Sure Start cut hospital visits for children in deprived areas

Tuesday, June 4, 2019

Sure Start children’s centres significantly reduced hospitalisations for children in poorer neighbourhoods and saved the NHS millions of pounds, new research has found.

The new study by researchers at the Institute of Fiscal Studies followed children who had access to Sure Start right through to the end of primary school.

Researchers studied the impact of the programme on health in England over the period that it was being rolled out, between its start in 1999 and its peak in the late 2000s.

The study found that Sure Start had 'a big positive effect' on children’s health by the time they finished primary school, reducing hospitalisations, with the strongest benefits on children living in disadvantaged areas.

Researchers said these effects built over time: while there was no significant effect at the age of five, by 11 greater Sure Start coverage (one more centre per 1,000 children aged 0-4) prevents around 5,500 hospitalisations per year.

The direct savings to the NHS from fewer hospitalisations for children between five- and 11-years old amount to about £5 million per cohort, or just 0.4 per cent of average annual spending on Sure Start.

There was no effect on the hospitalisations of children living in the richest 30 per cent of neighbourhoods. This means that providing access to Sure Start at the level of the programme’s peak closes about a half of the gap in hospitalisation rates between the 30 per cent poorest and 30 per cent richest areas by the end of primary school.

At every age in primary school, Sure Start reduced hospital admissions for injuries.

Including the longer-run savings from fewer injuries as well, the financial benefits reach around 6 per cent of Sure Start’s budget.

UCL Associate Professor and IFS Research Fellow Gabriella Conti said, ‘Access to Sure Start has had big benefits for children’s health during primary school. Relative to not having Sure Start, opening one centre for every thousand children prevents 5,500 hospital admissions of 11-year-olds each year. Since the benefits are biggest in the poorest neighbourhoods, access to Sure Start can help close around half the gap in hospitalisations between rich and poor areas.’

The research argues that even if some of the cuts to Sure Start were reversed, it would be hard to return to the funding levels of 2009-10.

It suggested that one way to deliver more value for money would be to focus on providing services to the disadvantaged areas, which are more likely to benefit from them, and to consider which types of services and models of provision could most effectively help this group.

IFS research economist Christine Farquharson said, ‘Sure Start has had a turbulent history, with a fast roll-out followed by deep spending cuts. But these decisions were not always based on thorough evidence about the programme’s impacts on children and their families. ‘Ahead of the Spending Review, it’s crucial that both central government and local authorities use the best evidence available to decide on their vision for Sure Start as the programme turns 20. Our findings suggest that limited resources are best focused on the poorest areas.’

The study was funded by the Nuffield Foundation.

'A lifeline'

Commenting on the findings, councillor Anntoinette Bramble, chair of the Local Government Association’s Children and Young People Board, said, ‘As this report shows, children’s centres can provide a lifeline for children, parents and carers, offering an incredibly important service in the local community.

‘This could be anything from advice for parents on physical and mental health, caring for a new-born, or simply a place for children to enjoy free-play and interact with one another.

‘While many councils have adapted well to the funding pressures and changed how they provide children’s centre services, in particular to target those communities most in need of support, there is a growing sense that councils have done all they can within ever tightening budgets.

‘It is inevitable that without new investment from government in children’s services, councils will face the difficult but unavoidable decision of having to cut or close early help services such as children’s centres.’

Neil Leitch, chief executive of the Early Years Alliance, said, ‘Few people with experience of Sure Start centres will be surprised by these findings because we’ve always understood the vital work they do. What is shocking, however, is the carelessness with which the Government has treated these invaluable community assets. Successive ministers now have overseen the mismanaged decline of Sure Start. What began with a “temporary” pause on inspections has led to hundreds of closures and forced dozens of centres to step back from delivering frontline services.’

‘If ministers were ever serious about social mobility then now would be the time to show it. This report makes clear what’s at stake and the government should be questioning where their indifference has left some of our most vulnerable children - and start reinvesting in and reaffirming their support for Sure Start immediately.’

Tracy Brabin MP, Labour’s shadow early years minister, said, ‘This research shows the critical role Sure Start plays in children’s health, as well as their development. But shamefully, over a thousand Sure Start centres have been lost through years of austerity, meaning children and families across the country are missing out.’ 

A Government spokesperson said, ‘Children’s centres can play an important role in supporting families, and local councils decide how to organise and provide services for families in their areas to meet local needs – whether this is through children’s centre buildings or delivering services in different ways, and we continuously reflect on what works best.

‘We want every child to have the best start in life, which is why our Healthy Child Programme means children and families receive five mandatory Health Visitor checks before they are two- and-a-half.’

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