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NATIONAL PILOT FOR
INTEGRATED TWO YEAR REVIEW
SUMMARY
SUMMARY
1
Contents
Introduction
Page 3
Purpose
Page 4
The Integrated Review Process
Page 6
Additional Information
Page 7
Pilot milestones until end of February
Page 8
Time table from 28th February 2013
Page 9
APPENDICES
1) Resources
Page 10-11
2) Information sharing
Page 12
2
INTEGRATED TWO YEAR REVIEW
“Age two is an important time for children and their parents”.
Introduction
This is a crucial time in a child’s life, meetings with children and their parents to review
children’s progress is part of both the NHS and the education system programmes. These
reviews will identify developmental strengths but also the need for any interventions that can
help to make a real difference to a child’s future outcomes.
The Healthy Child Programme review is completed at age 2 – 2 ½, and the new Progress
Check at age 2 is now part of the Early Years Foundation Stage. However, these two
opportunities for reflection and review of a child’s development and health are not integrated
in a formal way.
On 18 July 2011, Department of Education (DfE) and Department of Health (DoH) jointly
published Supporting Families in the Foundation Years. This document makes the
commitment to explore options for bringing together the summary of a child’s progress at age
two by nurseries and childminders with the Healthy Child Programme 2 – 2 ½ year review.
Integrating health and education reviews will give a more complete picture of the child
through drawing together the detailed knowledge of how the child is learning and developing
day to day at their educational setting with the expertise of the child’s health visitor at the
health review, along with parents’ views and concerns about their child’s health and
development. It will be more straightforward for parents if their child’s learning and
development and health review is presented to them at one contact.
Currently there is an uptake of 12% of two year old children in the early year’s settings.
However the government is commitment to extending free early education to the most
disadvantaged 40% of two year olds. The number of children eligible for the two year old
entitlement is estimated at around 3,800 in Northamptonshire. The aim is for as many of
those two year olds as possible to be in a setting by September 2014 (although actual uptake
may be lower than this initially).
Northamptonshire is one of five Health authorities taking part in the national Pilot for the
integrated review that is being led by the DfE and DoH. These five areas are exploring ways
to integrate these two reviews in order to best facilitate appropriate intervention and support
for children and their families, especially those for whom progress is less than expected.
We aim to minimise impact on everyone involved whilst exploring this exciting new
opportunity for joined approaches and ways of working.
3
“Age two is an important time for children and their parents”.
Purpose
The Integrated Two Year Review will mean that:

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Parents receive information about their child’s development and health review that
incorporates the professionals who are working together and encourages parents to
include their views.
Any developmental or health needs are identified at an early point to ensure
appropriate support is offered.
That there is a clearer pathway for referral and monitoring and support in place to
promote the best possible outcome for that child.
The Health Visitors will have professional accountability and take the lead during the
process.
The following currently describes the purpose of the Early Years Settings and Health Visiting
Service offer for 2-2 1/2 yr olds, and the areas that are duplicated. This pilot addresses these
duplications and offers one process of integrated working.
This, as previously stated is one of five pilot sites addressing this issue; all five pilot areas
involved have differing approaches:
Early Years Settings: - Progress Check
A child who attends any form of child care and is aged between two and three, will have their
progress reviewed by an Early Years Practitioner, they will provide parents and/or carers with
is short written summary of their child’s development in the prime areas of learning
(Personal, Social and Emotional development, Communication and Language and Physical
development). This progress check must identify the child’s strengths, and any areas where
the child’s progress is less than expected.If there are any significant concerns or any
identified special educational need or disability the practitioners should develop a targeted
plan to support the child’s future learning and development and involve relevant
professionals.
The Early Years setting follow the Early Years Foundation Stage documents (EYFS) which
sets out the Learning and Development requirements for children birth to five in seven areas
of learning encompassing children’s physical, intellectual, emotional and social development:

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
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Personal, Social and Emotional development
Communication and Language
Physical development
Literacy
Mathematics
Understanding of the World
Expressive Arts and Design
4
“Age two is an important time for children and their parents”.
Health Visiting: - Healthy Child Programme- universal offer
The Healthy Child Programme currently provides a structured programme; this is offered to
all children. Universal Plus and Universal partnership plus will have additional intensive
contacts providing support to the child in context and their family.
The following are aspects that form the review:







