Working together better for two
year olds:
The integrated health and education review at
aged 2
Tracy Smith
Team leader; teaching and learning
Islington Council EYFS Team
Images courtesy of ‘A good place to
be two’: Community Playthings 2013
What is the Integrated Review?
• Joint Health and Education review for children aged 2430 months
• Recommendation of Tickell review (2011) of the Early
Years Foundation Stage
• Brings together:
 Health review part of ‘Healthy Child Programme’
 Statutory EYFS Progress Check for children attending an early
years setting
• To be implemented nationally by 2015
Islington context
• Borough of stark contrasts
• Islington Fairness
Commission (2011)
• First 21 Months initiative
• Established integrated
working
• 1000+ 2-year-olds in
provision (50% of cohort)
• Education progress
checks
Our vision for the Islington Integrated Review
• To provide the best
possible support for
parents and children
• To share professional
knowledge, learning and
support between services
• To use the review as a
key opportunity for early
identification and
intervention
• To have a truly integrated
review
The
Community
Community
Support
Neighbourhood
Deprivation
Personal,
and local
Social and
resources
Emotional
Development
Adverse
Family
Physical
Circumst- Development
ances
and
Self Care
Family
Employment/
Economic
status
The Family
Attachment
relationships
Parenting
style
Communication
and Language
Evidencebased
tool e.g.
ASQ-3
Physical
Health
Learning
And
Cognitive
Development
Family
Education/
qualifications
The
Child in the Family
Family Health
(physical and
mental)
Couple
Relationships
Home
Learning
Environment
The
Child
The
Child
In
Context
Work so far
•
•
•
•
•
•
Partnership working at strategic and operational levels
Named HV for each early years setting
Ongoing communication with frontline practitioners
Developed documentation and supporting guidance
Trained health and education practitioners together
Adopted a phased approach to roll-out:
1.Children’s centres
2. Private, voluntary, independent & school settings
3. Childminders
4. Children not in EY provision
• Gathered evaluations - ongoing
Engaging parents
Ages & Stages Questionnaire – ASQ
• The government intends to introduce a public health
measure at aged 2
• Pilot LAs have been asked to trial the Ages and Stages
Questionnaire (ASQ)
• Areas measured include:
• Communication
• Gross Motor
• Fine Motor
• Problem – solving
• Personal Social
• Hearing/vision/medical
Successes
• High no. of people trained
across both education and
health since summer 13
• Development of skills and
knowledge across both
sectors
• Making and developing links
– particularly between the
PVI and health sector and
between PVI and CCs
• Well-received by frontline
practitioners and by parents
• Increased support for early
home learning
Successes: what parents say
With my daughter who’s
now 5 I had a regular
review. The integrated
review for my son felt like
it gave a more complete
picture. For me it really
worked – it felt safe and
thorough and just all-round
a positive experience.
It’s not often you get a
chance to sit down and talk
in depth about your own
child. They pointed out
things that my son has been
doing that I didn’t know were
important. I felt included;
they asked what I thought
and how he is at home.
What practitioners say
I had worries about the child’s speech and
the health practitioner agreed. Sometimes
there’s a bit of a grey area and you
wonder ‘am I being a bit too hard, is the
best fit too low?’ - so it was good to have
that back up from another professional.
What health practitioners say
It was so useful to work with a non health
professional and get their contribution about
the child.
Challenges
• Design phase
• Establishing a robust
system
• Practical challenges –
time, space
• Culture change
• Data sharing and data
recording
• Quality assurance
Next steps……..
•
•
•
•
Embed systems, processes and ways of working
Consider roll-out to children not attending EY provision
Evaluate timeliness and impact of interventions on children
Joint conference
Being two…….
By the time I am two I have a
story to tell you about lots of
things. The highlights of my
story give you insights about
the understanding I have and
the things I can do now.
I am two! Working effectively with two
year olds and their families
Kay Mathieson 2013