The Sure Start programme of children’s centres made a real difference, but funding cuts have seen thousands close. What needs to happen now? Journalist Kaye McIntosh reports.
Imagine a government policy that improves the life chances of disadvantaged children, boosting their GCSE results by up to three grades and reducing the number of children injured or ill enough to go to hospital.
Research by the Institute of Fiscal Studies (IFS) has shown that’s what Sure Start achieved (IFS, 2024). By 2010-11, the programme had developed into a network of 3500 one-stop shops across England, bringing together health services and early years education, parenting support and childcare. They operated in deprived areas but were open to all.
However, Conservative government cuts saw the numbers drop dramatically. From 2010 to 2022, the IFS report says funding fell by two-thirds. More than 1300 centres closed (IFS, 2024). Government support (at time of writing: pre-election) has been focused on subsidising nursery and childcare fees (HM Treasury, 2024).
‘The dismantling of Sure Start after 2010 and the cuts to early intervention funding were a historic mistake,’ says Anne Longfield, the former Children’s Commissioner in England who is now chair of the Centre for Young Lives.
‘The consequences are the large numbers of families in crisis, or on the edge of it, going without help; high rates of absenteeism from school; the growing epidemic of poor mental health; the increasing numbers of children with special educational needs and disabilities; and the ever-higher amounts being spent by councils dealing with late intervention.’
SURE START: EDUCATIONAL BENEFITS
The 2024 IFS report focuses on education, following previous research findings that outlined important health benefits of Sure Start (IFS, 2021). The 2024 IFS report found that performance improved throughout children’s school careers, lasting until at least GCSEs. There were much bigger effects of living near a Sure Start centre for those from the most deprived backgrounds and those from ethnic minorities. By the time students took their GCSEs, effects were six times higher for those eligible for free school meals than the rest.
Positive impacts for the poorest families were spread across children of all ethnicities. But among those not eligible for free school meals, Sure Start significantly improved school results for children from ethnic minority backgrounds only.
The success of Sure Start was almost entirely due to the first wave, which opened from 1999-2003. These had bigger budgets than the centres that opened later.
Much of this extra funding focused on reaching out to disadvantaged families who were both less likely to use and more likely to benefit from Sure Start. The early programmes also had much more community input into what was offered.
Nick Ridpath, report co-author and IFS economist, says that while it’s not absolutely clear what drove the improvement in educational results, ‘we find that centres that spent a lot more on teacher input into early learning were particularly effective’.
SURE START: BETTER HEALTH
Previous work (IFS, 2021) found that Sure Start reduced the numbers attending hospital due to injuries or illness. ‘It suggested that there might be improvements in parenting style and parenting in ways that help children stay safe,’ Nick says.
Play sessions may have helped certain groups needing extra support, such as very young parents. The early learning curriculum used at Sure Start, developed with the input of teachers, was a key element.
The 2021 IFS report found employment support wasn’t a factor, Nick notes. ‘Job centre links with Sure Start centres didn’t seem to have much of an effect. There doesn’t seem to have been a particular boost in parents’ employment.’
Other than funding and community input, what else made a difference? ‘One thing that was particularly prominent in the centres that had the biggest effects is outreach. It does seem that reaching out to disadvantaged families appeared to lead to particularly positive impacts,’ Nick explains.
Today’s picture is much less bright. ‘Some local authorities have lost 70-80% of their children’s centres,’ says Ruth Maisey, head of the Nuffield Foundation’s education programme.
The danger, she suggests, is that policy-makers think ‘you can withdraw those early intervention services without immediate cost’, Ruth adds. ‘The cost arrives later. It’s counterproductive.’
FAMILY HUBS – NOT UNIVERSAL
In 2023 the Conservative government provided money for ‘family hubs’ in 75 deprived areas in England. However, the funding – £301m over three years – is a fraction of what Sure Start had and is currently set to end in 2025. Meanwhile, there are only about 400 family hubs (Department of Health and Social Care, 2024).
In response, the Department for Education said at the time (of the 2024 IFS report), that it was spending more on early years overall (Standley, 2024).
Family hubs aim to join up and enhance services for parents, carers and children up to the age of 19 (or up to 25 if there are special educational needs or disabilities). But it’s not a universal offer, as provided by Sure Start. Family hubs – which are perhaps less well known than Sure Start, suggests Ruth – focus on families with the highest needs, and so there’s a risk of creating a stigma that puts parents off.
Unite (health) lead professional officer, Ethel Rodrigues, says that some family hubs have less involvement from qualified professionals with specialist knowledge. ‘As a professional, when you talk to a mum about a new class, you can ask if they’re getting enough sleep, you can pick up postnatal depression.’
But in a family hub there can be fewer ‘professionals specialising in actually caring for these children’, Ethel notes. The exact mix of professionals involved working together varies. While some hubs include health visitors, school nurses and early years staff, others do not (Department for Education, 2023). Support workers are valuable members of the team, Ethel says, but they don’t have the same depth of knowledge to spot problems and know how to refer on.