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Ages and Stages Questionnaire (ASQ) developmental review, this encourages
parental involvement.
The ASQ has been deemed an appropriate tool to be used during this pilot as it is a
reliable and evidenced based tool.
Review with parents the child’s social emotional, behavioural and language
development and uptake of immunisations to date.
Respond to parental concerns about physical development, growth, hearing and vision
Offer guidance on behavioural management. Highlight that this is an opportunity to
share concerns and information to address worries. Provide advice on nutrition and
physical exercise and the promotion of language development.
Provide information (including useful telephone numbers and websites) and
signposting to relevant services.
Raise awareness around dental care, accident prevention, sleep management, toilet
training and sources of parenting advice and family information.
Maternal mental Health.
Interaction between child and parents.
5
The Integrated Review Process
Settings verify to HV admin
which children are due IR at
2yr 4mths. Some children
may have joined setting after
Headcount day
Childminders inform HV
admin which children in their
care are due IR
Early Years Family Information
Service (FIS) inform HV teams via
their admin staff, which children are
in EY setting, where and the child’s
GP
HV team take the lead and at cluster/ team meeting identifies children
due IR in the following month (children at this point are 2y4m) including
those in setting and assess for universal/universal plus services
HV admin send letters and ASQs to all parents
Extra info for parents of child in setting telling them about their IR meeting
in the setting
Early Years settings
Health Visitors
1. Meet with Children and Families at fixed
1. Collect observational evidence on all
children
points in child’s life (6wks, 8mths, and 2yrs
6mths) as well as responding to the need of a
child as needed
2. Summarise children’s learning for Progress
Check at 2years 5 months, or as close as
possible, highlighting strengths and areas
where development is below expectations
(EYFS Development Matters)
3. Share/discuss above with parents together
with the ASQ document and parent completed
health questionnaire which will provide the
parents view of their own child. Agree on next
steps to support Learning and development at
home and in the setting
4. Health leaflet pack resource given to family
5. Following the IR meeting with parents if
child is making expected progress forward the
ASQ score sheet and Health question sheet to
HVs. Any concerns must be alerted to HV
ASAP via telephone as well as any referrals
made e.g. SALT etc using established
pathways
2. Complete ASQ assessment and Healthy
Child programme review with parents, also
N’ptonshire Family Assessment Tool for all
level 2, 3, and 4s. HV could see any of these
children in EY setting if seen as appropriate
HV team NNs will
go to setting
monthly to
complete growth
measurement and
will collect any
completed ASQ
score sheet, parent
completed health
questions and a
copy of the
Progress Check
where an issue has
been identified
6. Note date of above in child’s Red Book
(where parents have produced Red Book) and
add if parent has completed ASQ
3. Record outcome in children’s records
electronically using System 1 and complete
sections of child’s Red Book
4. Receive ASQ information from EY settings
for children assessed as universal, and any
relevant information from the progress check
5. Add any further relevant info from a child’s
EY setting to child’s record
6. Put into action any identified further need
for support e.g. SALT using established
pathways
7. HV will record any major concerns
highlighted by EY settings and respond with
appropriate actions
Information about the HV team will be made available to the EY setting
HVs will be made aware of the EY settings in the GP reach area
Strong links with Sure Start Children’s Centres are important.
If at any point EY settings have any concerns around the child (in context) communicate concern to HV team for
joined up working. All safeguarding issues followed through following LSCB set procedures and policies
6
“Age two is an important time for children and their parents”.
Additional Information

The Progress Check at 2 currently completed in settings will continue with few minor changes
to the pro-forma and process i.e. adding parental consent to share information and moving the
completion of the Progress check to 2.5-2.6 months instead of as close to the child’s second
birthday as possible.

Score sheet and parents health questionnaire must be returned to the HV team. Any relevant
information regarding a child that is additional to the background history and gives cause for
concern, the HV will ensure that there is a clear care pathway planned and communicates
appropriately with relevant agencies.

If parents are clear that information must not be shared with HV team, setting is to note that
parents do not wish information shared and HV team will follow up.

Where children who are not seen as ‘universal’ but are in an EY setting the HV team may
conduct the review in the setting with setting contributing to the process if the parent and
setting agree.

