Context and diagnosis

Key questions to answer

A strong Best Start in Life strategic plan will build on existing assets and strengths, set clear priorities with a credible plan to deliver, and maximise resources to achieve your Good Level of Development (GLD) target while tackling disadvantage.

We recommend starting with your current outcomes, context and services, in order to help you and your teams align on:

  • What child outcomes do we need to improve?
  • Who do we need to prioritise?
  • Where do we need to focus our service delivery?
  • How can we enhance our current service offer, and what are the key enabling factors?

To this end, this section of the playbook offers tools and support to draw together outcomes data, professional insight, family experience and wider contextual data. You may choose to use Nesta’s strategy workbook to summarise your work as you progress through each section, though there is no obligation to do so.

Throughout, we have suggested ways in which you could go further to test your assumptions and shore up your diagnostic insights. If you would like additional guidance, we also recommend the Foundations Family Hub Planning Framework resources and the LGA toolkit.

As you read through this guidance and consider the suggested activities, you may find that our suggestions reflect work that you are already doing. If you find yourself in this situation, we hope you feel reassured. We also have additional support offers that could help you to take your Best Start in Life plan development even further.

Understanding your child outcomes

This section helps you answer two key questions:

  • What child outcomes do we need to improve?
  • Who do we need to prioritise?

It invites you to consider your GLD target and other outcome measures, drawing from Nesta’s local authority-specific data profiles and local insights.

Most importantly, your GLD target sets a clear ambition for your strategic plan. This LA-specific data profile summarises where you stand against this target now in terms of your overall GLD target, and GLD target for children eligible for free school meals.

In addition, your data profile provides data on child outcomes from the nationally available data, under the categories of the Common Outcomes Framework.

For a more granular school-by-school analysis of GLD, you can use the Department for Education’s View Your Education Data platform. The local team responsible for this data may also be able to provide ward profiles and gender breakdown.

Nesta has chosen to use the five dimensions of the Common Outcomes Framework - safe, healthy, learning, happy and engaged - to structure this guidance, as it encourages us to think holistically about children’s needs as they grow. The Common Outcomes Framework has been used by a collaboration of London boroughs, supported by the Common Outcomes for Children and Young People Collaborative, to co-produce a shared outcomes framework, starting with a focus on Family Hubs and now across wider local children’s services, partnerships and systems.

The framework gives more detail of those indicators and metrics most closely related to a consistent set of strengths-based outcomes for babies, children and young people, and for parents and carers, and the service/system level indicators most relevant to integrated family services. This more detailed shared framework is aligned to the Local Government Outcomes Framework and is already being used to shape local needs assessment, planning, commissioning and delivery. This includes where to focus to deliver local GLD targets, within a broader strategic view of what matters most for local children, families and communities.

In the following sections, we suggest how you might consider each outcome area individually, with prompts to help you identify areas of strength and weakness across all child outcomes. We have also indicated where it might be helpful to look at the detailed shared outcomes framework co-produced in London using the Common Outcomes Framework – more details and the latest version of the framework are available here.

Learning

Children are born ready to learn, and the characteristics and quality of their early environments shape their development. Strong evidence shows that responsive, nurturing adults and supportive home learning environments with access to appropriate learning materials and activities play a critical role in children’s development.

Alongside the GLD-related indicators discussed above, additional indicators can support you to understand the learning journey of children from birth to age five, and their engagement with early childhood education and care along the way.

Your data profile includes:

  • Proportion of children at expected levels of development on the ASQ-3 assessment at 2-2.5 years
  • Proportion of children taking up their 3 and 4 year entitlement.

Alongside your local insights, this data can help you understand:

  • How do child learning outcomes in our area compare to national figures?
  • Are outcomes improving, remaining static, or getting worse?
  • Where is there variation, and what might drive differences? ?
  • Are there any specific child learning concerns to consider prioritising in the strategic plan?

If you know of other areas of concern, or if you’d like to broaden your understanding of child learning in your area, consider gathering additional data on indicators.

