An integrated 2-2½ year review

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80% of children’s brain development happens in their first three years of life. Acknowledging the need to invest in people during these crucial early years, those working with children are mandated to carry out several reviews to ensure children’s health and mental wellbeing, and to ensure any issues with either are picked up and dealt with early. 

At the end of 2014, following a twelve month pilot exercise in five areas, it was announced that the health and early years reviews for 2-2½ year old children will be integrated from September 2015. 

Currently, health visitors carry out the healthy child programme check on children around two years of age, and an early years foundation stage review is done in an education setting around the same time. 

Bringing the two reviews together aims to help to:

  • build a picture of child development at age two across the country and by local area
  • assess effectiveness and impact of services for 0-2 years old
  • plan appropriate services for children aged two and beyond.

What does this mean for health visitors?

Health visiting teams will now need to work with education practitioners, combining their professional expertise to evaluate children’s development and support them and their families. 

The results of the pilot programme have recently been published by the National Children's Bureau (NCB), along with recommendations for implementation of the newly integrated review. New guidance for providers was published in March 2015. Access this, and the previous reports from the NCB website

The pilot programme found that two different ways of conducting the review were acceptable, depending on local need. Health visitors and early years colleagues are encouraged to decide which of these best suits their service users and practitioners: 

  • a single meeting involving parent(s), child, early years and health professional, or
  • two meetings supported by information sharing.

Data will be collected by health visitors at the universal Healthy Child Programme (HCP) two year review or integrated review. This data will contribute to the new outcome measure of child development at age 2-2½ which will be included in the Public Health Outcomes Framework from 2015.

The tool which health visitors will be required to use from April 2015 is Ages and Stages Questionnaire-3. Originally American, a British version of the tool has now been developed, which contains minor (mainly linguistic) changes to the original. Each health visiting service provider will be sent an ASQ-3 training CD-ROM by the Department of Health (DH) in early 2015. Online training is available now on the e-learning for health website

Find out more 

Find out more in this informative presentation delivered by DH colleagues at the last NHS Employers Share and Learn event in London.

Visit our NHS Employers health visitor workforce hub for more information, advice and guidance. 

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