The Government has today published its Early Years Healthy Development Review “The best start for life: a vision for the 1,001 critical days”, which was led by Early Years Health Adviser Andrea Leadsom MP. The review, initiated in July 2020, intends to set out a “vision for best practice across the health system to ensure babies and children can get the best possible start”.
Measures to tackle the impact of inequality during the first 1,001 days
The review seeks to recognise that care given during the first 1,001 days of a child’s life has “more influence on a child’s future than at any other time in their life… However, children living in households in the lowest socio-economic groups have significantly worse health outcomes than other children”.
The review is seen as playing a key part of the Government’s ‘levelling up’ agenda, with Andrea Leadsom MP saying “The coronavirus pandemic has put even more pressure on already-struggling families and, just as we need to level up economic opportunity across the country, we need to level up the support and care for the very youngest.”
Health and Social Care Secretary Matt Hancock, who wrote a foreword to the review, stated:
“Everybody should have a solid foundation on which to build their health and we are determined to level up the opportunities for children, no matter their background from or where they grow up.”
Health Minister Jo Churchill meanwhile added her commitment to “removing barriers so all children are supported and nurtured so they are ready for life.”
Key recommendations and Action Areas
Key among the recommendations put forward by the review are calls for local authorities to offer a new Start for Life pack, outlining all of the key services and support available to parents in this critical early stage of a child’s life. These packs will make “parents and carers aware of what support they can expect in their local area, including services they should expect to receive like health visits, and localised and specialist services, such as help to quit smoking and intensive parenting support”.
The review calls for the establishment of family hubs, a recommendation that has been seized upon by some as a call for the Government to backtrack on a long-term downward trend in resourcing for Sure Start centres.
Leadsom acknowledged the Sure Start similarities, saying
“I think the key thing with the family hubs is, they will be a welcoming place for all families: that’s where Sure Start started… We’ll certainly be working with local authorities on how they can bring their Sure Start estate into the family hub network.”
Other key recommendations include a commitment to digitising the ‘Red Book’, children’s health records by April 2023 to ensure seamless access to data for parents and health practitioners, and a major push to empower a new Start for Life “modern skilled workforce” to deliver the new programme.
To achieve its aims the review has outlined six key action areas to address
Action Area 1: Seamless support for new families
This will be tackled through the new Start for Life pack, ensuring a more joined up approach in communication between local provision and new parents.
Action Area 2: A welcoming hub for families
This builds on past commitment to champion family hubs, making them a place for families to access Start for Life services, such as childcare, early education and healthcare, as well as advice on jobs and training.
Action Area 3: The information families need when they need it
This will include the implementation of new digital telephone and virtual services and the above-mentioned digitisation of children’s Red Books.
This involves bringing forward an already planned digitisation of these records and will be implemented with the support of NHSX and in consultation with parents.
Action Area 4: An empowered Start for Life workforce
There are two newly defined remits; one is developing a new workforce to “meet the changing needs of families with babies” and a drive to “support and empower staff to increase retention of health visitors”.
Action Area 5: continually improving the Start for Life offer
The review highlights key accountabilities and measures, for example “health services for families and babies must improve data, evaluation and outcomes to ensure they are meeting a family’s needs”. There is a renewed commitment to “hold local services to account, including through proportionate inspections, giving parents and carers confidence and assurance that services are working in their area”.
Action Area 6: Leadership for change
Work will begin to encourage local areas to nominate a leader and to ensure the delivery of the review is overseen at a national level.
Well received, but with long-standing questions around Government commitment and funding:
The review has been largely well received across the Early Years and Healthcare sectors, although concerns remain as to whether HM Treasury will provide enough resource to effectively see through all of the recommendations, with the 1001 Days Movement stating:
“It is vitally important that this review informs the next Spending Review. The Treasury must now commit to working with other government departments to ensure that there is funding available to deliver this vision.”
Home Start similarly welcomed the review, but again urged the Government to follow-through with clear and generous financial commitment:
“We welcome the ambitions set out in the review but would urge government to make tangible commitments to enable parents to give their babies the strongest start in life… Sustainable investment in the support structures for babies, children and families is long overdue.”
Cross-Government support for implementation.
To implement the recommendations the Department for Health and Social Care will work with Public Health England, NHS England and Improvement, as well as local governments, and aims to work with parents and carers to capture “how they experience digital, virtual and telephone-based services during the 1,001 critical days from conception to the age of 2.”
This implementation phase is expected to begin in the next few months.
The Chair of the Early Years Healthy Development Review, Rt Hon Andrea Leadsom MP, made the following video to act as an explainer and introduction to the review and its recommendations:
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