Evidence from ten years of the A Better Start Programme
Evidence from A Better Start shows that health visiting has a key role to play: through additional universal contacts, sustained home-visiting programmes for families at greatest risk, and paid peer workforces that complement professional teams. It also builds capacity, generates employment, and reduces longer-term pressure on health, education and social care systems.
Key recommendations
- Protect and invest in universal health visiting as core preventative infrastructure. Health visiting is the only universal service with reach into every family with a baby or young child. It must be resourced to deliver, not just survive.
- Move from a reactive, tiered model to proportionate universalism, with more universal contacts. Blackpool’s eight-contact model and Bradford’s experience demonstrate the value of additional universal touchpoints alongside more intensive support for families at greater risk. Sustained relationships with the same health visitor are central to impact.
- Invest in workforce training, supervision and continuous professional development. Across all sites, additional training in perinatal and infant mental health, attachment, ACEs, speech and language, and trauma-informed practice has been essential to delivering enhanced models.
- Strengthen data infrastructure and evaluation to track impact and inform commissioning. ABS partnerships have invested in robust evaluation and data systems, including the Better Start Bradford Innovation Hub.
- Align health visiting with Family Hubs, the Healthy Child Programme and the NHS 10-Year Health Plan. Health visiting should be central to the Government’s shift from treatment to prevention.