Guidance

Publishing your Start for Life offer

Published 9 February 2023

Applies to England

Introduction

Background to this guidance

Every family knows the immense joy that the arrival of a baby can bring. But every parent or carer also knows the anxiety of this sudden responsibility. The sleepless nights, the doubt, the questions – these are all natural and common experiences during the 1,001 days from conception to a baby’s second birthday.

All families need some help to give their babies the best start in life. Whether it is from healthcare professionals or volunteers, family or friends, there is a diverse range of support and services available in this country. However, it is not always easy for families to access information about what support is available. This can make it hard for families who are juggling the demands of caring for a baby to find the support they need when they need it.

In July 2020, the Prime Minister asked the Rt Hon Dame Andrea Leadsom MP to chair a review into improving health and development outcomes for babies in England. The best start for life: a vision for the 1,001 critical days report was published in March 2021, following an intensive period of engagement with parents, carers, sector professionals, volunteers and academics. The report highlighted that the services offered to families in the critical period between conception and age 2 are often disjointed, making it hard for those who need help to navigate the support available to them. At worst, babies miss out on the best care because parents and carers are unable to access the support they need, or the support they need is not available.

The review sets out a vision to transform how we support families to ensure babies get the best possible start in life. The review:

• identified 6 action areas to achieve this vision, including giving families access to the right information when they need it
• recommended that every local area develop and make clearly accessible a coherent and joined-up Start for Life offer that sets out the support that families may need

By bringing together your Start for Life offer in one place, you will ensure that families can identify the support and services that will help them give our youngest citizens the best possible start in life. Our ambition is that all local authorities will have an easily accessible, single point of reference that families can use to navigate local services specifically for babies from conception to 2 years of age.

Your Start for Life offer

Your Start for Life offer should include all services available locally for families during the period from conception to the age of 2, including those that are taken up on the basis of need. You will want to design this to reflect the specific needs of your local communities and to publicise it online, as well as in locations that parents and carers are likely to visit in person. For example, you may wish to work with local GP surgeries and midwives to provide physical copies of your Start for Life offer that can be handed to families who are expecting or have a baby who is under 2 years old. This information might also appear in the resources listed in your local area’s family information service, but should be available separately from information about services for older children.

Using this guidance

This guidance is intended for all local authorities and is designed to support you in developing and promoting your Start for Life offer by outlining some key principles to think about, providing suggestions and offering case studies. These case studies reflect just some of the many ways that you and your local delivery partners could communicate the support available to families in the critical time from conception until a baby’s second birthday. We anticipate that this guidance will build on how you currently share information about your services with families in your local community. Depending on your current approach, you may find some sections more relevant than others.

On 2 April 2022, 75 local authorities were announced as eligible to receive a share of a £301.75 million investment to establish a Family Hubs and Start for Life programme for the period 2022 to 2025. Family hubs:

• bring services together to improve access
• improve the connections between families, professionals, services and providers
• put relationships at the heart of family support

At the core of every family hub network is a great Start for Life for babies from conception to 2 years old, and support is also available to families of children aged up to 19, or to children with special educational needs and disabilities (SEND) aged up to 25.

Our ambition is that families in every local authority area can access the support they need when they need it. Local authorities taking part in the programme are receiving additional funding to support them in publishing a Start for Life offer. This should explain to parents and carers what support is available locally from conception to the age of 2 in a clear, accessible and seamless way. The funding also supports the establishing of local parent and carer panels, which will ensure that families are able to influence the improvement of Start for Life offers.

Even if your local area has not been selected to receive a share of this funding, this guidance is designed to help you to bring together a Start for Life offer that clearly sets out the services available to families locally.

If you are participating in the Start for Life and Family Hubs programme, you will have received the programme guide. This sets out what you are expected to deliver over the life of the programme, as well as ways you could ‘go further’ and make the biggest difference for families in your area.

Those local authorities participating have also been asked to engage with the national online directory of family hubs and services, and embedded tools. This is being developed through the Department for Education’s Family Hubs – Growing Up Well digital project. The directory will make it easier for professionals to connect families with services, and improve how families can themselves access and navigate local services.

What to include when publishing your Start for Life offer

During pregnancy and the first 2 years of a baby’s life, families interact with many services and sources of support – ranging from antenatal scans to ‘sling libraries’ where they can borrow baby-carrying equipment. These are often delivered by different organisations and could be offered in a wide range of locations. Broadly, support will fall into 2 categories:

• universal services
• additional, targeted or specialist services and support

Both categories are important and should be included in your Start for Life offer.

