Before School Check (B4SC)

Any practice, regardless of PHO alignment in Waikato can offer and claim for this service.  

The B4SC is delivered by practice nurses and GPs who are B4SC trained and certified in order to ensure consistency and best practice.  

The B4SC is delivered by health professionals, supported by Vision Hearing Technicians (VHTs) in a range of settings, including early childhood centers, kōhanga reo, general practice, community venues, marae and home visits.

The Ministry of Health has set up a national information management system to support the B4SC. The B4SCs information management system captures and stores data relating to the B4SC (height, weight, hearing, vision, development and behaviour assessments), any issues identified, and referrals made. It also provides regular standard and ad hoc reports using anonymized data for stakeholders in the health sector. 

The following general principles guide delivery of the B4SC

• The B4SC is primarily an opportunity for a health promoting and wellness enhancing contact between parents/caregivers and a health professional with a focus on improving child health and education outcomes and reducing inequalities.
• Early detection of and provision of supports for vision, hearing, behavioral and developmental problems, and existing health and disability conditions, is important to support learning and school attendance.
• Promotion and delivery of four-year-old immunisations as per the National Immunisation Schedule. The B4SC provides an ideal opportunity for four-year-old immunisations and catch-ups to occur.
• Provide timely referral using the regionally agreed referral pathways, to appropriate services and make best endeavors to ensure any referral is accepted and that the child receives the appropriate service.
• Importance of the continuum of care for children/tamariki and family/whānau to the sharing of the B4SC information, in particular with their lead primary health care and education providers.
• Engaging with children/tamariki and family/whānau who are not well connected with services and linking them back to primary health care and education.
• Support for the family/whānau to maximise their child's educational potential and health status.
• Collaboration between the health and education sectors to complete the B4SC and to plan for any resources and supports that the child and school may need for successful learning.
• Health and educational professionals have a greater awareness of the child's needs and are supported to deliver quality care.

The B4SC includes the following content, and the health professional delivering the check records the information in the B4SC's information management system.

• The date of the B4SC.
• A general health questionnaire/checklist as per the B4SC Seeit resources received with Treasure Tins.
• Measurement of height and weight, which is recorded in the Child Health Book where available.
• Behavioural/developmental screening using the Strengths and Difficulties Questionnaire ("SDQ") and Parental Evaluation of Developmental Status ("PEDS") tools.
• An oral health assessment and check of enrolment in a school dental clinic.
• Anticipatory guidance and health education through provision of resources, advice and support as required by the child and their family/whānau.
• Referrals to appropriate health, education or social services where the B4SC has identified a need for such services, including recording of the date of referral.
• Make best endeavours to follow up referrals to confirm:
  • that a provider has acknowledged a referral and the date
  • whether or not referral services have been provided and the date; and
  • outcome from the referral (e.g. no further action, further assessment, treatment, support etc.).

Once all components are completed, return the child's file to the Midlands Health Network B4SC coordinator by ’returning’ the B4SC on the database.

Also, either deliver immunisation services at the time of the B4SC to children who are not up to date or due for their next immunisations or facilitate delivery through immunisation service providers within their area. Each child can have their own B4 School treasure tin (or equivalent) containing specific items for the child and health promotion materials that can be discussed with their caregiver(s).

Practices will be provided with:

• access to the MoH electronic B4S data collection tool
• all paper-based resources/data collection tools required to complete the B4SC – via the Seeit website
• treasure tins (or equivalent) – via the Seeit website
• promotional and support material (posters etc)
• an electronic form for invoicing purposes.

The health professional delivering the service is to:  

• ensure that timely referrals are made to appropriate services for any children who are identified as requiring those services
• make best endeavours to confirm that a referral service provider has accepted and assessed the referral, provided the appropriate referral service, and that information on the timing and outcome of this referral is recorded in the B4SC’s information management system 
• ensure appropriate referrals are made to complementary services, according to their eligibility criteria, for children who have not been able to be contacted for the B4SCs   
• ensure parents are informed of the B4SC in writing using the MoH B4SC 'Information for Parents and Guardians' pamphlet and obtain informed consent using the nationally developed consent form in the same pamphlet.  

Note: The legal parent(s)/caregiver(s)/guardian(s) of the child must sign the consent form, but anyone can bring the child in for the check – provided they bring the signed consent with them. 

Referring hard to reach children

You can refer to public health nurses via BPAC if: 

• you have made at least three unsuccessful attempts to contact the family
• the child is aged between 4 years 3 months and 4 years 10 months and
• they live in a quintile 5 area and the child is of Māori ethnicity. 

K’aute Pasifica Services and SWPICS both receive referrals for eligible Pasifika children. 

Settings for service delivery

The health professional delivering the service is to:

• ensure that the B4SC is delivered in a culturally and socially appropriate manner and that the privacy of children/tamariki and families/whānau is respected
• ensure that the setting for service delivery is clinically and culturally appropriate for delivery of the B4SC
• ensure that where possible the content of the B4SC is delivered at one session for each child/tamaiti and their family/whānau.

Equipment

The health professional delivering the service is to:

• ensure provision, maintenance and calibration of any equipment required for the B4SC including scales, stadiometers, and paper-based resources including questionnaires, growth charts, forms and health promotion and education materials
• ensure any existing equipment meets the standards required for delivery of the B4SC and where new equipment is required, the recommended equipment outlined in the B4SC's handbook is purchased.

Legislative requirements

The health professional must comply with all legislative requirements in the provision of the B4SC, including, but not limited to:

• The Privacy Act 1993 and the Health Information Privacy Code 1994
• The Code of Consumer Health and Disability Services 1996
• The Children, Young Persons and their Families Act 2017
• Section 125 of the Health Act 1956, with respect to the medical examination of children
• The Public Records Act 2005.

Children eligible for the B4SC must be:

• 4 years old; or
• up to 5 years 7 days.

Claims cannot be accepted for children aged more than 5 years and 7 days old.

The service can be provided to children whether they are enrolled or casual with a particular focus on providing the service to priority population groups, including high risk/high need populations and Māori and Pacific people.

Children are expected to be recalled by the practice around the time of their fourth birthday. Children will be recruited into the programme in several ways:

• by presenting routinely for the 4-year immunisation
• by opportunistic screening when the child presents for some other reason (dependent on available time)
• by invitation using the usual practice recall systems and the B4SC resources.

Children whose parents do not wish to have them immunised are still eligible and should be encouraged to have the B4SC.

Children may also be referred to their primary care service provider by another provider e.g. a public health nurse.

The B4SC cannot be claimed for children under 4 years of age, or over 5 years and 7 days.   

The practice delivered component of the check is finished once all general practice elements of the check are complete and appropriate referrals have been made.

The full check is not considered complete until elements such as the vision and hearing test is complete.

Once all elements and all referrals are completed, the check is considered closed.

All completed and closed checks are counted towards the target number of Waikato checks.

The price listed below is GST inclusive. 

Before School check (once only/child)                                                                                                                        $149.50

Please be aware this claim is all inclusive of consultation time and any consumables.

As required by the B4SC database. 

No. The B4SC is provided to families free of charge.  

The service is funded by Waikato DHB.