Guidance

Interim data submission for the universal health visiting service: 2023 to 2024

Updated 2 October 2024

This document explains what analysts and commissioners in your local authority need to do to submit health visiting activity and outcomes data to the Office for Health Improvement and Disparities (OHID) for 2023 to 2024. It should give your local team, including your service providers, the technical detail they need to assemble and submit aggregate health visiting data to the central system. By submitting data to the interim reporting system on a voluntary basis, local government contributes to our understanding of health visiting services and their outcomes and informs improvement.

If you have any questions or suggestions, please contact us at [email protected].

Data required

The metrics to report include the 5 mandated elements of service described in the Local Authorities and Local Authority regulations 2015 as universal health visitor reviews:

• antenatal reviews
• new birth visits
• 6 to 8 week reviews
• 12 month reviews
• 2 to 2 and a half year reviews

The 5 mandated elements also contain information about health outcomes as described in the Public Health Outcomes Framework. We recommend that these metrics and indicators are included as the main performance indicators outlined within local commissioning contracts. The number of health visitor reviews that family nurse practitioners undertake should be included in the total number of reviews reported.

This is a list of the indicators for collection and submission:

• C1: mothers who received a first face-to-face antenatal contact with a health visitor at 28 weeks or above
• C2: percentage of births that receive a New Birth Visit (NBV) within 14 days
• C3: percentage of births that receive a New Birth Visit (NBV) after 14 days
• C8i: percentage of infants who received a 6 to 8 week review by the time they were 8 weeks
• C8ii: infants totally or partially breastfed
• C4: percentage of children who received a 12 month review by the time they turned 12 months
• C5: percentage of children who received a 12 month review by the time they turned 15 months
• C6i: percentage of children who received a 2 to 2 and a half year review
• C6ii: percentage of children who received a 2 to 2 and a half year review using ages and stages questionnaire (ASQ-3)
• C6iii: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in communication skills
• C6iv: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in gross motor skills
• C6v: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in fine motor skills
• C6vi: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in problem solving skills
• C6vii: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in personal to social skills
• C6viii: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in all five areas of development

Full indicator specifications and validation rules can be found in appendix 1.

Online data submission

Local authorities submit their data through a website operated by the Local Government Association (LGA). To access the site and submit data for health visiting activity and outcomes, each local authority needs to use a unique link. The nominated contact for your local authority will receive a new unique organisation link by email for each quarterly reporting period in 2023 to 2024. This link will be different from those received in previous years. The nominated contact is usually the lead analyst or commissioner who is responsible for submitting your organisation’s data onto the system.

If you have any trouble with your new unique organisation link please email [email protected].

Timetable for data submission and publication

Reporting periods for data submission

Following a consultation with users about the frequency of publication and reporting, we have decided to reduce the collection dates to 2 windows for 2023 to 2024:

• reporting period 1 covers submission of data for quarters 1 and 2 2023 to 2024 (April to September 2023). The collection window opens on Monday 16 October 2023 and closes on Friday 24 November 2023
• reporting period 2 covers submission of data for quarters 3 and 4 2023 to 2024 (October 2023 to March 2024), and revision of data submitted in period 1. The collection window opens on Monday 15 April 2024 and closes on Friday 24 May 2024

These are the periods during which the LGA’s national web-based data entry system will accept uploads and submissions for the reporting period. Data entry cannot be made once the submission periods are closed.

Data should be submitted following this schedule with each submission containing all the relevant activity for the reporting period. Previously entered data can be saved and then updated by accessing the system again during the same submission period. Period 2 also enables revision of any data for a previous quarter in that year if required (see below).

Data amendments

If errors are identified in the data which has been submitted or new data becomes available, submitters should notify [email protected]. Submitters will be contacted over the summer of 2024 to ask if they wish to make any amendments, ideally by Friday 1 September 2024. Where possible, we will work with local areas to accept a manual submission of revised or additional data and include it in the annual publication for 2023 to 2024.

