Health and development two year old reviews

Information for early years providers on the Health review at 2 and the EYFS progress check at 3.

In Oxfordshire, the two assessments at age 2 are complementary and equally important. They provide parents with a more complete picture of their child’s development while conveying the importance of early identification of needs and provision of support to ensure children’s health and good level of development:

Health and development review

This is completed by a health visitor when the child is aged 2 to 2 ½. This is a universal entitlement which is carried out in the context of the child’s family and home environment and is part of Government’s Healthy Child Programme.

The EYFS progress check

This is completed when the child is between 2 ½ - 3 years of age. This is a statutory requirement of the EYFS and is carried out for all the children in the context of the early years provision they attend (including childminders).

Early years providers are encouraged to work with Oxford Health NHS to establish good communication systems between their early years provision and Health Visiting team, in partnership with parents. This allows for any concerns identified as part of the reviews at two to be followed up quickly and effectively. Communication tools for HVs and EY providers include: HV postcard (pdf format, 99Kb), the child’s red book and the communication pathway (pdf format, 295Kb) for sharing outcomes of the reviews and ‘what to do’ plan if concerns arise.

Two year health review and contact with early years providers

All children are offered a health and development review between the age of 2 - 2 ½.

Health review

The health review is carried out by the child’s Health Visitor as part of the wider Healthy Child Programme and uses Ages and Stages Questionnaires (ASQ-3 and ASQ:SE) and to assess the child’s development in six domains: Communication, Gross motor skills, Fine motor skills, Problem solving, Personal-Social and Social-Emotional development.

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

Postcard and communication pathway

Communication tools for HVs and EY providers include: HV postcard, the child’s red book and the communication pathway (pdf format, 295Kb) for sharing outcomes of the reviews and ‘what to do’ plan if concerns arise.


When the health review has been carried out, the Health Visitor will complete and send a postcard (pdf format, 99Kb) of the review outcomes to an identified setting if the child attends one and the parent consents. This will soon be changing to an email postcard. Providers will need to set up on Egress system to be able to receive information securely via email.

Childminders should receive postcards in the same way that settings do, as long as the parent provides the health visitor with the childminder’s contact details and this is where the child attends for the majority of sessions.

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 so please ask for it when they start with you.

If a child has not had a 2 year health review, encourage the parent to contact their Health Visitor or you could highlight this to the Health Visiting team and they will contact the parent.

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 concerns 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.

This communication pathway following a child’s health review at 2 – 2 ½ 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.

Provider example

The EYFS progress check at age 2

The Early Years Foundation Stage 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: Personal, Social and Emotional Development, Physical Development and Communication and Language. In Oxfordshire, practitioners are advised to carry out the progress check when a child is aged between 2 ½ - 3.

Progress check

The summary must:

  • highlight areas in which the child is progressing well
  • highlight areas in which some additional support might be needed
  • focus particularly on any areas where there is a significant concern that may indicate a special educational need or disability
  • describe the activities and strategies the provider intends to adopt to address any issues or concerns

Where any needs in areas of development are identified, providers should discuss how they will support the child, in partnership with parents and other professionals (for example, health visitor) as appropriate.

There is no prescribed or standard format for the progress check summary – below are some provider examples.

Link health visitor

Every early years provider has been allocated a link health visitor to act as a point of contact between that provider and the health visiting service.

Do you know who your link health visitor is?

List of health visitors (xls format, 35Kb)

The role of Link health Visitor to Early Years Settings and Childminders

  • To be the named contact for that provider for liaison between the provider and Health Visiting service.
  • To signpost to named HV team for the child should any concerns arise.
  • To provide the setting with a generic email address for the HV team that the link HV is part of.
  • 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.

Information for parents

Resources to display in your setting or give to parents to raise awareness:

Training and useful links


Useful information