Increasing the uptake of Healthy Start in Nottingham

Hayley Ellis, Learning and Development Officer at Small Steps Big Changes (SSBC) writes about the work being done in Nottingham to increase the uptake of the NHS’s Healthy Start Scheme.

The NHS Healthy Start Scheme

Hayley Ellis

The NHS Healthy Start is a food welfare scheme supporting pregnant women and families with children under four to buy healthy food, cow’s milk, and infant formula, and to access free vitamins.

As part of Small Steps Big Change’s ambition to support nutrition as a key child development outcome, we commission several projects in Nottingham which align with Nottingham’s Joint Health & Wellbeing Strategy.

The strategy has four oversight groups. Eating and Moving for Good Health and Financial Wellbeing both link directly to the Healthy Start Scheme.

As part of the Eating and Moving for Good Health Strategy, there is an agreed target to increase the number of eligible families receiving the scheme to 90% by 2027.

An overarching ambition for Financial Wellbeing is that Nottingham is a city where people can meet their current needs comfortably and have the financial resilience to maintain this in the future. To support this work, SSBC has undertaken a range of measures, with activity aimed at raising awareness across the maternity and early years work force and amongst families.

For families, we have produced digital content to share on our social media channels to remind parents of the scheme and how they can access it, this has included producing recipes and an animation.

For the workforce, training to raise awareness and knowledge of the scheme has been the focus of our attention. This started with a webinar in February 2022 to support the transition within the Healthy Start scheme from vouchers to a prepaid card.

Delivering Healthy Start training

Following the webinar, SSBC has continued to offer Healthy Start training through a rolling programme delivery. The aim was to increase practitioner knowledge to allow them to speak confidently to parents about the scheme and support the application process, if needed.

The training was promoted to all services who have contact with pregnant women, and with families from birth to four years, these included:

  • Nottingham County Council Children's Services
  • Nottingham City
  • Care Partnership Children’s 0-19 Public Health Service
  • Nottingham University Hospitals NHS Trust Midwifery Services
  • Nottingham Community & Voluntary Services
  • GP Surgeries
  • Early Years Services
  • Financial Support Services (including food banks)
  • Nottingham Housing Services

In January 2023, 66% of eligible families in Nottingham were accessing the scheme. 5018 were identified as eligible, but only 3309 were receiving the benefit, meaning that 1709 were missing out on this vital support. To understand why, SSBC held a consultation, which produced the following findings:

  • People were not aware of the scheme.
  • People were finding the application process too complex due to:
    • Having English as an additional language
    • Not having access to a computer
    • Not having the skills to apply online
    • Too challenging- applying for the scheme and Healthy Start requesting more information or having to reapply on several occasions to no avail.
    • Complex application route depending upon benefit received.

In response to this feedback, our training included a request for services to pledge one way they could add Healthy Start to their everyday activities. Following this pledge, services are recognised as a Nottingham City Healthy Start setting and receive:

  • A Healthy Start Setting certificate
  • A Healthy Start setting pin badge - for the Healthy Start Champion
  • A Healthy Start Setting logo - this can be added to websites, printed resources, and email signatures.

Current uptake of Healthy Start in Nottingham

Healthy Start Setting logo

A range of services across Nottingham are now participating. GP surgeries promote NHS Healthy Start in text messages to pregnant women. The Nottingham City Free Fun and Food Programme promotes the scheme in emails to registered families and the Midwifery and Children’s Public Health (0-19) Nursing Service often promote it during visits. This practice supports data reporting and enables SSBC to identify where the uptake is low so they can provide targeted support.

As of April 2024, the uptake of Healthy Start in Nottingham had increased to 70%. Whilst there is still a long journey ahead to achieve the ambitious of 90% uptake, we are confident that continued promotion and training will raise awareness and ensure that Nottingham will reach its target by 2027.

As part of SSBC’s ambitions around sustainability and legacy, this work will be passed to the Eating & Moving for Good Health working group to continue delivery from July 2024.

For more information visit the SSBC website and search Healthy Start.

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK.

Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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Visit the A Better Start website to find out more.