What we've changed

Working with local parents in five areas of England and grounded in scientific evidence and research, the A Better Start partnerships developed and tested ways to improve their children’s diet and nutrition, social and emotional development and speech, language, and communication. 

A Better Start was place-based and aimed to improve the way that organisations work together and with families, to shift attitudes and spending towards preventing problems that can start in early life.

To improve systems change, NCB specialises in applying an evidence-based approach to influencing policy at the highest level. We are sharing important insights and making policy recommendations from the A Better Start programme with policymakers and parliamentarians to inform present and future government priorities for early years.   

Health visiting policy briefing 

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

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

Download the full policy briefing

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The impact of these systems changes is being monitored and assessed by the A Better Start national evaluation team, which includes NCB family member Research in Practice and is led by the National Centre for Social Research (NatCen).