As you write your Start for Life offer, you should consider what information will help families to access relevant support. This might include:

• details of the service
• which organisation runs it
• when and where it is available
• appropriate contact details
• a link to a website and any associated costs

Universal services and open access support

The universal Start for Life offer should include the essential support that any new family might need:

• midwifery
• health visiting
• mental health support
• infant-feeding advice and specialist breastfeeding support

Some of this support must be accessed by all families, such as maternity care. Other support is available to all families regardless of their level of need, such as breastfeeding support. In addition, all local authorities should provide safeguarding services and a SEND local offer for all families that need them.

We consider all of the following to be universal services. Your Start for Life offer should therefore include:

• midwifery
• health visiting
• mental health support
• infant feeding and specialist breastfeeding support
• safeguarding
• services relating to special educational needs and disabilities (SEND)

In addition to the 6 universal services above, you may also wish to include ‘open access’ sources of support that are available for any parent or carer with a baby. We know that many valued sources of support are delivered by volunteers in the community. For example, there may be a ‘stay and play’ session for parents and carers with babies in a community hall or family hub, or an exercise class for parents and carers in the local park.

There may also be paid-for services in your local area that you wish to highlight – for example, an antenatal education group delivered by a charity for a fee. We would encourage you to make your Start for Life offer as comprehensive as you reasonably can. If you do include paid-for services or resources in your Start for Life offer, highlight clearly how much these will cost.

Additional, targeted or specialist services and support

As you will know, some families may need additional or targeted support, particularly those without access to family and social support or those experiencing adversity. Your Start for Life offer should include the specialist support available to those who need it, including but not limited to:

• support for domestic abuse
• help with drug and alcohol use or smoking cessation
• debt advice
• help overcoming language barriers

Publishing your Start for Life offer could also be an opportunity to raise awareness of other local services, such as those available through a family hub.

Principles for publishing Start for Life offer guidance

Supporting accessibility

Your Start for Life offer represents a complex system of support and services. You will know from the work you already deliver that local services need to be accessible to families with different needs. This may include those for whom English is not their first language.

You know your local communities best, so please draw on your existing outreach and accessibility programmes when designing your Start for Life offer.

Think about how to make information accessible for everyone

You may want to think about how to write your digital and physical communications as clearly and simply as possible to help busy families navigate the information. There is specific guidance on writing accessible documents, which you may find helpful.

You may also want to translate your Start for Life offer to make it accessible to all parents and carers, including those for whom English is not their first language. If you are receiving additional Start for Life funding, you may want to use this to translate your Start for Life offer into the most commonly spoken languages in your area, as well as having your offer translated into or recorded in British Sign Language. You should arrange to update these translations at the same time as the English version of your Start for Life offer if the information changes.

Use digital resources to reach more families

Your Start for Life offer should bring together information on all Start for Life services and support in a single online space. This digital space should be easy to use and easily accessible from your local authority’s website and your family information service.

Social media can play an important role in increasing awareness of your digital resource that hosts your Start for Life offer. It is also a great way of connecting with your local delivery partners. For example, if there is a third-sector organisation providing some elements of your Start for Life offer then you can ask them to disseminate your offer through their social media channels.

Another opportunity is the national online directory being developed through the Family Hubs – Growing Up Well digital programme. This directory will provide an opportunity for local authorities and third-sector organisations to share information about family hubs and their services, including local Start for Life offers.

Create a physical version of your Start for Life offer

We know that some families are less likely to access information that is made available online – for example, those experiencing digital poverty or families who are simply not aware of the support that is available to them in their local area and so don’t actively search for support online. Make sure your Start for Life offer is available as a hard copy and share it proactively with all parts of your community. It is entirely up to you how you do this: you will know best whether and how to tailor the materials you provide to different areas served by your local authority.

You may want to think about advertising digital access availability at a local library, or similar facility. This will be especially relevant if physical leaflets refer to websites or email addresses where families can find out more.

We would also recommend working with NHS partners to share your Start for Life offer with families as soon as possible in pregnancy – for example, the first appointment that a family has with a midwife (also called the booking appointment) at 8 to 12 weeks could be a good opportunity. You could also raise awareness using leaflets and posters in places that families are likely to visit in person, such as family hubs and GP practices.

