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Linking with your health visiting team and the health and development review

Health and early education reviews for young children at the age of two.

Link health visiting team

Every Early Years Provider has been allocated a link health visiting team to act as a point of contact between that provider and the health visiting service.

The role of the linked health visiting team is:

  • to work in partnership with the provider
  • to liaise between the provider and health visiting service
  • to signpost to named HV team for the child should any concerns arise
  • to act as a public health contact for providers should they need advice on any current public health issues affecting that provision. This may then require signposting to other services or provision of health promotion, including health promotion groups for parents to support school readiness.

Health and development review

This is completed by a health visitor when the child is between the ages of 2 to 2 ½. This is a mandated contact as part of the Healthy Child Programme. It is in the context of the child’s health and development within the wider family. Depending on individual circumstances the review is carried out in the home, clinic setting or virtually. Some children may be invited to a group review.

The review is an opportunity to give age-appropriate health promotion messages, including speech, language, and communication; play and behaviour; healthy nutrition; toileting; child safety & accident prevention; seasonal advice; immunisation advice; parental and family wellbeing; access to early years education

As part of the review health visiting staff use the parent-led Ages and Stages Questionnaires (ASQ-3 and ASQ:SE) to assess the child’s development in six domains:

  1. Communication
  2. Gross motor skills
  3. Fine motor skills
  4. Problem-solving
  5. Personal-social
  6. Social-emotional development. 

A free ASQ-3 and the two-year review programme e-learning module provide more information.

Health visiting and Early Years communication tools

The communication tools for HVs and EY providers include:

  • A 2 – 2 ½ year integrated process for early years setting

This is a communication pathway following the health review for sharing the outcomes of the reviews and the ‘what to do’ plan if concerns arise. It sets out a process of communication and partnership working between Oxford Health NHS and Early Years sector to support concerns about a child’s development with the aim of improving outcomes for the child and to support school readiness.

Integrated process for Early Years settings (pdf format,1Mb)

  • HV postcard (electronic or a paper version) sent to the EY setting when there is a concern

If following the completion of the 2 – 2 ½ year review, the health visitor has concerns about the development, emotional or social skills of the child, with parental consent, the HV will complete and send an electronic postcard (pdf format) via secure email to the identified setting or childminder (where the child spends the greatest amount of time)

If the health visitor has no concerns about a child, early years practitioners will not be notified of the health review, however, information from the review will be recorded in the child’s red book which you can request from parents.

If the child is not currently in a setting, then the postcard will be given to the parent/carer to pass on when they begin attending a setting, so please ask for the postcard or the Red Book.

If a child has not had a 2- 2 ½ year health review, encourage the parent to contact their health visiting team or you could highlight this to the team, and they will contact the parent (providing you obtain consent from the parent to contact the HV).

The postcard will identify the contact details of the health visitor that has seen the child and provide a brief outline of any concerns. This information can be used to help guide your support for the child and to help you prepare for the EYFS progress check at 2 ½ -3 years of age.

If when a postcard is received and you also have questions and would like to liaise with the health visitor, please use the contact details on the card to get in touch.

If any more significant concerns are identified, then the health visitor will contact the setting directly to discuss a joint approach of support to the child and family.

  • Information in the child’s red book

The health visitor records the outcome of reviews in the red book, as well as other relevant information. Do ask the parent if you would like to see the child’s red book.

The EYFS Progress Check at Age Two

 The Early Years Foundation Stage (2021) requires that practitioners must review children’s progress, and provide parents and/or carers with a short written summary of their child’s development in the prime areas: Communication and Language, Personal, Social and Emotional Development and Physical Development and. In Oxfordshire, practitioners are advised to carry out the progress check when a child is aged between 2½ - 3.

 The EYFS Progress Check at Age Two will help you to make an accurate assessment of children’s development, health and wellbeing. This involves working closely with parents and other professionals involved in the child’s life. After completing the progress check at age two, parents and practitioners can take appropriate actions in the best interests of the child. It will also reduce unnecessary workload. Practitioners do not need to spend a long time away from the children to complete the check.

 The progress check at age two has three main purposes:

  1. Partnership with Parents: While practitioners and other professionals can support children’s development and wellbeing individually, they can achieve so much more by working together.
  2. Action for every child:  Writing down observation and sharing reports do not help children.  Practitioners need to listen to the child, talk with each other and then plan together.  Working together makes a difference.
  3. Early identification: Some children need extra help for a while as they grow and develop – for example, with their communication. Other children may have long-term developmental needs. Some families may struggle and need support. Whatever the circumstances, sensitive early intervention can make a big difference. Children develop rapidly between the ages of two and three – practitioners need to be quick to support and identify help where it is needed.

There is no prescribed format for the EYFS progress check at age two summary. Each setting can decide on its own progress check format, but as a minimum it must include a short written summary of the child's development in the prime areas; the summary must identify the child's strengths and areas for improvement. There is an example format in the appendices.

The DfE have also published a vodcast to explain the new guidance to early years practitioners and a blog that highlights why the progress check is important now, more than ever as we support children to bounce back from the COVID-19 pandemic.

Supporting school readiness

The health visiting service runs “Marvellous Me” health promotion groups for parents to provide health promotion information to support school readiness. These groups are for children between 1½ and 2 years of age and then at 3½ years of age.  In addition, health visiting staff provide individual “episodes of care” when a child needs extra support in different areas of development relating to school readiness, for example, speech, language and communication or toilet training.

Please speak to your health visiting team (with parental consent) or ask parents to phone the Oxfordshire HV ChatHealth parenting line on 07312 263081, if you feel a child would benefit from this support.