Flagship family hubs rollout is being done on the cheap

Lack of funding, staff shortages and a poorly paid workforce have “stalled” progress in delivering early support for children, an influential Westminster committee has found.

A report by the Health and Social Care Committee criticises the government’s failure to properly fund its flagship family hubs rollout in England.

It unfavourably compared the £600 million annual funding for the programme to the £2 billion a year for Sure Start, the early support network it’s effectively replacing.

Sure Start’s focus was on the first two years of a child. Family hubs aim to provide universal services up to 19 (or 25 for children with special educational needs) on less money, the report points out.

First 1,000 Days: a renewed focus, looked at progress made since the committee's inquiry looking into early years’ provision published seven years ago.

The report states: “Since our 2019 inquiry progress on proportionate universalism in the early years appears to have stalled.

“Over one third of parents from low-income households are not able to access children’s centres or family hubs in their local area, compared to 23 per cent of parents on average incomes.”

Services have “remained siloed and fragmented across the country” due to the “inconsistent” rollout of family hubs and “funding instability”.

The report highlights a 43 per cent fall in health visitors since 2015 and a current shortfall of 5,000 in the role. There is also a 2,500 shortfall in full-time midwives in England.

Moreover, a steady decline in vaccinations against preventable diseases such as measles, mumps and rubella since 2012/13 is described as “a national disgrace”.

The vision

family hubs are a key part of the government’s Best Start strategy to steer family support towards community-based universal “one-stop shop” provision.

Viewed as the “next-generation” of Sure Start’s children centres, the vision is for services to be tailored to local need. They will feature multidisciplinary professionals including social workers, midwives, health visitors, midwives, GPs, youth workers and early years practitioners. 

The aim is for the hubs to provide a suite of support across parenting, housing, debt advice, youth services, domestic abuse, SEND, mental health and more.

Investment of nearly £1 billion aims to see 1,000 hubs in operation by 2028. Estimates indicate there are more than 600 up and running currently.

The report points out that evidence shows for every £1 invested in early intervention up to £200 is released in long-term benefits, saving the taxpayer £45.5 billion a year.

The reality

“However,” says the committee, “despite this acknowledgement of the potential of early intervention, children in the UK have some of the worst health outcomes in Europe.

“This is across health conditions such as obesity and asthma, dentistry, mental health, vaccine uptake and infant mortality.”

While welcoming additional funding of £500 million for family hubs announced last year, the committee added: “However, the funding available for these programmes is still significantly below the level of Sure Start, while hubs are being expected to cater to a much broader age range of children and young people.”

It called for “sustained and ringfenced funding” to expand the network of family hubs. 

Better perinatal mental health support is also needed, said the committee.

Poor pay was “repeatedly highlighted” as an issue for the early years’ workforce. The committee stressed this must be addressed in the delayed NHS 10 Year Workforce Plan due out in the spring.

It added “a plan that does not set out a clear, achievable and funded road map for addressing staff shortages would completely lack credibility”.