Publication of data collected

The provisional publication dates for the data collected are January to February 2024 for period 1, and June to July 2024 for period 2. The provisional publication date for annual official statistics for 2023 to 2024 is expected to be in November 2024.

Quarterly data will be published as a data file. Following consultation with users in June 2022, we have decided to discontinue the publication of a separate statistical commentary and instead include relevant information in the data files. The annual data will also be included in OHID’s Fingertips tool.

Reporting geography

The data collection is based on the local authority of residence of each child. This matches the structure of the public health grant and the legislation describing the universal health visitor reviews. It is the responsibility of each local authority to collect the data for their resident population, requesting data from other local authorities as required. Data for children resident in any local authority who have moved in after they received a review while resident in another local authority must be included.

There may still be work ongoing in a few areas to refine reporting by resident population where there is a variety of local IT systems and local ownership. Record level data in Child Health Information Systems (or equivalent) records both GP practice of registration and local authority of residence for each child.

The data items required should be extracted directly from the appropriate local information systems, such as Child Health Information System (CHIS), health visiting systems and Patient Administration Systems (PAS) as appropriate.

Data submission: a step-by-step guide

Step 1: review your local information flow model

In advance of the first submission for 2023 to 2024, review how arrangements have worked in previous years. Make any decisions about whether you will continue with established flows or make changes to improve them. You will need to ensure that robust arrangements are still in place to collect the data through commissioning arrangements, ensuring that your providers can submit data based on where every child lives (residence of child).

Step 2: receive data from provider(s) each quarter

Following the end of the quarter you will start to receive data from your provider or providers. If you receive data which relates to other local authorities, you will need to disseminate it among the appropriate local authorities. Your provider should submit data to NHS England’s community services data set (CSDS) as well. Please see the end of this section for more detail.

Step 3: collate figures for each quarter

Collate your own local authority figures for each metric required by bringing together all the data files you have received. This includes suggested validation processes which focus on checking that numbers make sense as they are entered, as well as ‘sense-checking’ denominators against recent population estimates.

The collation spreadsheet allows extra fields to be added if you wish to record additional data items which you collect locally. Any validation rules for these will need to be applied locally and you will not be able to submit these to the interim reporting system.

Step 4: local data validation for each quarter

Perform local data validation to identify issues and address them with your providers or other local authorities and resolve them to your satisfaction. Use the collation spreadsheet, comparison to previous submissions, and the definitions in this technical guidance to sense-check your data. It is hoped that local authorities will work together to identify issues that may relate to specific providers.

Step 5: local authorities ‘sign off’ data each quarter

Arrive at a final, agreed value for each metric representing activity delivered to children living in your local authority (residents) and outcomes, going through any internal approvals processes your local authority requires.

Step 6: submission of data through the LGA

Following the end of the quarter the collection window for submission opens. A unique link for the LGA online system will be emailed to you (or to the nominated individual in your local authority); this will take you to a data upload screen with instructions for navigating through the data return.

Complete this process for the current quarters. Your entries will be saved when you navigate away but they will not be submitted until you finalise your submission on the last page. Once you have submitted the data you cannot revise it in the same submission period, so please make sure you are happy with the data before you click to complete the process.

It is important that you enter up-to-date contact information and ‘sign off’ authorisation details on the LGA web-based data entry system so that we can maintain contact with you.

Step 7: publication of official statistics

Approximately 2 months after the end of the submission window, the quarterly statistics are published as official statistics. This includes updated statistics for previous quarters. Published statistics are available in the child and maternal health statistics collection.

Background

From 1 October 2015, the responsibility for commissioning children’s public health 0 to 5 years (including the delivery of universal health visitor reviews) transferred from the NHS to local authorities as part of their public health function. These services are funded through the public health grant for local authorities. It is important that we can understand, track and benchmark performance collectively.

