Understanding service use at a local level: Area-level attendance at B4 School Checks

Understanding service use at a local level: Area-l…
01 Apr 2021


This work was undertaken in partnership with the ‘A Better Start’ National Science challenge big data team.

Access to services plays a fundamental role in government’s ability to improve wellbeing. The Social Wellbeing Agency is interested in understanding service provision and use at a more granular geographic level. This project was intended to be our first exploration of the value of local area level analyses, and how the local experience may differ from nationally reported figures.

We focused on uptake of B4 School Checks, as national level analysis had already been undertaken as part of the Better Start research programme and we could readily build on this work. This project provided an opportunity to describe the children and their families missing out on this important universal health and development screen at a local area level. 


For this project we created DHB specific reports describing attendance at B4 School Checks at the level of territorial authority/local board (TALB) area. We also considered the sociodemographic and health factors associated with differences in B4 School Check attendance. 

Key Results

Key findings include: 

  • At a national level, the rate of reported teacher completion of the SDQ is much lower than the rate of attendance at VHT or nurse checks. In 2018 the average national completion of SDQ-T was 61% compared to 93% for VHT and 88% for nurse checks.
  • Across DHBs there is a large variation in the rate of reported teacher completion of SDQ. In 2018 completion rates ranged between 30-89% across DHBs. This shows that undertaking more granular geographic analysis is useful as national results may mask significant variation in local experiences.
  • Whilst the trend for all checks at a national level has been positive or stable for the last few years, some DHBs have experienced sharp reductions and volatility in SDQ-T reported completion rates over the last 5 years.
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