MPs call for national early intervention strategy to transform lives

The Evidence-based early years intervention Report urges the Government to capitalise fully on the opportunity that early intervention provides to transform the lives of those who suffer adversity in childhood, while also saving long-term costs to Government.

The Committee’s Report identifies examples of early intervention working well around the country, but also the challenges that local authorities and their partners currently face in delivering effective, evidence-based early intervention. It concludes that the overall provision of early intervention in England is fragmented, with varying levels of support, focus on evidence, and success.

The Committee calls for a new national strategy to be drawn up to ensure that the opportunity provided by early intervention—to transform lives and save long-term costs to Government—is seized fully, and by all local authorities in England.

In addition to raising the profile of early intervention as an effective way of addressing childhood adversity and driving its provision, the national strategy recommended by the Committee should include the following components:

Defining and training the early years workforce

A wide range of professions engage with young people and their families, and could help to identify those who would benefit from early intervention or would play a role in delivering early intervention services. The strategy should identify and define this ‘early years workforce’.

The Government should then review the pre-qualification training and continuing professional development offered to the different professions in the early intervention workforce.

Making use of ‘implementation science’

Implementation science is a developing field that explores how interventions that have proven effective can best be promoted and delivered in frontline practice.

The new strategy should make use of implementation science, as well as examples of best practice around the country.

Support for local authorities

A central team should be established within an expanded Early Intervention Foundation to help local authorities plan and deliver effective, sustainable, evidence-based early intervention.

Better use of data

Collection and analysis of appropriate data can help to evaluate the effectiveness of early intervention programmes being delivered, as well as identify the families who could benefit from early intervention.

The strategy should:

• promote the value of data-driven practice;
• provide case studies of best practice;
• identify measures that can be used to assess the effectiveness of early intervention and identify families who could benefit from early intervention;
• provide guidance on data-sharing; and
• ensure national reporting of data from the healthy Child Programme.

Funding

In adopting a new national strategy for early intervention as a route to addressing childhood adversity, the Government should see effective early intervention as an opportunity to make long-term cost efficiencies—as well as to improve people’s lives—rather than a demand on resources.

The Government should correspondingly make the necessary funding available where elements of the new strategy will require funding from central Government.

The new strategy should also seek to drive a general shift in the focus of current expenditure on ‘late interventions’, required where problems have escalated, to earlier intervention.

Rt Hon Norman Lamb MP, Chair of the Science and Technology Committee, said:

“Adversity in childhood appears to be the biggest single risk factor in the emergence of mental ill health in childhood and teenage years, and beyond. If we are to make any impact on the high prevalence of mental ill-health in childhood, we have to transform how we address the causes.”

“Early intervention offers young people who have suffered adversity in their childhood an opportunity to avoid the long-term problems associated with such experiences. When delivered effectively, there is strong evidence that early intervention can dramatically improve people’s lives, whilst also reducing long-term costs to the Government.”

“The Scottish and Welsh Governments and some local authorities in England have made using early intervention to address childhood adversity and trauma a priority. We urge the UK Government to do the same. During our inquiry, we have seen examples of good practice being delivered around the country, but a national strategy with co-ordinated support for local authorities could see the transformative benefits of early intervention offered to all children who need it, irrespective of where they live.”

The Committee also recommends that:

• The Government should address the serious shortfall in coverage of the five health visits mandated by the Healthy Child Programme, so that all children receive all five visits.

• The Government should ensure that academic researchers can access Government administrative data relevant to childhood adversity, long-term outcomes and the impact of early intervention, while ensuring appropriate privacy and safeguarding mechanisms are in place.

• The Government should work with researchers and practitioners to examine how new specifications on the free childcare it funds could increase the use of evidence-based programmes, and what the impact would be on the families affected.

• The Government should clarify its position on Sure Start centres. In response to this Report, it should specify if—and when—it intends to hold a consultation on the future of Sure Start centres, which it announced in 2015. If it intends to proceed with a consultation, this should be held within three months. If a consultation is not going to be held, the Government must urgently reinstate Ofsted inspections of children’s centres, which have been suspended since 2015.

BACKGROUND

Early intervention is a loosely-defined term that refers to acting as soon as possible, to tackle problems before they become more difficult to reverse. In this Report, the Committee considers early intervention in relation to childhood adversity and trauma. It is known that those who suffer adverse childhood experiences, including abuse, neglect and growing up in other difficult household situations, are more likely to encounter a wide range of negative outcomes in later life—in particular physical and mental health problems. However, effective early intervention programmes have been shown to positively impact upon the life chances of those who have suffered childhood adversity, helping young people to avoid problems rather than overcome them. These early interventions take a variety of forms, including parenting programmes, behavioural classes for children or programmes supporting early years child development.

In 2010, Graham Allen, the then MP for Nottingham North, was commissioned by the Coalition Government to review early intervention in the UK. Two reports were published by Mr Allen the following year. Following his recommendations, the Early Intervention Foundation was established in 2013 as the ‘What Works Centre’ covering this area. In 2016, the Early Intervention Foundation estimated that the cost of ‘late’ intervention in England and Wales reached at least £16.6bn, and in 2017 reported a “significant gap between what is known to be effective from peer-reviewed studies and what is delivered in local child protection systems”. We consequently decided to launch an inquiry to examine the evidence base underpinning the arguments for early intervention as an effective strategy to address childhood adversity and trauma, and to assess the extent to which this evidence base was informing early intervention practice across England.

The Children and Parents Service (CAPS) in Manchester has been identified by the National Institute for Health and Care Excellence as a service that has achieved success in recognising and managing antisocial behaviour and conduct disorders in children and young people. CAPS is a jointly commissioned, multi-agency, early intervention service for pre-school children and their families. The service identifies early social and emotional problems in pre-school children, provides thorough psychological assessment for them and then offers intervention as appropriate.