This interim collection covers the delivery of universal health visitor reviews (mandated services) and outcomes, including breastfeeding at 6 to 8 weeks and child development outcomes aged 2 to 2 and a half years. The longer term strategic solution for data collection and reporting for these metrics is the community services data set (CSDS) which is operated by NHS England (formerly NHS Digital). Providers of publicly funded community services are legally mandated to collect and submit community health data, as set out in the Health and Social Care Act 2012.

While the CSDS is operational and reporting is underway, providers remain at different stages of maturity with their submissions and additional time is needed for this dataset to reach sufficient coverage for reporting purposes. Additional guidance can be found in NHS England resources about implementing the CSDS.

This interim reporting solution allows local authorities to gain a clear picture of the delivery of local universal health visiting services and make comparisons to other parts of the country. The data also helps secure standardised information to demonstrate improvements in commissioning, aid future local planning of service provision and enable benchmarking across populations to detect trends in 0 to 5 year olds’ public health.

The interim reporting remains a voluntary data submission and your ongoing support in submitting data is appreciated. Interim reporting to OHID should in no way distract your provider from making submissions to the CSDS. We are asking local authorities for the aggregate data which they would be expected to have available to monitor their local commissioning contracts. Please use your local commissioning contracts to ensure your providers continue to submit record level data to the CSDS and work with them to improve data coverage and quality.

Options for the future of interim reporting for children’s public health 0 to 5 years after the 2023 to 2024 collection are being considered. One of the options is to discontinue these interim arrangements. It is possible that the 2024 to 2025 health visitor service delivery, breastfeeding and child development outcomes statistics may be derived from CSDS. Local authority directors of public health will be kept informed about their data quality in CSDS and what to expect if and when CSDS becomes the data source for these statistics. If you have questions about this, please email [email protected].

CSDS submissions to NHS England by service providers

To secure reporting through the CSDS, it is recommended that local commissioners:

• use the supporting commissioning guides (updated March 2021) to assist in the commissioning of health visiting and school nursing services to lead and co-ordinate delivery of public health for children aged 0 to 19 years
• ensure that local service providers benefit from the operation of a Child Health Information System (or equivalent) and that the standardised data required is entered into this system
• ensure that NHS England is informed of every health visiting service provider commissioned by your local authority (including when this changes) so coverage of CSDS data submissions can be monitored and uptake supported
• ensure that the standardised data flows from the local Child Health Information System (or equivalent) to NHS England via the CSDS flows monthly
• ensure that local information sharing agreements are in place for the sharing of performance data between providers and commissioners where necessary

The Healthy Child Programme is a universal framework available to all children and aims to ensure that every child gets the good start they need to lay the foundations of a healthy life. The universal reach of the Healthy Child Programme provides an invaluable opportunity from early in a child’s life to identify families that may need additional support and children who are at risk of poor outcomes. The 0 to 19: health visitor and school nurse commissioning guides give further detail about the programme.

OHID’s interim reporting system includes reporting from the ages and stages questionnaire (ASQ) to cover child development outcomes aged 2 to 2 and a half years. These metrics are available through the early years section in child health profiles in OHID’s Fingertips tool and cover the number and percentage of children at or above the expected level of development in each of the domains of development (communication, gross motor, fine motor, problem solving, personal-social skills), as well as the number of children at or above the expected level of development (scoring above the threshold) in all 5 domains.

Of those, the following have been included in the Public Health Outcomes Framework:

• child development - percentage of children at or above the expected level of development in communication skills at 2 to 2 and a half years
• child development - percentage of children at or above the expected level of development in personal-social skills at 2 to 2 and a half years
• child development - percentage of children at or above the expected level of development at 2 to 2 and a half years

Commissioners are asked to review the data submitted by their provider and support them where necessary to improve the quality and coverage of this ASQ data. The licence held for ASQ-3 allows for the individual domain scores to be recorded in local IT systems and transmitted to NHS England.