Nursery Nurses working within the HV team will complete the Healthy Child Programme
aspects of the review in the setting, by arrangement with the setting. E.g. weight and check
height

Children with EAL (see Top Tips booklet)

ASQ is available in a few other languages but if there is an issue please contact HV team to
arrange a translator or identify a family member who can support.

Health Visitors and Early Years Settings to communicate with each other regarding referrals.

Any more serious issues regarding less than expected progress for children must be alerted to
the HV, recorded on child’s record on System 1 and followed up.

System1 to have a drop down box for Early Years setting venue. This will enable data to be
accessed and reflect the number of reviews carried out during the pilot. .
.
7
“Age two is an important time for children and their parents”
Time table from March 2013
Time
Activity
Comments
7th March 2013
Presentation at the Health visitor
development day as part of the IR launch
Builds on previous presentation
to HV team on Progress Check
and the IR
14th and 15th
March 2013
Launch dates for Early Years settings, Health
visitors teams invited. Guest Speaker is Dr
Kay Mathieson Early Years Consultant and
trainer
Opportunity for all settings
involved to be fully briefed about
the trial, expectations and
process
26th March 2013
Second opportunity for HV staff to access the
IR presentation
15th April 2013
LAUNCH OF INTEGRATED TWO YEAR
REVIEW
Mid way
Integrated meeting to reflect on the
experiences so far
External evaluators arranged by the DoH and
DfE will be working with Northamptonshire
EY and HV practitioners and parents involved
in the trial
From this date settings
involved in the trial will
discuss ASQs with parents at
the Progress Check meeting
when their child is between
2.5 and 2.6 months
Awaiting information
31st December
2013
The pilot finishes
There will be feedback from the
DH and DfE
2014
A case study will be completed
Opportunity for all settings to
respond to the consultation
All trials will be evaluated and findings
reported. Potential model defined and
consulted upon
September 2015
IR rolled out nationally
8
“Age two is an important time for children and their parents”.
APPENDIX 1
Resources
To support parents, Health Visiting Teams and Early Years Settings staff, the following resource have
been compiled. They are not exclusive and you may find many other resources to support your work
and support parents
Resources for parents includes:
Topic
Resource
Web links
Behaviour
Birth to 5 book
www.nhs.uk/birthtofive
NHS Choices website
www.nhs.uk/
Birth to 5 book DoH/
www.nhs.uk/birthtofive
NHS Choices website
www.nhs.uk/
Birth to 5 book DoH/
NHS Choices website
www.nhs.uk/birthtofive
Birth to 5 book DoH/
NHS Choices website
www.nhs.uk/birthtofive Available
Birth to 5 book DoH/
NHS Choices website
www.nhs.uk/birthtofive
Sleeping problems
Nutrition
Immunisations
Safety in and out of the
home
Leaflets
www.nhs.uk/
www.nhs.uk/
www.nhs.uk/
www.rospa.com
Dental care
Birth to 5 book DoH/
NHS Choices website
www.nhs.uk/birthtofive Snack card
www.nhs.uk/
Snack card
9
“Age two is an important time for children and their parents”.
APPENDIX 1 cont.
Early Years staff as above with addition of the following:
Healthy Child programme
www.dh.gov.uk
ASQ
www.agesandstages.com
Birth to five
www.nhs.uk/birthtofive
EYFS
www.foundationyears.org.uk
EY contacts
Added to pack
Top tips for parents
Added to pack
Contact details of Health Visiting Teams
Added to pack
Health Visitor Team
Development matters
www.foundationyears.org.uk
Progress check at two
www.foundationyears.org.uk
Description of roles
Added to pack
Top tips for parents
Added to pack
Details of 2 year olds in a setting
Notified by EY settings and also LA
10
“Age two is an important time for children and their parents”.
APPENDIX 2
HV Record of Information sharing for the “Integrated Two Year Review” pilot
Name
Date and time of
communication
Address
Early Years setting
Date of Birth
GP
Record of
communication
Action plan for
identified need
Signature
11
Please contact:
Pauline O’Neill School Improvement Manager EY
poneill@northamptonshire.gov.uk
07841940007
Helen Chappell Locality clinical team facilitator NHFT 07717856412
helen.chappell@nhft.nhs.uk
12