Potential sources of additional information

  • Other locally collected child development outcome data, including
    • Aggregated ELIM data
    • Aggregated WellComm data
    • Aggregated ASQ-SE data at 2-2.5 years
    • Aggregated ASQ-3 data at other ages
    • Speech and Language Therapy referral rates and wait lists figures
  • See also the detailed shared outcomes framework co-produced in London using the Common Outcomes Framework for additional metrics.

When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy.

Healthy

Children’s early health outcomes are strong predictors of their later health and wellbeing, and data on uptake of health services can be a proxy for access to appropriate healthcare and support. We also know that health outcomes in England show large social inequalities, with children from more deprived backgrounds being less likely to have good health in their earliest years.

Your data profile includes a wide range of relevant metrics that can help you understand variation in children’s health and physical development, including:

  • Number of children categorised as healthy weight at reception
  • Admission for dental caries for children 0-5 years
  • Proportion of parents attending 2-year health check
  • Breastfeeding rates
  • Vaccination take up of MMR at 2 years
  • Vaccination take up of MMR second dose at 5 years

Alongside local insights, this data can help you understand:

  • How do child health outcomes in our area compare to national figures?
  • Are outcomes improving, remaining static, or getting worse?
  • Are there any specific child health and physical development concerns to consider prioritising in the strategic plan?

If you know of other areas of concern, or if you’d like to broaden your understanding of child health in your area, consider gathering additional data on related indicators.

Potential sources of additional relevant information:

  • Child eligibility for Healthy Start (health visiting data)
  • Absence of visible dental caries
  • Access to healthy food
  • Parental smoking
  • Access to fast food*
  • Dentist accessibility*
  • Pharmacy accessibility*
  • GP practice accessibility*
  • Hospital accessibility*
  • See also the detailed shared outcomes framework co-produced in London using the Common Outcomes Framework for additional metrics.

* View using the map of the Access to Healthy Assets and Hazards dataset

When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy.

Safe

Safety encompasses both the physical and emotional safety of children in all their environments, including home, early childhood education and care (ECEC) settings and school, and the community.

While these children represent a relatively small proportion of your total population of children, they are likely to be some of the most vulnerable.

Your data profile includes data on figures of Children in Need (CiN), which has been shown to vary widely across local authorities . It also includes data on hospital admissions for young children.

Alongside local insights, this data can help you understand:

  • How do CiN outcomes for children aged 0-5 in our area compare to national figures?
  • How do hospital admissions for young children compare to national figures?
  • Are these outcomes improving, remaining static, or getting worse, for children aged 0-5?
  • Are there any specific CiN concerns to consider prioritising in the strategic plan?

Family Help colleagues can support you to understand this data in more detail. They can help you to identify the specific needs of your CiN population, and the prevalence of wider challenges families within the Family Help cohort (e.g. domestic abuse, parental substance misuse).

If you know of other areas of concern, or if you’d like to broaden your understanding of child safety in your area, consider gathering additional data on indicators, such as:

  • Number of children experiencing domestic abuse (CiN and Family Help end of assessment data; police data)
  • Number open to Early Help; Family Help
  • Number of children in low income families (relevant data available in your data profile)

When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy.

Happy

The Common Outcomes Framework includes under ‘Happy’ that children have their emotional, social, and personal needs met, are supported to build resilience and have opportunities to play and engage with nature and art.

There is very little nationally collected data to consider, though you may have access to locally available data and insights relating to:

  • Children with good quality infant/child-parent interaction, attachment and emotional connection
  • Parents with positive emotional health and wellbeing, including during the perinatal period
  • Parents accessing perinatal and parental mental health services, infant mental health service, parent-infant relationship services
  • Availability of green spaces and playgrounds in your area, or the provision of arts activities and clubs for young children.
  • See also more examples in the detailed shared outcomes framework co-produced in London using the Common Outcomes Framework for additional metrics.

Engaged

The Common Outcomes Framework includes under ‘Engaged’ that children are happy with family life, family networks, friendships and connections, have a choice of things to do and places to go, feel valued and respected and that they belong to a community and have their voices heard and acted upon.