Important indicators in the Public Health Outcomes Framework for best start in life

The Public Health Outcomes Framework (PHOF) is published as Official Statistics. This includes various indicators which are derived from data submitted through the interim reporting system:

• breastfeeding prevalence at 6 to 8 weeks after birth
• proportion of new birth visits (NBVs) completed with 14 days
• child development - percentage of children at or above expected level of development in all 5 domains of development at 2 to 2 and a half years
• child development - percentage of children at or above expected level of development in communication skills at 2 to 2 and a half years
• child development - percentage of children at or above expected level of development in personal-social skills at 2 to 2 and a half years

The online version of the PHOF allows local government to compare services and outcomes in their local area with those in others, alongside other important health and wellbeing indicators.

Monitor compliance with the regulations for the mandated universal health visitor reviews and delivery of services funded via the public health grant

This includes coverage of the antenatal visit, new birth visit, 6 to 8 week review, 1 year review and 2 to 2 and a half year review as described in The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) and Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) (Amendment) Regulations 2015 and which continue under the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) (Amendment) Regulations 2017. Further guidance about the reviews is given in 0 to 19: health visitor and school nurse commissioning guides.

Useful links

NHS England regularly publishes data from the CSDS.

Quarterly and annual data from the interim reporting system about health visitor service delivery and outcomes for children aged 0 to 5 years is available from 2015:

• health visiting service delivery metrics
• breastfeeding at 6 to 8 weeks
• child development outcomes at 2 to 2 and a half years

Appendix 1: full indicator specifications and validation rules

Indicator C1: mothers who received a first face-to-face antenatal contact with a health visitor at 28 weeks or above

• definition: mothers who received a first face-to-face antenatal contact with a health visitor at 28 weeks or above
• numerator: number of mothers who received a first face-to-face antenatal contact with a health visitor at 28 weeks or above
• denominator: not applicable
• method: due to difficulties in establishing a reliable denominator, this is a count
• validation: no validation performed

Indicator C2: percentage of births that receive a New Birth Visit (NBV) within 14 days

• definition: percentage of births that receive a face-to face New Birth Visit (NBV) within 14 days by a health visitor
• numerator: number of infants who turned 30 days in the quarter who received a NBV within 14 days from birth, by a health visitor with mother (and ideally father)
• denominator: number of infants who turned 30 days within the quarter. Infants should be included in the denominator even if the NBV is declined
• method: percentage reported to one decimal point
• validation: the combined numerators of C2 and C3 (all babies who received a new birth visit) and denominator (total number of infants who turned 30 days in the quarter) are integers, and combined numerators of C2 and C3 less than or equal to denominator

Indicator C3: percentage of births that receive a New Birth Visit (NBV) after 14 days

• definition: the percentage of births that receive a face-to-face NBV after 14 days by a health visitor
• numerator: number of infants who turned 30 days in the quarter who received a face-to-face NBV after 14 days from birth, by a health visitor with mother (and ideally father)
• denominator: number of infants who turned 30 days in the quarter. Infants should be included in the denominator even if the NBV is declined
• method: percentage reported to one decimal point
• validation: the combined numerators of C2 and C3 (all babies who received a NBV) and denominator (total number of infants who turned 30 days in the quarter) are integers, and combined numerators of C2 and C3 less than or equal to denominator

Indicator C8i: percentage of infants who received a 6 to 8 week review by the time they were 8 weeks

• definition: percentage of infants who received a 6 to 8 week review by the time they were 8 weeks
• numerator: number of infants who are due and receive a 6 to 8 week review by the time they turned 8 weeks
• denominator: number of infants due a 6 to 8 week review by the end of the quarter. Infants should be included in the denominator even if the 6 to 8 week review is declined
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is within 20% of the resident population of the relevant age (0 years for 6 to 8 week reviews)

