Opportunities to Build Back Better?

The past year has been challenging for everyone. It has been particularly difficult for expectant mothers and families with babies and young children. The Prime Minister wants to build back better after the pandemic and two recent announcements may provide an opportunity to do this for the under threes and their families. The first is NHS England announcing the creation of 26 mental health hubs specifically to provide a new service for pregnant mothers with moderate to severe mental health problems. The second is the launch of the government’s Early Years Healthy Development Review report.

Mental Health Hubs.

On 6th April NHS England announced the setting up of 26 mental health hubs by 2022. 10 hubs will open in the next few months and the remainder by April 2022. This dedicated mental health service is for new mothers, expectant mothers and bereaved mothers and will bring services together under one roof.  As part of the NHS Long Term Plan there will eventually be a hub in each of the 44 local NHS areas and the service will be extended to include dads and partners.

The Best Start For life: a vision for the 1,001 critical days.

The best start for life: a vision for the 1,001 critical days – GOV.UK (www.gov.uk)

In March the The Early Years Healthy Development Review report was published. This was undertaken by a team led by Andrea Leadsom MP at the request of the Prime Minister. Six areas for action were identified.

1. A Start for Life offer for all families. This will identify the services such as health visiting, infant feeding and mental health that are there to support families.

2. A welcoming hub where services can be accessed.

3. Improved access to comprehensive information that families need by means of digital, virtual and telephone services.

4. A skilled work force needed to deliver these services, including recognition that health visitors are central to how families are supported.

5. Evaluation and data collection to ensure continuing improvement of the Start for Life offer.

6. Leadership – At local authority level there will be an identified person accountable for the service and responsible for the co-commissioning.  At national level a Cabinet Minister will oversee implementing the agreed actions from this Review and for ensuring that Start for Life is kept at the heart of policy-making decisions across the government.

The intention is to tackle inequalities, identify the most needy families, work in partnership with the NHS and volunteers and have a parent and carers forum to give a consistent coordinated service for families. Many of these services are already being provided by the local authority but because of shortage of funds and professional staff the provision can be patchy and the most needy are often the families that miss out.

It is only in the next phase of the review that financial resources will be addressed:-

“In the next phase we will work with local leaders and lead minister in conjunction with colleagues in HM Treasury to understand efficiencies and begin building the economic case for further investment in The Start for Life” (page 121 of the report)  This does not appear to be a guarantee of additional funding,

Are these two announcements great opportunities to build back better for under threes and their families?

The new mental health hubs, which do have NHS funding, are a welcome addition, but are just one part of a range of services needed to support mothers, their babies and their families with issues relating to mental  health. The Initial contacts for support are the midwives, health visitors and GPs.  The current shortage of these professionals can mean that early help and support may not be readily available.

The Start for Life offer can be considered to be a replacement to the Sure Start Children Centres which were developed between1998 and 2003 with protected funding from central government. Control was transferred to local authorities in 2005, but in 2011 the protected funding was removed. The years of austerity let to the closure, by local authorities, of many of these centres.  If the central government had retained the protected funding and the centres had continued to provide a comprehensive service to under -fives and their families it is unlikely that the Early Years Health Development Review would have been necessary.  A lot of the Start for Life offers will be delivered from the Sure Start Children Centres that are still functioning.

To build back better additional funding is needed to increase the numbers of midwives and health visitors whose numbers have been falling for several years and to resource and protect additional funding for local authorities to provide the Start for Life offer long term.  Time will tell.