Practitioners back joint health and early years reviews

The study by the National Children’s Bureau (NCB) of five areas piloting health checks and early years progress when a child reaches 24 to 30 months, found the approach had also been effective in identifying hard-to-reach children and engaging their parents in services.

However, the study said that one of the models tested – where early years staff took sole responsibility for carrying out both checks – had not worked well due to practitioners having insufficient training and experience to identify health problems.

Publication of the NCB study coincided with the government announcing plans this week to introduce joint health and early years reviews for children aged 24 to 30 months from September 2015. The NCB has also published a toolkit to help local teams successfully deliver the integrated review, which the government hopes will provide a more complete picture of a child's health and wellbeing.

The NCB study looked at how pilot sites in Islington, Leeds, Medway, Norfolk and Northamptonshire implemented the integrated Early Years Foundation Stage (EYFS) progress review alongside the Healthy Child Programme check. Starting in January 2013, most sites involved early years and health staff either working together to carry out joint assessments or sharing information on the review findings.

Although the study said it was not possible to say whether assessment quality or child outcomes had improved as a result of the new arrangements, practitioners reported that joint reviews had provided a "strong understanding" of children’s developmental needs, enabling advice to be given and information gathered so further support could be put in place.

In addition, pilot areas often achieved higher check take-up rates compared to when the reviews were delivered separately. Better information sharing also helped health and early years teams to identify transient families they had otherwise struggled to engage with.

The extra costs of setting up and providing joint reviews were deemed a necessary investment by practitioners as it was hoped to deliver long-term savings.

The study concluded, however, that at the two sites that trialled early years practitioners undertaking both health and EYFS reviews – with results fed back to health teams – children's needs went unidentified and parents sometimes asked for a health visitor assessment because of concerns over this. In these sites, there were also problems with information sharing systems.

The report states: "In the area that initially piloted assessments by early years staff on their own, they had identified some problems with early years practitioners making inappropriate referrals of children to speech and language therapy.

"It is clear that achieving full and accurate needs identification, based on the input of early years staff alone seeing the child is challenging to achieve."

Information sharing between health and early years staff was also identified in a report by the Early Intervention Foundation as a barrier to ensuring under-5s receive the support they need.