Indicator C8ii: infants totally or partially breastfed

• definition: percentage of infants being breastfed (totally or partially) at 6 to 8 weeks
• numerator: number of infants recorded as being totally breastfed at 6 to 8 weeks plus number of infants recorded as being partially breastfed (receiving both breastmilk and formula) at 6 to 8 weeks. The number of infants recorded as not breastfed at 6 to 8 weeks is also collected for validation purposes
• denominator: number of infants due a 6 to 8 week review by the end of the quarter. Infants should be included in the denominator even if the 6 to 8 week review is declined.
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator (combined number of infants fully breastfed and number of infants partially breastfed) less than or equal to denominator; stage 2 - indicator denominator is within 20% of the resident population of the relevant age (0 years for 6 to 8 week reviews); stage 3 - the combined number of infants with known breastfeeding status is greater than or equal to 95% of the denominator

Indicator C4: percentage of children who received a 12 month review by the time they turned 12 months

• definition: percentage of children who received a 12 month review by the time they turned 12 months
• numerator: number of children who turn 12 months in the quarter, who receive a 12 month review, by the age of 12 months
• denominator: number of children turning 12 months during the quarter. Infants should be included in the denominator even if the 12 month review is declined
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator is less than or equal to denominator; stage 2 - indicator denominator is within 20% of the resident population of the relevant age (1 year for 12 month reviews)

Indicator C5: percentage of children who received a 12 month review by the time they turned 15 months

• definition: percentage of children who received a 12 month review by the time they turned 15 months
• numerator: number of children who turn 15 months in the quarter, who receive a 12 month review, by the age of 15 months
• denominator: number of children turning 15 months during the quarter. Children should be included in the denominator even if the 12 month review is declined
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator is less than or equal to denominator; stage 2 - indicator denominator is within 20% of the resident population of the relevant age (1 year for 12 month reviews)

Indicator C6i: percentage of children who received a 2 to 2 and a half year review

• definition: percentage of children who received a 2 to 2 and a half year review
• numerator: number of children, due a 2 to 2 and a half year review by the end of the quarter, who received a 2 to 2 and a half year review by the time they turned 2 and a half years
• denominator: number of children aged 2 and a half years in the quarter. Children should be included in the denominator even if the 2 to 2 and a half year review is declined
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is within 20% of the resident population of the relevant age (2 years for 2 to 2 and a half year reviews)

Indicator C6ii: percentage of children who received a 2 to 2 and a half year review using ages and stages questionnaire (ASQ-3)

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3
• numerator: number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review
• denominator: number of children who received a 2 to 2 and a half year review by the end of the quarter. Children should be included in the denominator even if the 2 to 2 and a half year review is declined
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator is less than or equal to denominator; stage 2 - indicator denominator is within 20% of the numerator of indicator C6i

Indicator C6iii: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in communication skills

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the threshold in the communication skills domain
• numerator: number of children who received a 2 to 2 and a half year review using either the 24-, 27- or 30-month ASQ-3, who scored above 25.17, 24.02 or 33.30 respectively in the communication skills domain
• denominator: number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Indicator C6iv: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in gross motor skills

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the threshold in the gross motor skills domain
• numerator: the number of children who received a 2 to 2 and a half year review using either the 24-, 27- or 30-month ASQ-3, who scored above 38.07, 28.01 or 36.14 respectively in the gross motor skills domain
• denominator: the number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Indicator C6v: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in fine motor skills

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the threshold in the fine motor skills domain
• numerator: the number of children who received a 2 to 2 and a half year review using either the 24-, 27- or 30-month ASQ-3, who scored above 35.16, 18.42 or 19.25 respectively in the fine motor skills domain
• denominator: the number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Indicator C6vi: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in problem solving skills

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the threshold in the problem solving skills domain
• numerator: the number of children who received a 2 to 2 and a half year review using either the 24-, 27- or 30-month ASQ-3, who scored above 29.78, 27.62 or 27.08 respectively in the problem solving skills domain
• denominator: the number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator are less than or equal to the denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Indicator C6vii: percentage of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in personal to social skills

