First 1001 Days Movement response to the Start for Life Vision

The Start for Life Review is a welcome government commitment to improve health and wellbeing in the First 1001 Days, from pregnancy to age two. It provides a solid evaluation of the services, workforce and leadership needed to improve outcomes during these formative years. As the document itself recognises, “The words on the page will not change what happens”, it is “what happens next that matters”. More work and resource will be required to ensure that the ambitions set out in this review become a reality for families. We look forward to discussing the details and practicalities with Government. 

 Today’s document should act as a springboard towards an ambitious cross-government strategy and implementation plan for under-twos. 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. 

As the review acknowledges, the national lockdown has limited opportunities to identify child development concerns and to support parents struggling at a time of increased need. The pandemic has taken a heavy toll on babies brought into the world at a time when 60% of parents have reported serious concerns about their mental health. Fathers have been routinely excluded from perinatal services. Many elements of the Healthy Child Programme were paused when families needed it most, creating a backlog of missed check-ups and support that have not been addressed by catch-up funding. In addition to the long-term reform set out in this review, urgent government action must be taken to include all parents and babies in the nation’s recovery from the pandemic. 

The Start for Life Review paves the way for a clear universal offer in every local area including health visiting, midwifery, breastfeeding and mental health support, as well as welcoming hubs where families can access public and third sector services. Alongside introduction of a digital red book, there are opportunities for integrated care systems to reach all families with enhanced support using digital resources to provide personalised, parent-centred, peer-reviewed information with signposting to local and national services.

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. As the review acknowledges, getting things right for children in the first 1001 days holds the key to levelling up opportunities those born in more deprived areas. 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.

This review is right to prioritise a skilled, resourced and empowered workforce that can provide a quality service to families. The Start for Life Unit should develop a workforce strategy setting out how it ensure 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.