Use outreach to raise awareness of your Start for Life offer

To raise awareness of your Start for Life offer across your community, you are likely to need to proactively reach out to families. The first important step is to ensure that your Start for Life workforce is aware of your Start for Life offer.

Anyone that works with families who are pregnant or have a baby under the age of 2 – for example, within a family hub network and wider – should be able to signpost families to your Start for Life offer. You may be able to work with local NHS practitioners that meet all families, such as midwives, health visitors, GPs and registrars, but also those who may be more likely to meet families in the community such as volunteers, librarians and early years practitioners.

You may wish to consider how you can raise awareness of your Start for Life offer across the wider Start for Life workforce. This could be through existing channels such as newsletters or by hosting some webinars about the offer and how they can help families access support they may need.

Finally, you may have existing links with local community centres or faith groups who could help you to publicise your Start for Life offer in places that parents and carers are likely to visit in person.

Case study: Norfolk ‘Just One Norfolk’ digital platform

All families want to give their babies the best possible start in life, and all families need some support to do this. In Norfolk, the local NHS trust has worked with parents and carers to identify where the digital information available to them:

• was not coherent
• did not readily address local issues
• could not be personally identified with
• was not in an accessible format

Just One Norfolk is the result of this work.

Just One Norfolk aims to provide readily available validated information that reflects the areas of health concern for parents, using local data to shape the website and the information contained within it. Norfolk has recognised areas of deprivation, isolation, and low levels of literacy and breastfeeding that impact on health outcomes for children. The website is built to be accessible by all with clear content delivered in text, animation and video formats, and has inbuilt translation accessibility with the ultimate objective of providing the best start in life for all Norfolk children and families.

Just One Norfolk is integrated within the service delivery of Norfolk and Waveney Children and Young People’s Health Services. It provides a single digital access point for Norfolk’s families and professionals, and exists in parallel with physical information. Printed posters, flyers and sometimes video resources are used in libraries, GPS, midwifery clinics and acute settings, and reference the online site. A booklet of QR codes directing people to specific areas of the site is also available for all GP practices, pharmacies, early years settings, libraries and so on. This helps ensure that as many families as possible can learn about the resources they can access through Just One Norfolk.

All the content on the site has been sourced and approved by qualified professionals and created in partnership with parents to ensure maximum accessibility. The resources are designed to improve parents’ confidence and their ability to care for their children during key developmental stages. They also ensure consistent messaging from professionals. This reduces over-reliance on professional resources and helps to improve parents’ health literacy, which will in turn increase children’s opportunity to thrive.

Norfolk also has an active joined-up approach to communication. System-wide organisations such as the healthy child programme, midwifery children’s services, GPs and A&E departments routinely share links to Just One Norfolk. For example, the integrated care system promotes Just One Norfolk as the self-care resource for families in its Keeping Families Warm and Well winter campaign on Facebook, as does the maternity and early childhood system. Health visitors use Just One Norfolk as their single clinical resources and share relevant content with families at every contact from antenatal onwards, and GPs regularly promote access through consultations.

Together, the system has developed a wide-ranging webinar programme accessed through Just One Norfolk, which is linked to relevant digital resources, facilitated by relevant organisations and professionals, and promoted to young families through social media. These continue to expand to cover topics including pelvic health, baby brain development, sleep and wellbeing. 

The site has gone from strength to strength since 2018 and is now used by the whole Norfolk children’s system as a single resource from the Start for Life period onwards.

Maximising the accessibility of your Start for Life offer

When publishing your Start for Life offer, you will want to ensure that it is as accessible as possible. Working with your key stakeholders will naturally support you to reach out to as many families as possible in your local area. Key stakeholders will include parents and carers, the NHS and other local delivery partners, including voluntary organisations and national organisations.

You could also adapt your material to empower key groups – for example, fathers – or think broadly about where to place promotional literature to focus on those places where families frequently go – for example, supermarkets or libraries. Your continued engagement with these groups will help to ensure that your Start for Life offer is kept up-to-date, helpful and relevant.

Parents and carers

Parents and carers should be at the heart of your Start for Life offer. You should include the voices and experiences of parents and carers in the development and publication of your offer.

As outlined in the parent and carer panel guidance, the membership of your panel will reflect the diversity of your community. This means that you will be able to use the range of voices and experiences from your parent and carer panel to help you co-design your Start for Life offer.

