Ms Leadsom’s recommendations, which were put before Government today (26 March), include a new ‘Start for Life’ package for prospective parents setting out a universal offer of health visiting, midwifery, breastfeeding and mental health support. Parents will be able to access these services from family hubs, similar to Labour’s Sure Start centres, which will also offer childcare, early education and healthcare, as well as advice on jobs and training.
This will be led by an ‘empowered, modern skilled’ Start for Life workforce, which will meet the changing needs of families with babies, looking at new ways to support and empower staff to increase retention of health visitors, Ms Leadsom said.
Launching the review, which has six key actions points, Andrea Leadsom MP said, ‘I am confident that delivering this vision will help millions of families to give their baby the very best start for life.
‘It sets out an ambitious programme of work to transform the support for families. Work to implement it will begin in the coming months. The goal is to ensure the best support throughout those 1,001 critical days, setting babies up to maximise their potential for lifelong emotional and physical well-being.’
Health Minister Jo Churchill added, ‘To implement this work, the Department for Health and Social Care will work with Public Health England, NHS England and Improvement as well as local government to map out the Start for Life journey of parents and carers that captures how they experience digital, virtual and telephone-based services during the 1,001 critical days from conception to the age of two. We will ensure parents and carers have an NHS-branded ‘one stop shop’ online to access all the information they need.’
There will be a cabinet minister responsible for implementing the Start for Life programme, which the review considers the key to success.
Tomorrow the implementation phase will begin with the creation of a new delivery unit across Whitehall with responsibility to deliver the first goals - look at needs and priorities of workforce and will be working with treasury officials to make economic case.
Ms Leadsom will continue to chair the review and the implementation phase will take about a year.
Sally Hogg, co-ordinator of the First 1001 Days Movement, welcomed the Government’s commitment to improving health and wellbeing from conception to age two and said that the review should act as a ‘springboard’ towards an ambitious cross-government strategy and implementation plan for under-twos.
But she added, ‘Building on the actions set out today, the Government must now create a timeline for delivery and clarify which Cabinet Minister will take responsibility for overseeing this programme of work. 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. The Government should also maximise the opportunities provided by other significant policy changes such as the Public Health England restructure and NHS reforms.’
Deprivation
The review acknowledges that getting things right for children in the first 1001 days holds the key to levelling up opportunities for those born in more deprived areas. Children living in households in the lowest socio-economic groups have significantly worse health outcomes than other children. These can be caused by stress and smoking in pregnancy, as well as communication problems due to language inequalities.
Ms Hogg said, ‘Making a reality of the vision set out today, and strengthening our depleted services, is vital to tackling the health and educational inequalities that have been growing in recent years and have been further exacerbated by the pandemic. The Government can level up and improve life chances for children not only by improving the services on offer for families, but also by tackling the growing adversity and poverty faced by many families.’
Digital 'red book'
Work will be brought forward to roll out the digitalisation of the ‘red book’, which contains details and information about baby’s growth and development. This will apply to every new birth from April 2023, which is a year earlier than planned. Digitising it will ensure information is easier to store, protect it from being lost and make it easier to share with medical staff.
Services will also designed around giving families the information they need when they need it. For example, digital, virtual and telephone services.
Skilled workforce
This review prioritises the need for a skilled, resourced and empowered workforce that can provide a quality service to families.
Ms Hogg said, ‘The Start for Life Unit should develop a workforce strategy setting out how it ensures sufficient, highly skilled workforce across universal, targeted and specialist services. The Government must invest in rebuilding the health visiting workforce which has been reduced by almost a third since 2015.
‘In addition, a specialist workforce, including highly skilled psychologists and psychotherapists, is required to deliver services like parent-infant relationship teams which support families facing more severe or persistent challenges. These specialists can offer training, consultation and supervision to help the wider workforce support families with more complex needs.’
Justin Irwin, interim CEO at the Parent-Infant Foundation said, ‘The review describes the value of specialist parent-infant relationship support, which should be part of the offer of mental health services available to families in each local area. It also recognises the action and investment needed to grow the specialist parent-infant workforce. This recognition is welcome. The NHS Long Term Plan committed to the development of specialist mental health provision for all children – including the youngest – but without a drive from national government and NHS England this goal will not be realised. We hope that the Start-for-Life Unit can provide this drive and secure the investment required.’
Purnima Tanuku, chief executive of the National Day Nurseries Association, said, 'This is a vital review for early childhood as we know a child’s earliest years are a crucial stage of development that determines their chances later in life. Families have struggled during the past twelve months with babies born during the pandemic and some young children spending most or all of their lives living under lockdown conditions.
'The impact this will have on Covid babies in terms of attachment and socialisation with other children is of great concern, especially where they have not had the usual social contact with their wider families and other children. High quality early education and care is important for all children to gain the skills for the future and lifelong learning.
'The Government could take this opportunity to provide additional investment in children’s early years and develop a family-centred system. To level up opportunity and address inequalities we need to see more support for families and providers in less advantaged areas who are being hit hard by chronic underfunding and the impact of Covid-19.'
Annamarie Hassall, director of practice and programmes at the National Children’s Bureau, said, 'Early years practitioners are some of the most undervalued professionals in the country. If we are serious about improving the lives of young children, we must make sure the early years workforce benefits from high quality professional development and acess to the latest research and training.
'Babies and very young children are too often overlooked by policymakers, but the past year has reminded us just how fragile their welfare is. Andrea Leadsom’s report points to the urgent improvements that are needed to support children during the vital period from conception to age two, including inclusive and accessible information for parents, more joined up services, and stronger leadership at local and national level.
'The report asks the right questions but now we need to know that the Government is prepared to deliver the right answers. We welcome the Prime Minister’s decision to appoint a Cabinet level minister to see these reforms through, and their role will be crucial in bringing an often-fragmented system together. Attention must also turn to the Treasury, who must ensure these promises to parents are fully funded in the Comprehensive Spending Review.'
- The review is available here