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Integrated Health and Early Education Review

Childcare providers and health visiting teams are expected to integrate the reviews they complete and share these with parents when a child is two years old.

From September 2015 childcare providers and health visiting teams will be expected to integrate the reviews they complete and share with parents when a child is two years old.

The Department for Education and the Department for Health have jointly commissioned an Implementation Study for the Integrated Review at 2-2½ years - integrating the Early Years Foundation Stage Progress Check and the Healthy Child Programme health and development review.

The NCB has also been commissioned to provide supporting materials for health and early years practitioners carrying out integrated reviews for children aged two to two-and-a-half.

The aims* of the Integrated Health and Early Education Review are:

  • To identify the child's progress, strengths and needs at this age in order to promote positive outcomes in health and well being, learning and behaviour.
  • To facilitate appropriate intervention and support for children and their families, especially those for whom progress is less than expected.
  • To generate information which can be used to plan services and contribute to the reduction of inequalities in children's outcomes.

(*Implementation study November 2014)

Leicestershire process in detail

Leicestershire County Council have worked with the Health teams for Leicester, Leicestershire and Rutland and produced a process for Leicestershire providers. The Leicestershire process will support you to implement the Integrated Health Review. Details of each step can be found below.

Leicestershire process to implement Integrated Health Review

Systems to support the review

Childminders and Settings ensure that the admissions and registration process includes 'consent to share information with other professionals', and is signed by Parent/Carers.

  • Example consent forms and letters can be found in Resources.
  • It is vital 'Consent to share information' is signed to allow partnership working with Health to take place. This can be signed even if the parent/carer does not know the name of the Health Visitor.
  • Information Sharing Matters is an elearning module from The Royal College of Paediatrics and Child Health (PCPCH).

Each setting and childminder to have a link Health Visitor. The setting needs to identify a Healthy Child Programme Lead.

  • A link Health Visitor has been allocated to each Children Centre Reach area. Please refer to 'List of Health Visitor contact details' to find out your link Health Visitor.
  • The link Health Visitor is a contact for each Setting but may not be the child's allocated Health Visitor.
  • This Health Visitor can be contacted if you have a concern about a child but you do not know who the child's named Health Visitor is.
  • As part of sharing information, Settings need to identify a named contact. This person will be known as the Healthy Child Programme Lead who the link Health Visitor can liaise with.
  • Guidance is available to support practitioners on their roles and responsibilities.

Settings / Childminders to identify the two year olds each term. In the middle of each term the Local Authority will send out a secure form via AnyComms+ for the Setting / Childminder to fill in the details of those children identified. This information will be sent directly to the Health Team and shared with the named Health Visitor.

  • This form shows an example of the information you will be asked for. Some sections will already be completed. This form highlights if any concerns need to be raised and in this way informs the health team a Progress Summary is to be expected at the appointment.

Example form of 2-year olds' names

  • The aim of sharing information is to ensure the information goes to the named Health Visitor.

The Health Visitor Team organises when and where the meetings will take place. In Leicestershire the Health & Development review takes place at two years and three months.

The Health Visitor invites Parents/Carers via a letter, to the meeting and sends the Ages and Stages questionnaires ASQ-3 and ASQSE two weeks prior to the meeting.

  • As the check in Leicestershire will normally take place at two years three months and parents/carers will only have two weeks notice, it is vital that Settings / Childminders are aware of the two specific timescales in order to support the review.
  • An example of the letter is available.

Each Setting and Childminder to raise awareness to parents /carers of the processes and procedures in place for the two year old check.

  • It is really important to ensure parents/carers are aware of the Health & Development Review and the Progress Check to ensure an Integrated Health Review can be established. It is therefore crucial that Settings / Childminders make parents/carers aware of these processes before the child is two.
  • Examples of resources to support awareness raising such as a poster and leaflet are available below.

Preparing for the review

Parents/Carers receive the Ages and Stages Questionnaires and complete them prior to the Health and Development review. The Parent/Carer may ask for the Key Person or Healthy Child Programme (HCP) Lead for help in completing this.

