Primary healthcare news, information & resources

B4 School Checks (B4SC) updates

November update

Kia ora koutou.  We have some really exciting news that can really help in reaching more of our Māori children throughout the Waikato region.  

The eligibility criteria to refer to Public health nurses (PHNs) has had a new addition in November 2019 to include referrals for all eligible Māori children - regardless of the deprivation index that they live in. This addition is effective immediately. 

You can now refer to PHNs via BPAC if:  

  • you have made at least three unsuccessful attempts to contact the family AND 
  • the child is aged between 4 years 3 months and 4 years 10 months  AND 
  • they live in a quintile 5 area AND/OR 
  • the child is of Māori ethnicity (regardless of the deprivation quintile that they live in) 

Please provide as much information as you can in your referrals to assist the PHNs in their attempts to contact your families. This information includes all contact details you may have on your family tree; dates and ways that you have tried to contact the family; and any safety issues that the PHN may need to know.  

November newsletter

Kia ora koutou!

B4SC training 2020

We have confirmed our training dates for 2020, which are up on our B4 School Webpage with embedded registration forms for both the two-hour updates and the three day training days.Our first update in April will have a focus on nutrition and physical activity, referrals and improving the referral rate for the growth component. We will have guest speakers from Sport Waikato's Whaanau Kori programme and a community dietician from Waikato District Health Board (DHB).

Claiming for follow up growth consultations

Our new growth contract and claiming process was sent out in March this year and was signed by many Pinnacle MHN practices at the time. Just a reminder to recall children who were identified in the 98th percentile or over in their B4 School Check, for follow up measurements and discussions using resources such as the BE SMARTER tool. These recalls should be prompted by automatic advanced form processes that were set up when contracts were signed.

If you need support with this or would like to come on board and sign the contract, please contact your practice support person, or discuss with your practice manager.

Encouraging referrals for the growth component

The Ministry of Health's Raising Healthy Kids target ensures all children identified with a BMI over the 98th percentile are offered a referral for follow up, to support families in making healthy lifestyle changes. Currently in the Waikato region, we have a 41 per cent decline rate for eligible children.

Referrals are a great opportunity to re-measure children as they are growing and have some further conversations with families. An acceptable referral includes referring to yourself as the practice nurse. This can be a great opportunity to review goals set in the initial B4 School consult, using tools such as the BE SMARTER resource, and reset new goals. And as mentioned above, if your practice has signed the growth contract, this follow up consult, 6-12 months after the B4 School Check, can be claimed for.

After gaining consent you can also refer to other services such as the child's GP, community based programmes such as Sport Waikato's Whaanau Kori programme or community dieticians.

We would love to see a decrease in declines in this important component of the B4 School check. Every interaction and discussion around making healthy lifestyle changes has the potential to make profound lifelong difference in many people's lives.

More information about referral pathways and the resources to support these conversations can be found on our raising healthy kids page.

New e-referral to the Whare Ora service

The Waikato DHB's Healthy Homes programme - Whare Ora, has a new e-referral process via BPAC. Whare Ora is such a fantastic programme, providing safer, warmer homes to those families most in need. Find out more on our waikato healthy homes page

Pinnacle website update

A new website was launched for Pinnacle, and the provider site we use for our B4SC information has now moved to a new domain. You will find it here: - if you had a bookmark to the site you will need to update it. If you have any queries please contact Brooklyn -

Using data to help in achieving B4 School Checks for all children

Achievement to targets, as at 1 November 2019


High dep







Month of October - 4/11/19





Financial Year to target









Your exception reports show you which children are due and overdue their checks (considered overdue at 4 years 3 months). You will also see that we have noted the target groupings of M?ori children, Pacific children, and those children living in deprivation quintile 5, as you can see in the example below, in the last two columns.

Please use this information to help you to prioritise your recalls according to our target populations. As you will see in the above table, we are well behind in reaching our M?ori and Pacific children, and our children living in deprivation. We need to have a concentrated focus of prioritising their checks and supporting families to make it in for their checks at a time that best suits their needs.

Another email comes out in the first fortnight of each month, highlighting those children who are overdue for their B4 School Check and who they could be referred to, according to their eligibility criteria. Referring your overdue children (over 4 years and 3 months of age) to the outreach providers frees you up to concentrate on your new 4 year olds. You can refer your eligible children to our public health nurses for children living in deprivation quintile 5, our Pasifika providers - Kaute and SWPICS for our Pasifika children, and our Independent B4 Schools Nurse for children living in the South Waikato Region who live in deprivation quintile 5, or who are M?ori, or who are Pasifika.

If you need further information on how to refer to these services, or more detail on their eligibility criteria, please contact Michelle or Brooklyn on or see our B4 School Webpage under the their respective service name headings.

Staff announcement

I (Michelle) have resigned from my role as B4 school nurse coordinator, with my last day in the role on 22 November. I have been offered a really exciting new opportunity to join the coaching team in a wellness programme. I have truly enjoyed my time in this role, working for Pinnacle Midlands Health Network, and working alongside all of you. I have been pleased with what I have achieved in the year and a half I have been here and have left lots of food for thought in my handover for the future of B4 Schools in the Waikato.

Brooklyn remains the key contact person for B4 Schools. As of 22 November, I will have an automated reply on my emails and phone messages, directing enquiries to the email in the first instance. Brooklyn will continue to manage this email, and forward on any messages that need clinical oversight.

I wish you all the best. I thank you for your continued hard work and dedication. And I challenge you to keep reviewing and improving HOW you do B4 Schools to best meet the varied needs of your patient populations.

B4SC contacts and resources

Latest B4 School Checks