How do we work with health visitors on early SEND?

Use the integrated review at age 2 to 2.5, which combines the health visitor's Healthy Child Programme check and the EYFS progress check, to share concerns with parental consent and agree a coordinated support plan. It is the one built-in moment that fuses what your setting sees day to day with what the health visitor sees, so align your age-2 progress check timing with the local health visiting team and you turn two separate duties into a single conversation.

Start with the integrated review

Health visitors deliver five universal reviews between birth and age 5, and the 2-to-2.5-year one is where additional needs are most often first spotted. The integrated review brings that health check together with the EYFS progress check at age two, giving you two opportunities to identify needs in the same window. The Healthy Child Programme guidance asks that this includes liaison between early years practitioners and health visitors where practical and necessary, with the family's consent.

Get parental permission before you share anything. You need consent to pass a child's information to the health visitor; the parent should understand what you are sharing and why. With that in place, do this:

1. Agree with the parent that you and the health visitor will compare what each of you sees.
2. Time your age-2 progress check to sit alongside the health visitor's 2-to-2.5-year review.
3. Write a short shared summary covering communication and language, physical development, and personal, social and emotional development.
4. Agree one coordinated plan, with named next steps and who owns each.

Then keep the relationship running

After the review, your setting SENCO, supported by the local Area SENCO (the local authority adviser who supports early years settings), coordinates the ongoing information-sharing and runs the graduated approach, the assess, plan, do, review cycle that every setting uses for a child with emerging needs. A standing, consent-led relationship with the health visiting team means you are not starting from cold each time a concern arises. Where you are putting targeted support in place, our guide to the graduated approach sets out the cycle.

The duty that runs the other way

The direction of the duties is not symmetric, and this is the point top results miss. You need the parent's consent to share with the health visitor. But where a health body, meaning an integrated care board, NHS trust or NHS foundation trust, forms the opinion that a child under compulsory school age has, or probably has, SEN or a disability, it has its own legal duty to tell the parent, give them a chance to discuss it, and bring the child to the council's attention (the "section 23 notification", under section 23 of the Children and Families Act 2014). That notification runs regardless of consent once the opinion is formed, and it is a different thing from a safeguarding referral. The SEND Code of Practice (paras 5.14–5.16) sits behind this.

One change to watch: the February 2026 Schools White Paper proposes a statutory Individual Support Plan for every setting. The consultation is live now, but no changes are expected before September 2030, so the graduated approach, the age-2 progress check and the section 23 route above remain the current law.

This page is general information, not clinical or legal advice.