‘What training was offered to these people? Who satisfied their competence?’ When they find difficult cases, do they know who to refer to, Ethel asks. The picture now is one of ‘fragmented services’ she suggests.
FOCUS ON EARLY INTERVENTION
‘If family hubs are going to be the new movement I would like to see more community professional involvement such as health visitors and school nurses,’ says Ethel. The activities on offer should promote child development. ‘There is a need to invest in these services.’
Information sharing is also a problem. Former Children’s Commissioner Anne says: ‘Although there is a family hub network that does share some information, there isn’t a national programme, or national information hub for all of those children’s centres and family hubs. I think that that is a gap.’
Ethel says that the government elected to power in July ‘should review what is happening and make a very conscious decision to actually put children at the centre of what they are doing’. She adds: ‘Because we know the benefits.’
Ruth from the Nuffield Foundation says she ‘would like to see a more strategic approach’, with a focus on integrated services. Although Sure Start was open to all – rich or poor – ‘the evaluations emphasise that these services had more effect in disadvantaged areas or for disadvantaged families’, she notes.
| RESOURCES |
| > The 2024 IFS report: The short- and medium term impacts of Sure Start on educational outcomes |
| > How are family hubs doing? Family Hubs Innovation Fund Evaluation Final research report |
| > The future: The Centre for Young Lives has called for an updated model of Sure Start |
| > Family Hubs and Start for Life programme guide |
Ruth also highlights the importance of investing in early intervention. ‘It’s so easy to end up firefighting and focusing on the problems that have arisen with children’s mental health or with speech and language problems. If you had invested upstream, those might not have transpired.’
Anne calls for a ‘consistent infrastructure that is high quality, robust and that parents rely on. The new government should bring family hubs together with the remaining children’s centres that are still operating, and create and rebuild an infrastructure of support for families in disadvantaged areas.’
CPHVA executive chair Janet Taylor agrees: ‘We believe it’s money well spent to have a robust programme that works in partnership across children’s services, health visiting, community nursery nursing and more. It’s investing in our children’s future, and it’s evidence based. Early intervention will reap rewards in the long term. Why would you not support that?’
FAMILY HUBS – HOW ARE THEY DOING?
A government evaluation of family hubs in six local authorities in England found some positive results (Department for Education, 2023). Generally, there were positive differences in the percentage of children aged from three to four benefiting from funded early years education, and on the percentage of Key Stage 4 children going to or remaining in education or employment.
The Essex Child and Family Wellbeing Service scored highly. It combined services from 10 providers into an integrated model. This brought together the 0-5 and 5-19 age group healthy child programmes, school nursing, family nurse partnership, children’s centres, the healthy schools programme, community specialist health services, speech and language, and special educational needs and disabilities (SEND) support. It improved accountability as one provider is held responsible for outcomes.
The Essex workforce consistently reported gathering new skills and competencies through integrated family hub working. They valued the common assessment plan and case management system across the hub workforce.
Improvements in Essex started before family hubs – locally named the Essex Child and Family Wellbeing Service – were introduced in 2017. For instance, the rate of Child in Need plans has been steadily falling since 2018.
The evaluation estimated that Essex stands to save £29 million over seven years, from 2017-18 onwards. However, the evaluation was unable to conclude that this was the result of family hubs – no causal link was established. It noted though, that: ‘This does not mean that outcomes will not be detected in the future.’ Family hubs have played a part ‘creating a step change in the organisation and provision of local family services’, it added.
THE REST OF THE UK A FLYING START?
The Flying Start programme in Wales offers:
> part-time childcare for 2- to 3-year-olds
> health visiting
> parenting programmes
> support for speech, language and communication.
It targets areas with the highest proportions of children aged 0-3 living in households on benefits. It brings together HVs, community nursery nurses, family workers, speech and language therapists, early years teachers and support staff.
The teams offer support such as baby massage sessions and activities, and advice on feeding, sleep and dental care.
> Northern Ireland has retained Sure Start for under-fives. Scotland has a different approach based on health, education and social work, working together with families under the universal health and care system.
REFERENCES
Department of Health and Social Care. (2024) Family Hubs and Start for Life – everything you need to know. See: healthmedia.blog.gov.uk/2024/05/02/start-for-life-and-family-hubs-everything-you-need-to-know (accessed 14 June 2024).
Department for Education. (2023) Family Hubs Innovation Fund Evaluation. See: bit.ly/3XmhVFm (accessed 14 June 2024).
Institute for Fiscal Studies. (2024) The short- and medium-term impacts of Sure Start on educational outcomes. See: ifs.org.uk/publications/short-and-medium-term-impacts-sure-start-educational-outcomes (accessed 14 June 2024).
Institute for Fiscal Studies. (2021) The health impacts of Sure Start. See: ifs.org.uk/publications/health-impacts-sure-start (accessed 14 June 2024).
HM Treasury. (2024) Spring Budget 2024. See: gov.uk/government/publications/spring-budget-2024/spring-budget-2024-html (accessed 14 June 2024).
Standley N. (2024) Children living near Sure Start centres did better at GCSEs, study suggests. See: bbc.in/3yZnsHU (accessed 14 June 2024).
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