address...... Date of Birth... GP... 1. Does your child have any medical conditions? If yes, please give details. 2. Is your child in good health at present? If "no" please give details:........ 3. Is your child on regular medication/treatment?.... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 4. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 5. Do you suspect poor hearing?. If yes please give details: (continued overleaf) 22

6. Does your child have epilepsy?.. If "yes", please give brief description of seizures (including how often) 7. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam? If yes has it been prescribed for emergency use in school? 8. Does your child have a bedwetting problem?. Is this a new problem?. Is your child dry by day?.. 9. Does your child have any bowel problems?. If yes please give details.... 10. Does your child have behaviour problems?.. If "yes" please give details:.......... 11. Does your child have any known allergies? If yes please give details and state if any emergency medication is required?. 12. Do you have any particular worries about your child?.. If "yes" please give details:........ Has your child previously attended another school? If yes please give details. Please state your current address if different from overleaf: Consent I have read and understood the information accompanying this form and, on this basis I agree to the child named overleaf receiving the health checks, as described, from the school Health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: I do not agree to the child named overleaf receiving the health checks, as described, from the school health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: 23

School Health Service Special School Questionnaire For Pupils with Hearing Impairment Name... Address...... Date of Birth... GP... 1. Does your child have any medical conditions? If yes, please give details. 2. Is your child in good health at present?.. If "no" please give details:......... 3. Is your child on regular medication/treatment?... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 4. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 5. Do you suspect poor vision?. If yes please give details: continued overleaf 24

6. Does your child have epilepsy?. If "yes", please give brief description of seizures (including how often).. 7. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam?.. If yes has it been prescribed for emergency use in school? 8. Does your child have a bedwetting problem?. Is this a new problem?. Is your child dry by day?.. 9. Does your child have any bowel problems?. If yes please give details.... 10. Does your child have behaviour problems?... If "yes" please give details:....... 11. Does your child have any known allergies? If yes please give details and state if any emergency medication is required?. 12. Do you have any particular worries about your child?.. If "yes" please give details:........ Has your child previously attended another school? If yes please give details. Please state your current address if different from overleaf: Consent I have read and understood the information accompanying this form and, on this basis I agree to the child named overleaf receiving the health checks, as described, from the school Health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: I do not agree to the child named overleaf receiving the health checks, as described, from the school health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: 25

Protocol for Health Appraisals and Medical Examinations in Thornfield House School and the Speech & Language Unit, Model Primary School, Ballymoney General Comments 1. Children attending a speech and language school or unit may have an isolated speech and language impairment or it may be a symptom of a wider clinical condition 2. Children may not attend any other medical consultant 3. Children may travel from across the Province to attend the special school 4. All children will have had a statement of educational need written and one of the components of this is the medical examination 5. Provided consent is obtained, health appraisal by the nurse will take place in the school even in the absence of a parent 6. In the event of a carer not being present for the appointment, information will be shared using the standard letter Health Appraisal Outcome Special Schools and LSC 7. The location of any subsequent medical examination (if required) will be determined jointly by the paediatrician and the child s carer given that children may travel some distance to attend their specialist education provision and therefore carers may have difficulty attending appointments in school. 8. Where an appointment has been cancelled, this will be rescheduled as soon as possible 9. In the event of a pupil being absent or consent not having been obtained (for health appraisal), one further appointment will be offered the following school year only. In the event of a health appraisal not taking place despite two invitations, the situation must be discussed with the paediatrician. P1 Pupils and New Entrants School Nurse Health Appraisal 1. All P1 pupils and all new entrants who have not had a previous P1 health appraisal will be offered an appraisal with the school nurse (universal school entrant health appraisal). 26

