Integrated reviews
Get advice on how to carry out integrated health and education reviews for children aged 2 to 3. Integrated reviews combine the EYFS progress check at age 2 and the health visitor 2 year old health check.
By Dr Julian Grenier and Megan Pacey. With thanks to Barnsley Local Authority Family Centre and the 0 to 19 Public Health Nursing Service.
Contents on this page
The importance of early years provision for early childhood development
The first 5 years of a child’s life are the most important years for health and wellbeing in adulthood.
Every child’s development is unique. As a result, different children may appear more developed in some areas than others.
Some children may need extra help in their early years setting to make similar progress to others. This could include children with less support at home, or those who have a special educational need or disability (SEND).
About integrated reviews
The early years foundation stage (EYFS) Progress check at age 2 and the Healthy Child Programme review offer 2 opportunities to:
- identify additional needs for children aged 2 to 3
- work in partnership with parents, carers, guardians and any relevant professionals to put the right support in place for the children who need it
Since 2015, the government has encouraged early years providers, local authorities, and health visiting services to work together to combine the Healthy Child Programme review and the EYFS Progress check at age 2. This is known as an ‘integrated review’.
Effective integrated reviews
Integrated reviews take a variety of formats. There is no one size fits all solution. You will need to adapt your approach to meet local needs and address local challenges in your area. However, good practice suggests that effective integrated reviews should bring together:
parents’, carers’ and guardians’ views, and any concerns about their child’s development
early years practitioners’ detailed knowledge of how the child is playing, learning and developing
health professionals’ expertise in the health and development of young children
Advice for early years practitioners
Integrated reviews are most effective when professionals are clear about:
- how each child will be reviewed
- who will review them
- what follow up support is available
- how and when the impact of any support will be evaluated, so that no child ‘falls through the net’
You can support effective integrated reviews in several ways. We will explore these in more detail below.
Partnership working
It is important to maintain positive partnerships with parents, carers and guardians. You can build understanding and trust with them by:
- offering them meaningful opportunities to contribute to discussions about their child’s progress
- listening to what they have to say
You should also build and maintain partnerships with other specialists and health professionals. These partnerships should be in place before, during, and beyond the progress check.
Getting consent to share information
At times, you may need to share information about a child with other relevant professionals. Before doing so, it is important you get permission from parents, carers or guardians.
Effective communication
When children join the setting, you can encourage parents, carers and guardians to share their child’s personal health record. This is also known as a PCHR or ‘red book’. You can use this as a tool to communicate between professionals about the child’s health and development.
Case study - Barnsley Local Authority Family Centre
Barnsley Local Authority Family Centre delivers integrated services for children. The centre offers a variety of provision according to the needs of local families. It also has an on site nursery which is owned and managed by the local authority. This nursery offers sessional childcare for funded children only from the ages of 2 to 5.
At the centre, a key person completed their key child’s 2 year progress check, when the child joined the setting in the term after their second birthday. During this check, the key person identified that the child’s progress was below expected levels of development against the prime areas of development. An integrated review gave an opportunity to understand this further.
The integrated review involved:
- the child’s parent
- the child’s key person
- the 0 to 19 Public Health Nursing Service (PHNS) Child Development Practitioner
During the integrated review process, the child’s parent was able to share their concerns with the child’s key person and the health professional at the same time. This gave everyone a clear understanding of the child’s needs and how best to support them. The parent commented on how much easier it had been to have one single meeting, with both professionals offering advice and support. They also found having the child’s key person at the meeting reassuring when meeting unfamiliar health professionals.
An Early Help Assessment was agreed at the integrated review meeting. This is a type of assessment completed with the help of the child’s family to:
- identify the child’s strengths and needs
- agree what the family would like to change
- develop an action plan
“The integrated review provided an opportunity to discuss concerns identified from the child’s 2 year progress check. Using a holistic approach with the family and health professional, we identified what support could be offered to the family. We completed an Early Help Assessment, referred to occupational therapy, and arranged for an Early Years Graduated Response to be completed. This helped to identify the child’s strengths and needs, as well as the support required for them and their family.“
Key person
The key person recognised that the parent had felt comfortable sharing their concerns during this meeting. This then encouraged further discussions about the wider support the family might need. Involving both the child’s setting and a health professional in the integrated review created a supportive and emotionally safe environment for the parent. It also enabled early identification and timely intervention for the child and family.
Following the integrated review, the family has benefited from:
- a family support worker
- support with parental literacy skills
- guidance on the education, health and care plan (EHCP) and SEND processes
“I am really happy with all the support and advice given from the family centre. I could not be happier.”
Parent
The child’s key person reflected that, through the integrated review process, parents gain a better picture of their child’s progress. They felt this was thanks to the consistency of messages and the holistic approach to the child’s development. They also emphasised that communication is critical for the success of the integrated 2 year review.
This example shows how the strong working relationships and regular communication between Barnsley Local Authority Family Centre, and the 0 to 19 Public Health Nursing Service, enables an equal partnership. In turn, this helps to ensure early intervention for children who need it.
Benefits of integrated reviews
Research about pre-school’s influence on children’s development and attainment over time (PDF, 745 KB) has shown that children who access high-quality early years provision are less likely to be identified as having a SEND in the long term. We as practitioners must be quick to support and identify the right help where needed.
DfE research (PDF, 1372 KB) has also shown that integrated review processes:
improve multi-agency working and information sharing to support families
reduce duplication
provide clearer and more consistent information for parents
offer a more holistic understanding of children’s needs
support earlier identification of need and earlier access to relevant support
contribute to improved outcomes for children, including school-readiness
Further reading and resources
Doncaster Council offers advice for early years practitioners on where to get help and support with childcare and early education. This includes guidance and example forms for integrated reviews.
Essex County Council have created these resources to help practitioners with integrated reviews.
Barnsley Metropolitan Borough Council provides guidance for integrated reviews, including templates and example reviews.
About the authors
Dr Julian Grenier was Headteacher at Sheringham Nursery School and Children’s Centre at the time of writing. Megan Pacey is Associate of Sheringham Nursery School and Children’s Centre.
Both Julian and Megan contributed to the Department for Education’s ‘Progress check at age 2’ guidance.