Childcare providers and health teams are now expected to integrate the reviews they complete when a child is two years old. The aim of this integrated review at age two (as defined by the Integrated Review Development Group, January 2012) is to:

- Identify the child's progress, strengths and needs at this age in order to promote positive outcomes in health and wellbeing, learning and development

- Facilitate appropriate intervention and support for children and their families, where progress is less than expected.

- Generate information which can be used to plan services and contribute to the reduction of inequalities in children's outcomes.

How the health review works in Surrey and why these changes are necessary

In Surrey, the check that health visitors complete is called a 27 month development review. Health visiting teams send parents a letter inviting them to their child's development review just before they are 27 months old.

That letter includes as Ages and Stages Questionnaire (ASQ-3). ASQ-3 is a screening tool that assesses developmental progress and makes it easier to identify a child's strengths as well as areas where they may need support. Parents are encouraged to fill in the questionnaire with their child just before the appointment and take it along on the day.

The letter also asks parents to bring their child's health record (red book) and their progress check at age two document to their appointment.

During the appointment the health visitor will review the ASQ-3 questionnaire and the progress check at age two document as well as talk to the parent and ask the child to complete some simple exercises. They will use all this information to assess whether or not the child is progressing as they should be.

The health visitor only has a very short amount of time to assess the child. As a setting we will have had weeks, months or even years to get to know them so the information that we provide on the progress check document could be invaluable. It is therefore important that, where possible, we complete the progress check before children are 27 months old so parents can take the document with them to their child's appointment.

We will send a letter to parents inviting them into a meeting with us to discuss the progress review with them. If your child starts with us after they are 27 months old a progress check will still be completed before they turn 3 but obviously won't be able to inform the health visitor 2 year check. If a child has already had a progress check completed by their previous setting, we are not required to also do one but will ask parents to share it with us. This also applies to the health visitor 2 year check if a child starts with us after they are 27 months.

For more information on the two year check please visit:

Child's key person contacts the parent to tell them about the progress check and invite them to a meeting after the check is completed.

Flowchart.odt (ODT — 9 KB)