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Joint working – Sussex Community NHS Foundation Trust & West Sussex County Council demonstrate innovative collaboration

28th April 2016

Sussex Community NHS Foundation Trust & West Sussex County Council show innovative joint working to set up the integrated 2 year old review.

Working collaboratively, Julie Warwick, HCP Manager and Lesley Jallow, Early Childhood Service Manager worked with the Health Visitors, Nursery staff and Childminders to demonstrate that with effective communication positive outcomes can be achieved. Here is Julie and Lesley’s story.


Julie and Lesley read the pilot authorities evaluations, visited Islington and spoke to Council and NHS staff leading the programme and visited Archway Children’s Centre and Nursery School to observe how the integrated review was working in practice.

They agreed that they wanted to have an integrated review where everyone was together in the same room. This would empower parents to support their children’s learning and development through their involvement in the process, enabling intervention at the earliest opportunity where children needed it, and would build trust between parents and professionals and achieve good outcomes for all children.

They ran a pilot in the Crawley area in the summer of 2015; asked Health Visitor team Managers to allocate Health Visitors to Nurseries and Childminders, and used their 2 Year Old Free Entitlement data to target nurseries with funded children.

They evaluated the pilot and planned briefing sessions for all nurseries and childminders using the information gathered; attended Health Visitor training days and gave a briefing on the outcome of the trial and expectations of working practice from September, the Early Childhood Service supplied information on the location and contact details of nurseries and childminders to the Health Visiting team Managers and continued to highlight those nurseries and childminders taking funded 2 year olds.


In September 2015 they ran half-day sessions in different parts of the County and invited Nursery practitioners and Health Visitors in the local area. They arranged the seating plan so that nursery staff and Health Visitors could network with each other. The sessions covered the process everyone should follow, lessons learned from the pilot, and a session on ‘being two’ by Dr Kay Mathieson. They asked nurseries to appoint a lead practitioner for the 2 year old integrated review to be the main point of contact with the Health Visiting team, and put up to date Health Visitor contact lists in the delegate packs. They planned to roll out the integrated review across County following the areas where the NHS data collection system had been introduced so that information could be collected by Health Visitors using this on-line system.

They carried out an on-line survey of Health Visitors, Nurseries and Childminders in January 2016 to find out how well things were going, how well prepared staff felt, what was working well and not so well, and what suggestions staff wanted to make.

They also kept in touch with Crawley as the staff there were embedding the process and decided to make a short film for early years practitioners and Health Visitors to answer questions that were coming up regularly about how to carry out an effective integrated review within an early years setting. This film that will be posted on the Foundation Years website on 18/4/16. View the video here


They started moderating the implementation of the integrated 2 year old review in February 2016 through Health Visitor group sessions around the County to ensure that everyone was clear on expectations and that systems were in place to support the process.

Through the NHS data collection system are now able to see how many integrated reviews are happening across the County and this informs management decisions.

Next steps

To increase take-up and stimulate demand we will be using social media to publicise parents’ views on the integrated review.

Julie says:

“The implementation of the 2 year integrated review in West Sussex has been an interesting project to work on. All staff groups across the health visiting teams have been flexible in the approach to this review as it has meant change not only in the HV teams’ processes but in the administration and communication with a much wider Children’s workforce.

Working in an integrated way has challenged systems and highlighted the importance of communication and information sharing which has unblocked many of the barriers initially encountered.  The process is not perfect yet and we still have improvements to make but with the combined mind-set between us and examples of where it is working well we have made a great start in West Sussex.

The integrated review with our Early Years colleagues offers a much more holistic review of the child in a more relaxed setting and using the Ages and Stages Questionnaire empowers parents by being more involved in their child’s developmental stages.  Additionally it has been an opportunity to highlight public health messages to a wider audience and work collaboratively with the best interests of all children in mind”

Contact details:

Julie Warwick Healthy Child Programme Manager, Sussex Community NHS Trust

Tel: 01403227000 Ext 7683 / 07747 006777

Lesley Jallow Early Childhood Service Manager, West Sussex County Council

Tel: 0330 2228809 / 07718 668943

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