There is very little nationally collected data to consider, though you may have access to locally available data and insights relating to:

  • Opportunities for participation, including in active parent panel
  • Parents accessing services, including (specialist) parenting programmes and family support in places and ways that work for them
  • Positive relationships at home, with conflict resolved constructively
  • Access to play, sport, recreation and enrichment
  • See also more examples in the detailed shared outcomes framework co-produced in London using the Common Outcomes Framework for additional metrics.

You may consider consulting your parent/carer panel if you have one. Further guidance for involving children and families in decision-making as you develop and deliver your strategic plan will be included in the next release of this playbook.

Take stock: based on local insight and what you’ve learned, what child outcomes need the most improvement? What scale of change is required? You may choose to use Nesta’s strategy workbook to summarise your work. The next section will help you unpack where and whom to prioritise improvement in relation to these child outcomes.

Understanding your population characteristics

The section above helps you consider which child outcomes to prioritise. This section aims to help you and your teams consider:

  • Where do we need to focus our efforts, in order to improve those outcomes?
  • Who do we need to prioritise - which groups of families need the most support?

Used alongside the data on child outcomes, population characteristics can support you to identify more explicitly who may need support, where support may be most useful, and possibly an indication of the magnitude of need. A strong understanding of your population characteristics, such as cultural backgrounds and language skills, can also help you to design and improve services in inclusive, accessible ways for those families you really want to reach.

Pay specific attention to those who are less likely to achieve GLD than their peers. The government's stated expectation is that Best Start in Life strategic plans prioritise improvement for children experiencing poverty and economic deprivation, and are inclusive to children with SEND. In addition, national trends suggest children from minority ethnic backgrounds, boys, summer-born children, and children with English as an additional language are less likely to achieve GLD..

Section three of your data profile can help you explore demographic characteristics of your population, to help you answer important questions including:

  • Where do young children (0-5 years) live in your community? Are there areas of particularly high or low numbers of young children?
  • What are the levels of economic deprivation in your area, and where is deprivation most concentrated? Do these areas overlap with those that have higher numbers of children age 0-5?
  • Are there any concentrations of overcrowded households and/or homeless households with children?
  • How do special education needs vary in your area and by age?

There is a wealth of data held locally that can help you create a richer picture of your local population characteristics and likely levels of need. In the time you have, we suggest that you focus on questions that are particularly pertinent to you and combine data with local insight to develop a rich and nuanced picture. Consider intersectionality as you interpret the data, for example the relationships between ethnicity, SEND, economic deprivation and geography.

When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy.

Take stock: based on local insight and what you’ve learned, where and for whom might you want to prioritise improvement? Which groups and areas are most important to reach, to achieve your GLD target? You may choose to use Nesta’s strategy workbook to summarise your work. The next section will help you map your current service offering in relation to these areas and groups.

Mapping your current service offer

The sections above help you consider which outcomes, where, and whom to prioritise. This section aims to help you and your teams consider:

  • Where do we need to focus our service delivery?
  • How can we enhance our current service offer, and what are the key enabling factors?

Mapping the strengths, weaknesses and gaps of the current support offer in your place is a critical part of the diagnostic stage of developing your Best Start in Life plan. Given limited time, this process should be rapid and pragmatic - but clear enough to inform decisions about how to allocate limited resources to drive improvement and achieve your GLD target.

This section of the playbook sets out practical suggestions, drawing on more comprehensive service mapping advice, including from the Foundations Family Hub Planning Framework.

Gather what you know about existing services and priorities

We recommend mapping the breadth of services for 0-5s which support your GLD target against the Common Outcomes Framework, and summarising:

  • What services are offered?
  • How much do they cost?
  • Who do they reach (age, geography, demographics)? How well do they reach and engage these groups?
  • How are they targeted? (universal, targeted, specialist)
  • How well evidenced are they?
  • What are the service delivery strengths and weaknesses?

This service mapping template can help you with this mapping, encompassing the breadth of services that support GLD, such as:

  • Home learning environment (HLE) programmes
  • Parenting programmes
  • Health visiting services
  • Perinatal mental health support
  • Parent-Infant relationship support
  • Infant feeding support
  • Support for children with additional needs
  • Reception year
  • ECEC access and quality*

*Your existing early education and childcare sufficiency assessments may have useful information to include in your service mapping.

