Happy, Healthy and Ready to Learn in Hackney
Embodying joint working across early years and health visiting services, Caroline Hart and Chrispina Omoniruvbe introduce the integrated review for two year olds in practice in Hackney. Their model emphasises the importance of both the child’s and parents’ involvement in the process.
In recognition of the importance of the early years in laying the foundations for health, development and wellbeing, the government has increased investment in preventative and early intervention services. The Government’s Healthy Child Programme includes a review at two to two-and-a-half years of age and the Department of Health and the Department for Education announced in December 2014 that integrated reviews would be rolled out nationally. This short article describes the ways in which a partnership between health visiting teams and early years services have delivered an integrated review for two-year-olds in Hackney.
Bringing health visitors and early years professionals together
An implementation group with representatives from the health visiting and early years services in Hackney was established in January 2012, creating a foundation of inter-professional working from the start. The work from this group included a practice guidance toolkit, a governance framework, joint conferences and a continuous professional development programme.
All early years settings have a healthy child programme lead and a named lead from the health visitor team with joint meetings held in lead children’s centres within the cluster areas. To date, 311 early years and health visiting staff and have been trained in conducting integrated reviews, including childminders and playgroup leaders.
The aims of the integrated reviews are:
- To identify the child’s progress, strengths and needs in order to promote positive outcomes in health and wellbeing, learning and development.
- To facilitate appropriate intervention and support for children and their families, where progress is less than expected.
- To generate information which can be used to plan services and contribute to the reduction of inequalities in children’s outcomes.
Reviews held in early years settings
The integrated review model developed in Hackney places emphasis on the importance of both the child’s and parents’ involvement in the process. Reviews are held in the child’s early years setting and are attended by an experienced member of the early years staff team, who are known to the family, together with a health visitor. This joint holistic approach by professionals which involves the family has proved highly successful. 90 per cent of early years providers are now able to offer integrated reviews. The uptake of these reviews in Hackney has risen from 23 per cent in 2008 to 92 per cent in 2014.
Parent feedback has been very positive, as shown by the following comments:
“I liked having my child’s health and education needs discussed together at one meeting.”
“I felt able to contribute what I know about my child and what they can do.”
Health visitors and early years practitioners also value the reviews:
“Greater insight into how nursery staff can support parents with development needs, e.g. toilet training.”
“Able to support parents better than before in their child’s learning and development.”
Sharing Hackney’s approach
We, the project leads, have worked closely with the Departments of Health, and Education, and NHS England to share the experience of Hackney’s approach and to explore how it relates to the introduction of the ages and stages questionnaire.
The success of this work has been largely due to the willingness of individuals, groups, and organisations to work cooperatively. The strategic multi-disciplinary healthy child programme group with representatives from paediatrics, community nursing, therapies, psychology, children’s centres and education, have set the strategic vision for this successful approach. It hasn’t been achieved overnight but we believe that it has provided long-term benefits for the care of children in Hackney.
Caroline Hart is a local authority early years consultant, leading on several key innovative educational/health partnership initiatives aimed at improving outcomes for young children, notably Hackney’s two-year-old integrated review. She has been supporting schools and early years settings across Hackney to ensure quality within EYFS delivery since 2003. Prior to working for Hackney Learning Trust, Caroline gained wide-ranging experience as a teacher in schools and children’s centres, building her expertise in early childhood development.
Chrispina Omoniruvbe is a lead health visitor in Hackney, working in partnership with health providers and children’s centres in her locality and leading a large team of area health visitors. With over 30 years’ experience in health visiting, Chrispina has also lectured in further education. For the past four years, Chrispina has been leading on Hackney’s integrated developmental review, coordinating a multi-disciplinary approach to meeting the needs of young children and their families.