Of particular importance for publishing your Start for Life offer will be asking parents and carers what would help to make the offer as accessible as possible. For example:

• where would they search if they were looking for information?
• where would be the most helpful place to have posters or leaflets about the Start for Life offer?

You can find more information about how to ensure that your Start for Life offer is published based on the needs of families in your area by using the government design principles.

Case study: Greater Manchester ‘Speaking Dadly’

Every parent and carer in every family should feel confident in accessing the services that will support them in giving their baby the best possible start in life. It is vital that dads feel that their local Start for Life offer is inclusive and relevant to them. In Greater Manchester, the combined authority has explored ways of engaging directly and effectively with dads, as well as mums, valuing the different but equal contribution dads make to a baby’s early development.

The 10 local authorities that make up Greater Manchester Combined Authority have worked collaboratively to develop an early language and communication pathway. This pathway steering group works in partnership with families and the wider children’s workforce to ensure that speech, language and communication needs are identified early, and can be followed by appropriate and timely interventions.

Each year, the group identifies areas for development to strengthen the pathway. Following an exploratory piece of work, the group worked with a social enterprise with particular expertise in engaging with dads. The purpose of the work was to:

• identify barriers to participation
• strengthen engagement by highlighting the unique contribution that dads make to the children’s speech and language development, which is different but complimentary to the role of mums

Based on this work, a short animation has been produced to help address this gap. Each message within the film is underpinned by the evidence of what works. The film celebrates the contribution of fathers by identifying a range of ideas to incorporate language and communication practice for babies and children into everyday activities, such as going for a walk.

The following quotes are from fathers who have been using the Greater Manchester ‘Speaking Dadly’ animation to help develop their children’s speech, language and communication.

Kieran, 21, said:

It’s exactly what a parent wants. It resonates with me lots because I don’t see my daughter all the time.

Danny, 21, said:

It’s mint. I was singing to my child as she was going to sleep and she kept on smiling at the chorus line.

Local delivery partners

NHS providers

The NHS provider landscape differs across the country. In your local area, you may have different NHS providers for your maternity care, health visiting and mental health services.

Your Start for Life offer will be an opportunity to bring together the elements of NHS provision that are relevant to the 1,001 critical days into one place, regardless of the NHS provider.

You may find it helpful to speak with your integrated care system to ensure that the full range of services available through the NHS has been captured in your Start for Life offer, and make them aware of the other services and resources you provide to families during the Start for Life period.

Case study: Doncaster multi-agency teams

The support and services available to families during the Start for Life period are diverse and delivered by a range of professionals. Strong relationships between different professionals are critical to ensuring that every family is able to give their baby the best possible start in life.

Doncaster Council’s Early Days Team delivers services within its most culturally diverse community. This multi-agency team consists of midwives, health visitors and key workers from the local authority who provide continuity of care to families. The team delivers their Start for Life offer through a shared caseload within the community.

A data-sharing agreement with midwifery provides the team with information on which families are pregnant, as well as additional personal data such as ethnicity. This information supports the team to begin to assess the best ways to communicate with families from the outset in a way that is appropriate to their individual needs.

Local practitioners said:

Honestly, the feedback I’ve had from the women about the support they have received from their key worker has been immeasurable. The women have felt they’ve had someone they can go to when they’ve needed it the most.

Key worker knowledge on referral processes and services available to support have been a lifeline. Without them, I really would have struggled to get the support that these women need and deserve. Just being able to have the contacts from other services really does help to alleviate the pressures placed upon both maternity and health visiting services.

Third-sector providers

Third-sector organisations provide many important services in the Start for Life period. You may commission these services directly and so will already be aware of their offer. However, they may provide services that you don’t commission.

We anticipate that you may want to approach third-sector organisations in your area to incorporate relevant services. One way that you could do this is by creating an online survey and sharing a link with all local organisations.

Case study: Islington joint workshops

Every family deserves a local Start for Life system that functions in an effective and joined-up way. As a local authority, you can play a key role in achieving this through bringing professionals together. In Islington, the local council has done this through their programme of Changing Lives workshops.

Islington Council runs these workshops on a termly basis for local authority and voluntary sector practitioners. The aim of the 50-minute online workshops, originally developed by Hempsall’s, is to outline the free early education entitlements and Bright Start Islington’s full offer for children aged 0 to 5.

