All schools must have access to a pupil health care team where dilemmas that arise in pedagogical practice must be treated with the aim of preventing students from getting into school difficulties. Pupil health care teams must have access to multiple professions who, based on their professional perspective, must nuance the perceived problem and find a consensus on how this should be handled in the best way. Based on guidelines from the School Act, this work must now take place from a salutogenic (health-promoting) and preventive perspective. This entails a work of change within the pupil health team that affects the school as an organization. The study has investigated how the salutogenic and preventive work of change imposed on schools affects pupil health's work in dealing with school difficulties. This qualitative study has used semi-structured interviews and observations as a method, in order to gain knowledge about the work of the pupil health teams. Six interviews were conducted with professions that belongs to pupil health team (principal, special education need teacher, school psychologist). In addition, six observations of student health meetings were carried out at three different schools. Collected data were then analyzed based on concepts related to organizational learning to create an understanding of how change of work develops. The results of the study show that there is an awareness among the pupil health professions that they are expected to work salutogenically and preventively, but they express difficulties in how this should be carried out in practice. There are questions about who should do it, how it should be structured, whether it is already being done and if they already work in this way, there is a risk of not taking care of the children who are already in school difficulties. The pupil health teams that are investigated have access to several different professions and strive for cooperation and that the different professional perspectives are taken into account. However, the interviews show that this cooperation does not always work fully and that the different professional languages can make cooperation difficult. The principal's role as the one who contributes with visions, structure and the release of resources is noticed in the study as essential for the change work to be able to lead to organizational learning and competence development for the entire organization and not just individual employees. Ways of adding competence within the college are noticed in the study such as tutoring time with a special education needs teacher or the presence of the pupil health team's professions at ”årskurslags”-meetings. The responsibility for students who have found themselves in school difficulties should not be left to the individual teacher, but should be handled in consensus with the pupil health professions.