This section enables you to submit comments and feedback relative to the new core section of the PCHR.
Click here to submit a comment for wider discussion. (Please ensure you include a subject header to enable other users to quickly reference your feedback)

Comments received:

Writing shield, loading of pages and reviews
"A page reminding people to insert the writing shield should go in front of
each set of pages for P 16 - 19. We have found real problems with writing
transferring through to the under copies of NCR pages so we have this
reminder in our version of the PCHR.

If local pages can be added at the rear of the book then the book should be
loaded from the back and not the front to make life easier!

Re the Screening & Routine Reviews section
Should there be an explanation of SPOTRN codes somewhere both for health
professionals and parents?

Re the 6-8-week review pages
Testes/Genitalia Guide to Content is slightly ambiguous. HFAC4 says to
refer if there is any doubt."

Insert for nurse prescription generated
"Health Visitors locally were asking about a page to include nurse prescriptions issued to inform named HV if a colleague had issued a prescription and as a permanent easy to see record.
Any views or is this a local insert?"

6-8 week check and immunisations
"The recommendation from the Health For All Children report is that the 6-8 week check should be performed at a maximum of 8 weeks. Most children have the 6-8 week check at the same time as their first set of immunisations. I have spoken to David Salisbury, from the DOH today and he would not recommend giving the first set of immunisations any earlier than 8 weeks because there is no good data on giving these vaccines before 8 weeks and what data there is suggests that the immune response is compromised. This causes a huge headache locally when we are trying to schedule appointments. The danger of trying to separate the 6-8 week check from immunisations is, of course, that uptake rates may be reduced. We are not in the position of having anyone trained locally to do the 6-8 week check other than GPs and it would be expensive to do all these checks at home. This must be a national problem if the HFAC recommendations are being taken seriously. How are others solving it?"

Response:
" This is indeed an issue. There was pressure from both ophthalmologists and
orthopaedic surgeons to bring the examination forward so that it was at 4-6
weeks. We resisted this for exactly the reasons you mentioned. However, if
the examination is timed for 8 weeks, it will take place at 10 weeks, so
this was a compromise. Giving the immunisation a few DAYS early will, I am
sure, not cause a problem, but weeks are a different matter. We would
therefore suggest that in previous visits the HV emphasises how important
it is to have the examination done on time, and then everything can be done
at once. What do people do about the 6 week maternal postnatal check? I
assume that could be left to 8 weeks, but I have heard people say that
trying to do it, the baby exam and the immunisations is too much at once."