First 1000 Days of Life: a Renewed Focus - Evidence to the Health and Social Care Committee Inquiry
The first 1000 days of life, from pregnancy to age two, are critical for an individual’s cognitive, emotional and physical development. High levels of stress during pregnancy, strained caregiver attachment and adverse childhood experiences can lead to lifelong effects. Early investment in this stage is essential to promote healthier outcomes and reduces future inequalities.
Since 2019, Integrated Care Systems (ICSs) have played a key role in bringing together local partners to improve health outcomes for babies and children. The work of the Integrated Care Partnership (ICP) has driven integration between Local Authority children’s services, children’s social care, public health services, NHS services and the wider VCSE sector, laying the foundation for more joined up care.
Looking forward, priorities in the first 1000 days of life must focus on improving vaccination access, including through home visits. Holistic services, in partnership with voluntary groups, parents and local authorities, in the most deprived areas could also improve outcomes. Urgent action is also needed to increase mental health support for parents and children under five, as demand far exceeds current NHS provisions.
However, structural barriers persist. Limited capital investment in the primary care estate and digital services hold back the implementation of new models of care within children and young people (CYP) services. Much of the digital expertise across the NHS sits in NHS England, making its abolition and the fifty per cent mandated for ICBs more concerning.
Reducing inequalities in early childhood requires strong partnership at place and system level. Forward Thinking Birmingham, working alongside Birmingham and Solihull ICS, have successfully reprioritised resources to invest in the need and opportunities around the first 1000 days. However, ICSs need longer-term funding cycles to be able to plan and commission services in ways that best meet local need and can be used flexibly to respond to different demographic groups.
