How I describe A Better Start and what it achieved

I had the privilege of being Head of Programme for A Better Start in Nottingham. Through the Small Steps Big Change (SSBC) partnership, the programme delivered £45 million of long-term investment into the city over 10 years. 

During this period, the programme operated through:

• 5 Prime Ministers
• policy responsibility spanning 4 government departments
• prolonged austerity
• ward boundary changes
• the COVID-19 pandemic

The programme’s longevity, ambitious vision, commitment to partnership working and coproduction made it unique. In Nottingham, the ambition was to reach 6,000 babies across 4 wards, improving outcomes in:

• diet and nutrition
• social and emotional development
• speech, language and communication
• meaningful system change

The programme’s achievements were far-reaching. In total, 16,800 children benefited from SSBC. Also, 46 services and 4 public health campaigns were commissioned, supported by over 150 volunteers. This contributed to: 

• increases in good levels of development
• improved speech and language outcomes
• better maths attainment for children living in the target wards 

Several commissioned services, including the Family Mentor Service and HomeTalk, received national awards. Learning from the programme was shared widely at local, national, and international conferences. The legacy of coproduction, father-inclusive practice, and system-change approaches has had a lasting impact both locally and nationally.

What I learned from the programme

My learning from the programme has been extensive and continues to shape my practice. My key reflections include:

Coproduction

Coproduction is central to creating meaningful and sustainable change. It is not free, quick, easy, or ever complete. The most effective coproduction happens where there is a genuine sharing of:

• power
• constructive challenge
• opportunities to develop together
• time, to engage fully in the process

Funding within the wider system

Well-intentioned funding streams can disrupt:

• systems
• workforces
• families

Eligibility thresholds can exclude those most in need.  Excessive monitoring and evaluation can overwhelm frontline services. Funding that’s long-term, outcomes-focused, and responsive to local circumstances is more likely to bring lasting change.

Leadership and system change

Strong local leadership is critical. Effective system change requires leaders to “leave their lanyards at the door,” focus on what is best for the child, and work with local assets and within the local context. This approach builds resilient partnerships that can withstand adversity and thrive when opportunities arise.

Relational-based services

Relational practice is highly impactful. When supported by:

• the right workforce
• resources
• autonomy
• training and time

Relational services build trust, increase self-belief, enable early support, and contribute to wider system change.

Social value

Social value is contagious. Where intentionally designed, unintentional social value often follows.

This included increased confidence and opportunity for:

• SSBC Parent Champions
• volunteers
• staff teams across the commissioned services
• members of the families they work with
• grassroots organisations

Investment in local community groups, building capacity, provided specialist support, and networking opportunities which created a ripple effect remains a significant part of the programme’s legacy.  

How I am applying this learning in my current role

It’s a privilege to continue working in Nottingham following SSBC. 

The programme’s legacy remains evident across the partnership. Particularly in:

• coproduction
• community-based commissioning
• Child Friendly Nottingham
• father-inclusive practice

While it feels odd to hear SSBC spoken about by partners, I'm proud that it’s still regarded as a valued asset in the city’s journey.

In my current role as Public Health Principal leading the Children’s Portfolio within the Public Health Team, I hold a broad remit. This includes leading the Best Start Strategy and commissioning Children’s Public Health 0-19 Integrated Services. I also support key agendas such as:

• teenage pregnancy
• infant mortality
• mental health across the 0–19 age range

This has enabled me to apply my SSBC experience directly, including:

• community-based commissioning
• translating national policy into effective local delivery
• collaborative commissioning
• outcomes-based accountability
• peer-led and relational-based approaches
• coproduction, engagement, and volunteering
• behaviour change campaigns
• evaluation, research, and data-driven improvement
• building sustainable community capacity
• partnership working and network leadership

Over the past year, there has been significant progress across child poverty, the Best Start Strategy, and the NHS 10-Year Plan. Increasing the visibility and prioritisation of:

• expectant parents
• babies
• children
• young people

This renewed focus brings welcome funding opportunities and a critical moment to ensure that services are genuinely coproduced, with babies’, children’s, and young people’s voices at the heart of transformation.

About A Better Start

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Read learning updates from across our programme.

A Better Start is a 10-year project set-up by The National Lottery Community Fund, the largest community funder 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 NCB is coordinating the ambitious A Better Start's NCB-led learning and evidence programme for ABS, 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.