Report champions areas leading practice for education and health

The locations picked include a pilot project in Luton that aims to support pregnant women living in deprived areas before and after the birth of their child.

Flying Start is described as Luton's 'primary prevention and early intervention strategy for the very early years in life, from pregnancy to a child's fourth birthday'. The midwifery team refers mums-to-be to Flying Start workers for extra support. This could be, for example, about debt and housing problems or mental health.

Midwives are able to make referrals from as early as the 12th week of pregnancy.

Gill Brook, the Flying Start manager, said, 'If midwives identify a mum who will benefit, contact will be made. Flying Start workers are able to spend more time with the mothers to build a trusting relationship through pregnancy, then pass the mother to the health visiting team.'

The idea grew from the benefit shown of having family support workers in schools, and more recently through its 'Stronger Families' programme.

Mrs Brook said, 'Anecdotally, this relationship to provide additional support seems to be working really well and we decided to see how it would work in the maternity period. Midwives see it as a really useful asset.' Luton has now commissioned an independent evaluation of the pilot.

Jenny Crisp, a Flying Start worker with the Pre-School Learning Alliance, said, 'The past six months have shown how important it is in any primary prevention model to build trusting relationships with families as early as possible during pregnancy. This not only gives the opportunity for working with families to access the services they need but provides additional support during this very important period.'

In Blackpool, the local authority has brought in training for all early years practitioners and health visitors on speech, language and communication, delivered by an educational psychologist, a speech therapist and early language consultant. The course is now part of the health visitor induction.

All of the 60 early years settings in Blackpool and ten children's centres also have a 'communication champion', whose role includes disseminating information from the early language consultant, identifying training needs, and maintaining information boards.

Sarah Lambert, development manager for the Blackpool programme, said, 'It's also about running activities for families, making sure mealtime communication is promoted in the home, and making it fun.'

• Information about the 'pioneering places' are included in the Early Intervention Foundation's report, which also highlights poor joined-up working between health services and the early years sector in some areas.