Report highlights health benefits of Sure Start

Sure Start services have saved the NHS millions, particularly in disadvantaged areas where they have the most benefit in improving healthcare, according to a new study.

The study by the Institute for Fiscal Studies investigates purely the health impact of Sure Start, looking in particular at hospitalisations.

It finds that Sure Start significantly reduced hospitalisations among children by the time they finish primary school and that these effects build over time.

At younger ages, a reduction in infection-related hospitalisations plays a big role in driving these effects. At older ages, the biggest impacts are felt in admissions for injuries, says the report. It suggests that Sure Start may be helping young children to develop their immune systems, perhaps through supporting immunisations or exposing children to other children’s illnesses (for instance, through childcare). Sure Start drives a significant fall in injuries throughout primary school, with the probability of an injury-related hospitalisation falling by around 17% at the younger ages and by 30% at ages 10 and 11.

The report says the health impact is greatest in more disadvantages areas.  The poorest 30% of areas saw the probability of any hospitalisation fall by 11% at age 10 and 19% at age 11, while those in more affluent neighbourhoods saw smaller benefits and those in the richest 30% of neighbourhoods saw practically no impact at all. The report says: “The bigger benefits in the poorest neighbourhoods could come about because disadvantaged children are more able to benefit from Sure Start, because the types of services Sure Start offers in poorer areas are more helpful, or because children in disadvantaged areas were more likely to attend a centre.”

Improvements in health was one of the aims of Sure Start, which was first introduced in 1999 as Sure Start Local Programmes, targeted at highly disadvantaged neighbourhoods. Five years later, the 10-Year Strategy for Childcare called for ‘a children’s centre in every community’, transforming the initiative into a universal service. At its peak in 2009–10, Sure Start accounted for £1.8 billion of public spending (in 2018–19 prices), about a third of overall spending on programmes for the under-5s. But in the decade since cuts have led to funding falling by two-thirds to £600 million in 2017–18.

The report says the financial benefits of Sure Start’s effects on hospitalisations amount to 6% of its budget and recommends a return to a targeted approach of providing services to the disadvantaged areas which are more likely to benefit from them. It also says policymakers should consider which types of services and models of provision could most effectively help this group.

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