The earliest years of a child’s life are when the foundations of physical, emotional and social development are laid. Supporting children in these earliest years can have huge positive impacts on the rest of their lives. 

But not every child in Scotland today experiences the same start in life. Toddlers growing up in the most disadvantaged areas of the country are two and a half times more likely to be identified as having a developmental concern than their peers in the least deprived areas. But this outcome gap is not inevitable. Providing robust support to families in the earliest years of a child’s life is vital in preventing these gaps from forming in the first place.

To understand how early childhood inequalities can be overcome, Nesta researched the support available to families with babies and young children from birth to age three across Scotland, working with six local authorities and analysing survey responses from 25 local authorities. We’ve developed a systematic set of recommendations for national and local change that, if delivered in full, would create a more preventative system where families receive support before crisis points occur and all children start their lives feeling safe, healthy and loved.

There is a policy blind spot in Scotland when it comes to babies. National policies and local plans are often focused on all ages or older age groups, overlooking the specific needs of babies. To ensure children are receiving the support and care they need in their earliest years, the Scottish Government should define a clear national vision and policy commitment for early childhood - from pregnancy to age three - and incorporate this into governance.

Currently, families often don’t receive support until they reach a breaking point. Immediate risk is prioritised over consistent early help. To shift to a preventative approach, where all families receive the support they need earlier on, the Scottish Government should refresh its Getting it right for every child guidance framework and practice model with specific guidance for pregnancy and early childhood and establish a consistent national core offer of support. This offer would include foundational services available to every family - such as maternity care, vaccinations and funded early learning and childcare - as well as preventative services which are available to all families, such as play-and-stay and infant mental health services, with additional support for those identified as at risk. Targeted, intensive support would also be available for those that have higher needs. 

Alongside this core offer, the Scottish Government should review and strengthen existing national touchpoints, fully implementing the recommendations in their enhancing delivery of the health visiting service action plan. They should review the relationship between health visiting and services such as midwifery and early learning and childcare (ELC) to ensure responsibilities are most effectively distributed and to strengthen coordination, handovers and touchpoints between services.

As with national policies, funding streams often prioritise older age groups or all-age groups, meaning the ages zero to one are overlooked. The Scottish Government should work to ensure a fair and proportionate allocation of existing funds is directed at babies and young children and target gaps in core areas including Universal Health Visiting Pathway (UHVP), Family Nurse Partnership (FNP), Allied Health Professionals (AHPs), national data infrastructure, and local co-located community support. 

Funding is frequently short-term and siloed, with resources tied to specific sectors or targets rather than holistic family needs. This makes it difficult for local authorities to develop longer-term and joined-up approaches that support families’ various needs. By transitioning to indicative multi-year funding commitments with pooled budgets, the Scottish Government can support local authorities in their longer-term plans.

Scotland possesses an abundance of skilled, passionate professionals dedicated to supporting young families. But a strained and under-resourced workforce often needs to prioritise high-need cases at the cost of preventative care or collaborative planning. The Scottish Government needs to create a long-term early childhood workforce strategy, considering headcount, retention, pay, progression and workload-reducing technology. As part of this, critical roles need to be invested in, with the Scottish Government funding national training and recruitment to address shortages in midwifery, health visiting, speech and language therapy, and early learning and childcare. Finally, the government should establish a high-quality, cross-sector learning framework to embed essential early childhood knowledge into workforce training.

The systems and data platforms local area practitioners are using are often disconnected, meaning there is no cohesive, system-wide view of family needs, and there is a high administrative burden on practitioners in retrieving the data they need. The Scottish Government must work with local areas to improve data infrastructure and guidance to enable best practice, for example by launching a single children and families portal which gives local areas easy access to cross-sector population data at the lowest geographical level, enabling cross-sector data linkage and establishing minimum standards for data and client systems. Alongside this, the Scottish Government should support local capacity and confidence with data through training and creative partnerships (for example, matching post-graduate and PhD researchers with local areas for targeted data projects).

Shifting to a proactive, preventative model of support will require a deliberate, coordinated effort at both national and local levels. While the Scottish Government must set the enabling conditions, local authorities hold significant scope and autonomy to shape place-based services. Local areas should prioritise establishing pre-birth and early childhood as a strategic priority, creating a singular, cross-agency vision and reviewing their existing early childhood systems and services so improvements can be made, with a focus on supporting families with lower-level or emerging needs into and between services.

As Scotland collectively considers widespread reform of its public services, babies and young children need to be front and centre of this work. Investing in the very earliest years is the single greatest opportunity to give every child the opportunity to thrive and fulfil their potential.

Nesta will be exploring these findings and what they mean for policy, strategy, and frontline practice in a joint webinar hosted by CELCIS on Thursday 8 October 12:00-13.30.