Practitioners from health, employment, adult education, early education, schools, income maximisation and benefits, social care, and early help come together to see how they play a vital role in helping families find out about and access services for 0 to 5-year-olds.

After taking participants through an overview of the free entitlement and early years services, the workshop looks at a case history describing a family with children of a range of ages to see how support through national and local initiatives in the early years can have a wide-ranging and profound positive impact on that family.

Following each workshop, practitioners understand more fully the potential information touch points they have with families. One practitioner who attended the workshop said:

This was great training – really informative and it increased my knowledge and confidence in supporting families around the free early learning and childcare entitlements.

Private providers

Although private providers make up a smaller proportion of the support available to families, there may be several for-profit providers in your area – for example, those running for-profit ‘stay and plays’ or ‘baby sensory’ groups.

You may wish to include these in your Start for Life offer and make the associated cost clear in your publication.

Case study: Staffordshire community event (Look for a Light)

The support of other families can be invaluable when facing the challenges of the Start for Life period. As a local authority, you can help families to form these connections. In Staffordshire, the local council held a community event to bring together families after the isolation of lockdown.

Staffordshire County Council’s Look for a Light project aimed to bring together communities across the county to showcase their resilience during the coronavirus (COVID-19) pandemic, and to increase the profile of the local children’s centres and family hubs offer.

Families across Staffordshire were encouraged to design and produce simple lanterns from plastic bottles and battery-operated LED tea-lights. Staffordshire County Council provided instructions and demonstration videos. Events were held across the county at community venues, children’s centres, churches, schools and other settings.

Over 75 groups and communities signed up to the project. It provided a good opportunity for families to meet, discuss their experiences and find out more about the local early years offer.

A parish councillor said:

It’s lovely to see lanterns popping up around the village. Thank you for a great community project.

A Keele resident said:

We invited our residents and friends here in Keele to make their own baubles to decorate the tree at our village hall and got more than 200. A kind resident sponsored the additional lights.

A childminder said:

We all thoroughly enjoyed it – I handed out 120+ packs to the residents and childminders in Perton and Wombourne. It was a lovely activity to get families and communities all working together to make these lovely lights.

National organisations who can support your Start for Life offer

As shown through the case studies in this guidance, there are many local authorities that have developed good practice in sharing information about their support offer locally. By connecting with other local authorities across the country, we hope that you gain ideas and inspiration to bring back to your own community.

The National Centre for Family Hubs is run by the Anna Freud Centre and funded by the Department for Education. They provide expert advice and guidance on family hubs implementation, and best practice to all local authorities, including hosting a comprehensive resource library and implementation toolkit. They will be able to connect you with other local authorities developing their Start for Life offers.

There are also programmes being implemented at a national level that will maximise the reach and impact of your Start for Life offer.

Case study: Family Hubs – Growing Up Well programme

The Family Hubs – Growing Up Well project is a cross-government pilot led by the Department for Education that aims to improve the practical implementation of family hubs across England, and link together Start for Life and wider service offers for families between local authority areas.

The project is developing digital products and embedded tools that will improve how professionals connect families to services and support, and how families themselves can navigate to and access services within their local family hub network online.

This initial phase of the project has been undertaken alongside 6 partner local authorities in Bristol, Lancashire, Suffolk, Salford, Tower Hamlets and Redbridge.

A webinar will be held soon for all local authorities to learn more about the programme and opportunities to engage with the digital products. Further details will be shared on the National Centre for Family Hubs website in due course. If you would like to find out any further information in the meantime, email [email protected].

Conclusion: empowering families to navigate services with confidence

Every family is different, and every family faces a unique set of challenges. This is why it is vital that all parents and carers are empowered to give their babies the best possible start in life.

As a local authority, you are key to delivering this ambition. Building on your own local expertise, this guidance supports you to bring together your own Start for Life offer, setting out the diverse range of support and services available to families locally.

This is an essential step toward empowering parents and families to identify the support they need, and to access this support quickly and with confidence. We know that when parents and carers feel confident in their ability to support their baby, and they know and trust where they can get help when they need it, babies and families thrive.

The support available to families in this country is diverse and often exceptional. Midwives, health visitors, primary care practitioners and thousands of committed volunteers make up a thriving system of support for new families. By getting your Start for Life offer right, you will help to join up these crucial services, allowing families to better manage challenges and provide their babies with the best possible start in life.