  • The ASQ must be completed by the parent/carer, however if it is requested, the key person or HCP can support the parent to complete the ASQ.
  • Information about the ASQ is available with the introduction to ASQ-3 being a useful section.

Key Person completes the Progress Check. This is shared with the Parent/Carer and given to them to take to the Health and Development review. The Key Person may attend the review if invited by the Parent/Carer.

  • It would be useful to have the Key Person attend as they would play a key role in informing the review.
  • Attendance at the review should always be in discussion with Parent/Carer. However this is not an expectation as cost and staffing implications need to be considered.

Named Health Visitor/Community Nursery Nurse to contact the Healthy Child Programme Lead/Childminder prior to two year Health and Development review appointment for further information and if necessary invite the Key Person to attend (with parent/carer consent).

  • As above it is not an expectation the Key Person will attend as cost and staffing implications need to be considered.

Completing the review

The two year Health and Development review meeting takes place. The Health Visitor or Community Nursery Nurse completes the insert for the Red Book. The Parent/ Carer are encouraged to share the outcome of the two year Health and Development review meeting with their child's Key Person and give them the copy of the Red Book insert for their records.

  • Health professionals are familiar with the progress check and the expectation is they will fill in a short summary.
  • Parents/carers will be encouraged to use the red book to store their childs Progress check and ASQ paperwork.

After the review

Health Visitors/Community Nursery Nurse follow up any additional information and advice to Parents/Carers and Healthy Child Programme Leads/Childminders resulting from the 2 year Health and Development review meeting.

Health Visitors/Community Nursery Nurse will make a referral to relevant agencies, for those children in need of help to meet their developmental milestones. Children Centre Workers support families to take up programmes to improve outcomes for children.

Resources to support the process and implementation of the Integrated Health and Early Education Review

Leicestershire process

Example Consent to share information letter

Example Secure Sharing of information proforma

Example form of 2-year olds' names

Example Leaflet for parents

Example leaflet for parents - what to expect when your child turns 2

Example Poster: Now your child is 2

Example letter to parents about the Progress Check

Example letter from Health Visitior

List of Health Visitor contact details

Parents guide to the EYFS

EYFS Progress check at age 2

2 Year old red book insert

ASQ and scoring explained

Progress from the Start

Ages and Stages Questionnaire information

Ages and Stages Introduction click on 'intro to ASQ-3'

Practitioner Roles and Responsibilities

Frequently Asked Questions

What do I do if a child comes to my setting and has already had a Health and Development Review?

  • Speak to the Parents/Carers to ask them if they have the ASQ paperwork to share with you. Use this to inform an EAR or Progress Check.

What do I do if I don't know the child's named Health Visitor but I have concerns?

  • Contact your settings link Health Visitor.

What if I don't have any children's details to add to the secure transfer form?

  • Leave the form blank, there is no need to submit.

Can I speak to the link Health Visitor about a child when I have a concern?

  • Yes, but permission must be sought form the Parents/Carers first. Always encourage a Parent/Carer to talk to their owned named Health Visitor.

How do I get the Progress Check to the Health Visitors?

  • The expectation is that the Parents/Carer will take the Progress Check to the Health and Development review.

Can I complete the ASQ for the Parents/Carer?

  • No. However you can support the Parents/Carers to complete if they ask you to.

Can I attend the Health and Development Review meeting?

  • Yes, if you are invited by the Parent/Carer.

Can I have copies of the ASQ questionnaires?

  • You could approach your link Health Visitor for further information

What if I have a child that attends two different settings?

  • The setting the child attends the most should complete the Progress Check for the Health and Development review. If a child splits the sessions equally the expectation would be to share information to support the Health and Development review.

What if the Parent/Carer does not bring back the Progress check after the Health and Development review?

  • Talk to the parent once you know the Health and Development review has taken place and discuss with them the outcomes.
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