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the threshold in the personal-social skills domain
• numerator: the number of children who received a 2 to 2 and a half year review using either the 24-, 27- or 30-month ASQ-3, who scored above 31.54, 25.31 or 32.01 respectively in the personal-social skills domain
• denominator: the number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Indicator C6viii: number of children who received a 2 to 2 and a half year review in the quarter who were at or above the expected level in all 5 areas of development

• definition: percentage of children who received a 2 to 2 and a half year review using ASQ-3, who were above the thresholds across all 5 domains
• numerator: the number of children who received a 2 to 2 and a half year review using ASQ-3, who scored above the relevant thresholds across all 5 domains of the ASQ
• denominator: the number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ-3 was completed as part of their 2 to 2 and a half year review. Please note this should be the same as the numerator for C6ii
• method: percentage reported to one decimal point
• validation: stage 1 - indicator numerator and denominator are integers, and numerator less than or equal to denominator; stage 2 - indicator denominator is equal to the numerator for C6ii

Appendix 2: detailed example of calculating child development indicators for 2 to 2 and a half year reviews

Difference between the denominators of C6i (percentage of 2 to 2 and a half year reviews completed) and C6ii (percentage of 2 to 2 and a half year reviews completed using ASQ-3)

The denominator for C6i is the number of children turning 2 and a half during the period. The denominator for C6ii is the number of 2 to 2 and a half year reviews that were carried out during the period.

So, for example, 200 children are due a review in Quarter 2. Of these:

Include: 190 receive their review in the quarter, and before they turned 2 and a half (160 using ASQ)

Include: 6 children turned 2 and a half at the beginning of the quarter and had their review after that point, still during Quarter 2 (2 using ASQ)

Include: 4 children had had their review in Quarter 1 (3 using ASQ)

In addition, 15 children who are due a review in Quarter 3 have their 2 to 2 and a half year reviews in Quarter 2 (11 using ASQ). The denominator for C6i is the children due a review in the quarter (200 children).

The numerator for C6i is:

Total number of children, due a 2 to 2 and a half year review by the end of the quarter, who received a 2 to 21 /2 year review by the time they turned 2 and a half years.

Include: 190 receive their review in the quarter, and before they turned 2 and a half

Exclude: 6 children turned 2 and a half at the beginning of the quarter and had their review after that point, still during Quarter 2 (not included as review carried out after the child turned 2 and a half )

Include: 4 children had had their review in Quarter 1

Exclude: 15 children who are due a review in Quarter 3 have their 2 to 2 and a half year reviews in Quarter 2 (11 using ASQ) (not included as review not due in Quarter 2)

= 194

The denominator for C6ii is:

Total number of children who received a 2 to 2 and a half year review by the end of the quarter.

Include: 190 receive their review in the quarter, and before they turned 2 and a half

Include: 6 children turned 2 and a half at the beginning of the quarter and had their review after that point, still during Quarter 2

Exclude: 4 children had had their review in Quarter 1 (not included as reviews not carried out in Quarter 2)

Include: 15 children who are due a review in Quarter 3 have their 2 to 2 and a half year reviews in Quarter 2

= 211

The numerator for C6ii is:

Total number of children who received a 2 to 2 and a half year review by the end of the quarter for which the ASQ 3 was completed as part of their 2 to 2 and a half year review.

Include: 190 receive their review in the quarter, and before they turned 2 and a half . (160 using ASQ)

Include: 6 children turned 2 and a half at the beginning of the quarter and had their review after that point, still during Quarter 2 (2 using ASQ)

Exclude: 4 children had had their review in Quarter 1 (3 using ASQ) (not included as reviews not carried out in Quarter 2)

Include: 15 children who are due a review in Quarter 3 have their 2 to 2 and a half year reviews in Quarter 2 (11 using ASQ)

=173