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  1. Working together better for two year olds: The integrated health and education review at aged 2 Tracy Smith Team leader; teaching and learning Islington Council EYFS Team Images courtesy of ‘A good place to be two’: Community Playthings 2013

  2. What is the Integrated Review? • Joint Health and Education review for children aged 24-30 months • Recommendation of Tickell review (2011) of the Early Years Foundation Stage • Brings together: • Health review part of ‘Healthy Child Programme’ • Statutory EYFS Progress Check for children attending an early years setting • To be implemented nationally by 2015

  3. Islington context • Borough of stark contrasts • Islington Fairness Commission (2011) • First 21 Months initiative • Established integrated working • 1000+ 2-year-olds in provision (50% of cohort) • Education progress checks

  4. Our vision for the Islington Integrated Review • To provide the best possible support for parents and children • To share professional knowledge, learning and support between services • To use the review as a key opportunity for early identification and intervention • To have a truly integrated review

  5. The Child in the Family The Community Attachment relationships Community Support Neighbourhood Deprivation and local resources Parenting style The Child Personal, Social and Emotional Development Communication and Language Evidence-based tool e.g. ASQ-3 Adverse Family Circumst- ances Couple Relation- ships The Child In Context Physical Development and Self Care Physical Health Family Employment/ Economic status Learning And Cognitive Development Home Learning Environment The Family Family Education/ qualifications Family Health (physical and mental)

  6. Work so far • Partnership working at strategic and operational levels • Named HV for each early years setting • Ongoing communication with frontline practitioners • Developed documentation and supporting guidance • Trained health and education practitioners together • Adopted a phased approach to roll-out: • Children’s centres • Private, voluntary, independent & school settings • Childminders • Children not in EY provision • Gathered evaluations - ongoing

  7. Engaging parents

  8. Ages & Stages Questionnaire – ASQ • The government intends to introduce a public health measure at aged 2 • Pilot LAs have been asked to trial the Ages and Stages Questionnaire (ASQ) • Areas measured include: • Communication • Gross Motor • Fine Motor • Problem – solving • Personal Social • Hearing/vision/medical

  9. Successes • High no. of people trained across both education and health since summer 13 • Development of skills and knowledge across both sectors • Making and developing links – particularly between the PVI and health sector and between PVI and CCs • Well-received by frontline practitioners and by parents • Increased support for early home learning

  10. Successes: what parents say It’s not often you get a chance to sit down and talk in depth about your own child. They pointed out things that my son has been doing that I didn’t know were important. I felt included; they asked what I thought and how he is at home. With my daughter who’s now 5 I had a regular review. The integrated review for my son felt like it gave a more complete picture. For me it really worked – it felt safe and thorough and just all-round a positive experience.

  11. What practitioners say I had worries about the child’s speech and the health practitioner agreed. Sometimes there’s a bit of a grey area and you wonder ‘am I being a bit too hard, is the best fit too low?’ - so it was good to have that back up from another professional.

  12. What health practitioners say It was so useful to work with a non health professional and get their contribution about the child.

  13. Challenges • Design phase • Establishing a robust system • Practical challenges – time, space • Culture change • Data sharing and data recording • Quality assurance

  14. Next steps…….. • Embed systems, processes and ways of working • Consider roll-out to children not attending EY provision • Evaluate timeliness and impact of interventions on children • Joint conference

  15. Being two……. By the time I am two I have a story to tell you about lots of things. The highlights of my story give you insights about the understanding I have and the things I can do now. I am two! Working effectively with two year olds and their families Kay Mathieson 2013