Too many children in Scotland are left behind when it comes to their early life chances and development: children living in our most deprived areas are two and a half times more likely to have a concern identified, and boys and care-experienced children face significantly higher rates of concerns than their peers according to health checks carried out at 27-30 months. In earlier analysis, we looked at how developmental concerns in Scotland are disproportionately affecting certain children in our population. 

The Scottish Government has set an ambitious target to reduce child development concerns identified at 27-30 months to 13.5% by 2030. Achieving this could mean around 2,000 fewer children are identified with a concern each year at this age. 

Data has an important role to play in helping us support babies and young children with their development, whether this is through early identification of need, providing targeted support, or enabling strategic-level decisions around resourcing and practice. Scotland has a relatively rich early years administrative data environment through initiatives such as the pre-school child health programme, which includes three review points of a child’s health and development before they start school.  But how do we make the most of the administrative data we have to provide early help and support to families with young children?

There is already a solid evidence base around the risk and protective factors that can lead to a child experiencing developmental concerns. However, to be able to develop effective and targeted support, we need to go further: to understand the patterns and distribution of developmental concerns across Scotland’s population and how concerns evolve for different cohorts of children across time. 

Having ready access to relevant, anonymised administrative data at the level of the individual child and over time would allow for patterns and trends to be identified within and across groups of children. While this data does exist, accessing it involves lengthy application and wait times, which means it is not being used effectively.

Information on individual children’s development is captured by health visitors at several points across the first five years of a child’s life, and provides crucial information about developmental progress of individual children. When aggregated at a local authority or health-board level, or ideally at sub-local authority level, this data can provide local decision-makers with crucial information to help shape decisions about where and how resources and supports are provided.    

Being able to access this data and having the capacity to engage with it as part of regular decision-making and improvement cycles is vital for local authority areas.   Nesta has supported similar work with local authorities in England via the A Fairer Start Local programme, using assessment data in Stockport to increase provision for those in need and similarly in York using a linked dataset across health and education.  

At the moment, it’s not clear how different local areas are accessing and using this data to inform their decisions. Better understanding how the data is currently being used - and what the barriers are for those not using it - will form a key part of our improving early help for babies and families project in early 2026, and will enable thinking about how to overcome these barriers.

Data relating to babies and young children in Scotland often exists in siloes. For example, the child health review system sits completely separately from the data systems operated within early learning and childcare settings. So, if a child is identified as having a developmental concern within one of their pre-school health reviews, there is no formal way for this information to be passed to the childcare setting they attend, which could lead to unnecessary delays in a child receiving important support. Similarly, information about a child’s development gathered at their four-to-five year review before they start school is not automatically available to their primary school. 

As a result, there is no single, holistic picture of a child’s journey through the first five years of their life and beyond. As well as leading to duplication of efforts, this disconnect makes it difficult to track developmental journeys, understand contact with services and support over time, or evaluate long-term outcomes. The introduction of a “single child record" for children across services and data systems, particularly health and education, would support a child’s journey over the first years of life (and potentially beyond), and reduce the burden on parents and individual service providers to join the dots between support and services.

As set out earlier, the data gathered via the pre-school health reviews already provides a rich foundation for us to build on. At each assessment point, the majority of children receive their assessments (90% at 13-15 months. 89% at 27-30 months, 75% at four-to-five years)and the multiple review points in the first five years of a child’s life provide us with the ability to identify trends and patterns over time. Planned additions to the health reviews, which explore long-term conditions, disability and family financial wellbeing, will only help to build our understanding of our under five population.

We could build our understanding of how to improve consistency within the assessment process itself. At present, when looking at the variations in the rates of developmental concerns across different local authorities and assessment stages, it’s not clear whether these variations are a reflection of how assessments are being conducted and recorded in different areas. Understanding more about how the practice of reviews vary would help in being able to interpret some of these variations. It could also enable recommendations on how to improve the overall consistency of the assessment process itself.

The current review process doesn’t provide sufficient detail of what happens for children as a result of a concern being identified. This means we don’t know for sure what support families are being offered and engaging with, or how this support might lead to certain developmental concerns resolving over time. One solution to this would be to embed the health review data within the broader “single child record” outlined above.  If this catch-all record also contained details of the services and supports that a family is accessing, it would enable a more rounded view of a child and family’s experience, and could support better understanding at a population level of the most effective ways to support child development.

Without consistent, high-quality, and linked child-level data, local authorities and health boards are working with an incomplete picture. This can make it more difficult for them to plan and prioritise services.  It also makes it more difficult for local partners to identify and work alongside families to provide them with the joined-up support and early help that they want and need.

Making the changes outlined here will require a concerted and collaborative effort from national and local stakeholders. By strengthening how data is collected, linked and used across services, Scotland can move from surface-level understanding to actionable insight - enabling the designing, testing and scaling of targeted support that meet the needs of children and families. Our improving early help for babies and families project will explore how data-driven approaches could support Scotland’s ambitions. Anyone interested in this developing programme of work - including future opportunities to engage in Scotland-focused data events - can get in touch.