Anne Longfield, Children’s Commissioner for England, last week published a report calling on the government to make early years central to the nation’s Covid-19 recovery with a new ‘Best Beginnings’ guarantee of support for under-5s. Understandably, much of the attention has focused on its strong recommendations for changes in funding and policy, including calls for a cross-government early years strategy. However, this should not obscure some valuable new research within the report which highlights why a more joined-up early years offer is urgently needed.

Delivering the 2–2.5 years review

The latest annual official statistics show that around one in five children in England do not receive their Healthy Child Programme review at 2–2.5 years of age, the last of five universally mandated reviews with the health visiting team that should occur before a child enters school. This has been underlined by the Children’s Commissioner who, through a data request to all local authorities, found a similar number of children missing out and huge variation across the country.

Why is this important? The 2–2.5 review plays an essential role in identifying children with developmental delays at a critical time in their physical, cognitive, social and emotional, and behavioural development. In recent EIF case studies looking at areas that have achieved reductions in the early language gap between disadvantaged children and their peers, we found that an important element of their success was the council’s ability to use the 2–2.5 review effectively to identify children in need of additional help with language and communication.

The review is also important in identifying wider risk factors in children’s lives, ranging from safeguarding concerns to maternal mental health issues, and is particularly important for children who are not regularly seen by other practitioners, such as those who don’t frequently attend early years settings. The review plays an essential role in checking children have received their required vaccinations, and is also used to deliver key public health messages, such as to promote healthy eating and oral health, or information on managing behaviour or establishing good sleeping habits.

Children not receiving this review are clearly missing out at a key moment in their young lives. Identifying factors within both families and services which prevent the 2–2.5 review from taking place – possibly similar to the work done on understanding take-up of free early education entitlements – would help to highlight where action could be taken to ensure more children receive this vital support.

Understanding all of a child’s needs

The Children’s Commissioner’s report also found that the majority of local authorities weren’t able to identify whether children who did receive the 2–2.5 review were recorded as having other, additional risk factors. For example, around a fifth of local authorities could identify whether children who had a review were defined as a Child in Need, a quarter could identify if they had Special Educational Needs (SEN) support, and less than a third could identify if they were eligible for the two-year-old offer to disadvantaged families for funded early education. This suggests that data on an individual level is poorly joined up.

Without a good understanding of a child’s additional needs and the potential risk factors in their lives, it is challenging for local areas to ensure that they receive the right support across the various agencies that might be involved. We need to improve our understanding of the relationship between different types of vulnerabilities for young children and what combination of support is most effective. Helping local areas to link and analyse data on different types of vulnerabilities to ensure children receive appropriate, effective support would be a good first step.

Tracking the support a child receives

The Children’s Commissioner highlights that close to half of local authorities did not have the ability to identify whether children were referred on to any additional support after receiving their 2–2.5 review. For those that could, most areas could not identify which services the children were referred to. As research suggests, including our evidence reviews on the Healthy Child Programme and early cognitive development, screening and assessments have the best evidence of improving parent and child outcomes when evidence-based services are offered as a result.

Tracking what support children receive is central to understanding service demand and impact, as well as why some families do not engage. As highlighted in our blog on evidence gaps needing attention, we need a better understanding of the combined impact of different services throughout a child’s preschool journey if we are to ensure that children get the most effective support they need at the right time.

Sharing data and assessments

Reasons given in the Children’s Commissioner report for areas not being able to identify children’s multiple needs and what support they are referred to centre on the lack of consistent data recording, limited data sharing agreements, and an inability to match and combine child data between various agencies. An upcoming report by Nesta and the Institute for Government will provide a good starting point to take many of these issues forward.

However, this is not just an issue of data linking: it also requires consistent assessment across multiple agencies. While there have been attempts to achieve this through, for instance, the integration of the 2–2.5 review and the Early Years Foundation Stage progress check for 2-year-olds undertaken by early years practitioners, progress has been limited. As the Children’s Commissioner’s report notes, less than one in 10 of these reviews are integrated, with nearly half of authorities reporting that none were integrated.

The work of Public Health England and the Department for Education on an early language assessment tool is a positive first step. Support for local areas to develop common data systems and common assessment could be a focus for the cross-departmental strategy which the Children’s Commissioner’s calls for in Better Beginnings.

Improving outcomes for children not starting ‘school-ready’

New analysis within the Children’s Commissioner’s report reveals that 13% of all children fail to meet half of the development goals at the end of reception, rising to 22% of children who are eligible for free school meals. The report then states that by the end of primary school, these children – those who failed to meet half of their development goals by end of reception – make up a higher proportion of those who have been excluded from school, have had contact with children’s social care, or are below the expected level of development for subjects such as reading and writing.

This highlights that poor outcomes at the end of reception are related to poorer academic attainment at the end of primary school. But it also reveals that these children have a higher risk of experiencing a broader set of negative outcomes, such as exclusions and contact with social care, which are known to have, in turn, a detrimental impact on later-life outcomes.

This is why it is so critical that we support local areas to be able to identify early development delays and risk factors through universal services such as 2–2.5 year review, and to ensure effective cross-agency support is available and provided to young children and their families, to establish the foundations for a happy, healthy start to life.