The National Child Health System is a complex system which supports the delivery of child health services and is run by many Health Professional groups across Wales and other parts of the UK at their Local Health Board/ Trust locations.
The system provides a database of all children born in, resident in or receiving services in their relevant Local Health Boards. The system aids the scheduling of appointments for immunisation and developmental screening, school health services and special needs review. Clinical results are recorded on the system.
In 1999, a new Windows NT/Oracle version of the system was developed. This new system was to facilitate the extraction of data and have the capability to link to other information systems. As well as standard reporting, the technology used allows users to create their own reports using standard end reporting tools.
This Oracle-based Community Child Health (CCH) 2000 System is maintained/enhanced and supported by the Child Health Team, at the NHS Wales Informatics Service.
In Wales, every Welsh Local Health Board has its own CCH2000 database.
The core system consists of:
a Child Register which provides the database of all children born in, resident or receiving services in a defined locality. A Notification of Birth (or Movement- In details from a previous locality) creates the record on the Child Register and this is the foundation for all the other service modules.
an Immunisation module which schedules all immunisation appointments automatically at the appropriate time, and records details of all immunisations given.
a Pre-School Health module which schedules and monitors the subsequent development of the child in terms of systematic examination. This module includes screening of developmental examinations and any referral and final diagnosis. All results are recorded, including any special needs of children
a School Health module which schedules and records data on any School Health activities.
a Special Needs module which can be used to record all children with special developmental, physical or social needs and for scheduling reviews. Such information can be shared with Educational and Social Services as well as acting as a basis as a joint register.
Data items are input to the Child Health System from various sources. The initial source of data is the maternity department where Notifications of Birth are produced, as are Neonatal Discharge Forms. The next source of data are the Health Visitors who begin sending information on the child at the ten-day visit and then continue inputting information on all medicals and screening tests that are carried out. GPs are a further source sending information on Immunisation and Medicals that they perform as well as information on Significant Diagnoses. Information on names is provided by the parents and also by the Registrar of Births. Schools attended are provided by the Local Education Authority whilst information on Special needs can be provided by the Social Services departments. Finally much information is provided by staff in the Community Health Offices, especially information obtained from other Local Health Boards in respect of children who move into the Local Health Board.
As each Local Health Board has its own CCH2000 database, there is no national database of information on the Health of Children in Wales. Consequently, there is no standard data set or format for monitoring and evaluating child health promotion programmes. There is no consistent set of data available for the establishment of some key indicators of the health status of the children in Wales.
The Child Health Information Requirements Project (CHIRP) was initiated by the Welsh Assembly Government to identify the actions needed to ensure the future of an All-Wales database and to increase the quality of the data contained in this database.
The main conclusion of the project was that a central Child Health database should be created by pulling together selected information from the locally managed CCH databases. Since data relating to children will be utilised in many different systems and clinical records, it becomes imperative to establish standardised protocols for data items, their coding, size, format and definition.
This database will be known as the National Community Child Health Database (NCCHD).
The software needed to enable the extraction of data from the CCH systems and to build the database, will be written and supported by the Child Health Team at the NHS Wales Informatics Service.
The first extracts into the NCCHD will commence on 1st April 2004.