New year, new review: What does the integrated review at age two to two and a half mean for health visitors and early years practitioners?

This September, local areas will be expected to integrate health and education child development reviews that are carried out at two to two and a half years of age. Susan Soar of NCB’s Early Childhood Unit (ECU) explains how this will affect early years practitioners, health visitors and others working with young children.

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The year ahead will see the introduction of an integrated health and early education review for children aged two to two and a half. In September 2015 local authorities will be required to bring together the Healthy Child Programme health and development review with the EYFS progress check at two, with the aim of identifying any developmental issues early on and putting in place effective early intervention and support. An NCB study of the implementation of the review in local authority pilot areas explored a number of possible models: from joint meetings between parents, early years practitioners and health visitors, to integration via information sharing after separate reviews have taken place.

So at a point in the calendar when many people choose to reflect upon the past and look ahead to what the coming months will bring, it seems a good time to consider what integrating health and early education reviews might mean for early years practitioners, health visitors and others working with young children. Likewise, are there any actions, or possibly ‘resolutions’, that we as individual practitioners could take during 2015 to support the introduction of the integrated review?

Being ready to form new relationships and build upon existing relationships. 

The integrated review is likely to mean the formation of new working relationships for health visitors, early years practitioners and other professionals working with young children and their families. Existing relationships may be re-framed or we may find ourselves needing to work closely with new and unfamiliar colleagues, becoming accustomed to their strengths, weakness and way of working. We will need to have respectful and balanced relationships with parents, or build these where they are lacking, valuing their perspective and the vital information they hold about their child. While the central tool of the integrated review is a parent-completed ‘Ages and Stages Questionnaire’ (ASQ-3), face-to-face discussion about the child is equally valuable and forming a strong partnership with parents can only make it easier for them to contribute freely and openly to the review process.

Going to new places. 

One integrated review model trialled by local authorities is that of physically bringing together parents, health visitors and early years practitioners for a joint review meeting. For us this may mean working in new environments, whether that is a health centre, an early years setting, a children’s centre or the child’s own home, or welcoming other professionals into our day-to-day workplace. It can take time to get used to a new environment, yet by acknowledging this we can make it our priority to ensure that the child and their parents feel as comfortable as possible, by providing toys, books and welcoming surroundings.

Learning a new language. 

In our work with young children we often speak our own professional ‘language’; using technical terms as an easy shorthand for elements of practice or patterns of behaviour.  While we can be instantly understood by our own colleagues, working with other professionals to carry out an integrated review is likely to mean gaining some familiarity with new technical terminology, or helping others to understand our own. This might be particularly important in areas where local authorities plan to integrate health and early education reviews via professional dialogue and information-sharing between health visitors and early years practitioners, after separate reviews have taken place.

Building on what we already do. 

Finally, introducing the integrated review is not so much a case of ‘out with the old, in with the new’, but rather a process of drawing together the complementary expertise of early years practitioners and health visitors who are both already reviewing the development of young children around their second birthday. An early years practitioner brings the ongoing observational knowledge of the child; a health visitor brings detailed knowledge of health and development in young children. While this may mean changes to the way we currently work, when these dual perspectives are brought together with the parents’ in-depth knowledge of the child then a more complete picture will be possible.

Susan Soar, NCB Early Childhood Unit and adviser to NCB’s 'Implementation study: integrated review at age 2 to 2-and-a-half years'.

The full review report and a slide pack to support local authorities in implementation of the integrated review are available here.

Find out more about the ECU at NCB here.