We strongly recommend including services provided by voluntary, community and faith sector organisations, in addition to those directly commissioned by the local authority or delivered by statutory partners.

Section four of your data profile includes a basic asset map showing the location of existing family hubs (where relevant) and libraries overlaid on local deprivation data.

You probably already hold most of the information you need, but it’s helpful to gather it in one place and involve other stakeholders who are critical to delivery. When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy. Consider involving and/or looking for additional information from:

  • Current service directories like the Family Information Service
  • Existing commissioning plans and contracts
  • Family Hubs / Best Start in Life progress documents
  • Public Health annual reports
  • Early Help and SEND pathways
  • Previous strategy reviews
  • Partner organisation offer lists (e.g., voluntary, community, and faith sector, health visitors, midwives)

Take stock: based on local insight and your service mapping, what are your strengths, weaknesses and gaps? How does this relate to the needs identified above, and evidence of impact on child development outcomes? You may choose to use Nesta’s strategy workbook to summarise your work. The next section will help you consider the experiences of children and families in relation to these services.

Experiences of children and families

The section above helps map the wide landscape of early years services that support children’s development. This section aims to help you and your teams consider the experiences of children and families accessing and using these services, to inform choices on:

  • Who do we need to prioritise?
  • How can we enhance our current service offer, and what are the key enabling factors?

If you already have well developed engagement infrastructure (such as parent panels and community advisory groups), consider how you will involve them in your process. If not, consider prioritising the formation of a parent panel and community engagement opportunities during the delivery of the Best Start in Life strategy. The Local Government Association offers guidance on engaging families in service design and delivery, to ensure it is meaningful for all involved.

You may also want to collate existing family, child and/or practitioner feedback on the services you have mapped (e.g., from user feedback forms or prior consultations), and/or ask staff and partners to summarise recent feedback shared with them. Pay particular attention to feedback from the priority groups you identified earlier.

Colleagues from other early years services are likely to hold insights and/or have qualitative feedback from parents and families they could share. Consider asking them to send you any recent qualitative data relating to 0-5 year olds that they have to hand, such as reports, case audit themes, engagement notes, or parent/child feedback.

This could include:

  • Health visitor & midwifery partners
  • Early years providers forums
  • Family hub managers
  • SEND team managers
  • Voluntary and community service groups
  • Community health partners
  • Domestic abuse services
  • Home visiting charities
  • Infant feeding support providers

When gathering information you should always make sure that you are complying with your organisation's applicable policies, including (where relevant) your organisation's data protection policy. In this case it’s particularly important to request that information is only shared in anonymous or aggregated formats, without personal or identifiable data.

Take stock: based on local insight and what you know about the experiences of children and families, what are your strengths and where is there room to improve? You may choose to use Nesta’s strategy workbook to summarise your work. The next section will help you draw together the breadth of insights you have gathered, to inform your strategic priorities.

Summarising your context and diagnosis insights

After gathering data on child outcomes, population characteristics and current services, consider:

  • What child outcomes do we need to improve? Which intermediate outcomes matter most to achieving our GLD target?
  • Who do we need to prioritise? For whom are gaps widening or stubbornly persistent? What are their characteristics?
  • Where do we need to focus our service delivery? Are there areas of disadvantage where more children are living? Areas where needs are high, and service reach is low?
  • How can we enhance our current service offer? What are the current challenges, and what drives them? What would enable improvement?

This is where the strategy workbook is most helpful to bring together insights and identify your emerging priorities. As you summarise what you know, look for areas where different sources of evidence converge on the same conclusions. Also consider areas where key stakeholders have different understanding or priorities. These insights can be valuable when deciding how to frame conversations with partners.

The next update to this playbook will offer guidance on developing a credible plan and allocating resources strategically, to deliver on these priorities. As a reminder, we also have additional support offers that could help you to take your Best Start in Life BSiL plan development even further. We encourage you to get in touch with us by emailing bsil-support@nesta.org.uk to find out more.

Strategic prioritisation chevron_right