2. The CHS24R will not be issued to these pupils. Clerical staff should issue relevant questionnaire Special School Health Questionnaire S&L Impairment together with CHS letter of invitation 3. School Nurse will discuss all children with the paediatrician for the school to determine the outcome of the health appraisal: a. There may be no indication for the child to be seen for long term review b. The child may require to be seen either at a local clinic or by the paediatrician in their area of residence. d. Where the paediatrican determines that a child requires an appointment he/she will be responsible for ensuring that an appointment is arranged/referral made to the child s area of residence (the paediatrician will have a list of colleagues across the province to whom they can make referrals where indicated) 4. The CHS18R is completed by the nurse and returned to clerical staff for input onto CHS The role of the Paediatrician 2009/10 only 1. The principal will be notified of the change in procedure and invited to refer any medical concerns at any time provided consent has been obtained 2. All children who are currently in the school will have their files reviewed in 2009/10 by the paediatrician to ascertain whether or not they require medical follow up a. Parents of those who do not require follow up will be informed (standard letter to be written) and invited to contact the paediatrician in the event of future concerns (service leaflet to be written). These children will be managed as for children in mainstream. CHS18R will be completed by the paediatrician and forwarded to the relevant CHS clerical officer for input onto CHS b. Those who do require a medical appointment will have this arranged by the paediatrician this may be undertaken in school without the presence of the school nurse or alternatively in a local clinic. Subsequent reviews will be arranged in accordance with condition specific guidelines or in line with professional judgment/parental request. CHS18R will be completed at the time of the medical appointment and forwarded to the relevant CHS clerical officer for input onto the CHS Where a medical appointment is required 1. Paediatrician will be responsible for organising the appointment at the most appropriate location this may require an appointment with a paediatrician in another locality 27

2. Paediatrician will make a handwritten record of the consultation and complete the CHS18R, ensuring it is returned to the relevant CHS clerical officer 3. Paediatrician will determine the need for further review and the frequency of same. 4. Information will be shared with the child s GP the exact format is yet to be determined - options include: a. Copy CHS18R b. Standard letter issued or c. Copy of file note (handwritten) 28

Name... Address... School Health Service Special School Health Questionnaire Speech & Language Impairment... Date of Birth... GP... 1. Does your child have any medical conditions? If yes, please give details. 2. Is your child in good health at present?.. If "no" please give details:......... 3. Is your child on regular medication/treatment?... (Include inhalers, nebulisers, catheters etc) If "yes" please give details in table below: Name Dose Time Given 4. Has your child been in hospital or attended a community clinic within the last year? If "yes" please complete the following: Hospital or Clinic attended Date of last appointment Reason for attendance Still attending? 5. Do you suspect poor hearing?. If yes please give details: 6. Do you suspect poor vision? If yes please give details: continued overleaf: 7. Does your child have epilepsy?. If "yes", please give brief description of seizures (including how often) 29

8. Has your child been prescribed rectal Diazepam (stesolid) or buccal Midazolam? If yes has it been prescribed for emergency use in school? 9. Does your child have a bedwetting problem?. Is this a new problem? Is your child dry by day?. 10. Does your child have any bowel problems? If yes please give details... 11. Does your child have behaviour problems?... If "yes" please give details:......... 12. Does your child have any known allergies?. If yes please give details and state if any emergency medication is required?.. 13. Do you have any particular worries about your child? If "yes" please give details:.......... Has your child previously attended another school? If yes please give details. Please state your current address if different from overleaf: Consent I have read and understood the information accompanying this form and, on this basis I agree to the child named overleaf receiving the health checks, as described, from the school Health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: I do not agree to the child named overleaf receiving the health checks, as described, from the school health team Signature: Date:. (Person with Parental Responsibility) Relationship to Child: Contact Tel No: 30

Health Appraisal Outcome Special Schools & LSC Date: To the Person with Parental Responsibility for: Name: D.O.B.: Address: School: Your child has had a health appraisal in school. The results are as follows: Hearing: Vision: Height: Weight: normal/see attached letter normal/see attached letter cms kgs I have discussed the detail of the health appraisal of your child with the paediatrician for the school who has decided that your child would/would not benefit from a medical appointment. Details of an appointment will be sent out in due course if this is required. Yours sincerely SCHOOL NURSE School Nursing, Northern Health & Social Care Trust, «Company», «Address1», «Address2», «PostalCode», «TelNumber» 31