Did Sure Start work? 

From an article by Beautiful Enterprise

Tim Thorlby was the development director at the Centre for Theology and Community in east London and is now the Director of Beautiful Enterprise, providing research and consultancy support to public services, charities and enterprises. He has been looking at some of the UK’s most effective economic policy interventions of the last 25 years.

There is a saying in policy circles (and many organisations); we tend to overestimate what we can achieve in one year and underestimate what we can achieve in ten years. He looked at the major early intervention programme, Sure Start, which took a long term view. Did it work? What can we learn? 

What is Sure Start?

In 1999, the New Labour Government launched something of a novelty for the UK – a pioneering early intervention initiative which sought to integrate a whole bunch of health and education services into one place for young families. The aim was to improve the health and wellbeing of young children living in England’s most deprived neighbourhoods (the 20% most deprived).

These ‘Sure Start’ centres were designed to bring together a wide range of services for families with children under the age of 5 to help new parents navigate pregnancy, parenting, childcare, early learning and even how to find a job. The services were delivered from a network of 500 Sure Start centres across the country – ‘one stop shops’ for families with pre-school children. They provided an integrated mix of antenatal care, childcare, family health support, parenting advice, early learning, support for children with special needs and links to Jobcentre Plus to help with training and employment.

The service was a key part of the Government’s ambition to tackle poverty and social exclusion and change the trajectory of disadvantaged communities. It was led by a new Sure Start Unit, jointly owned by the Departments of Education and Health. Delivery in each community was led by local government.

Initially targeted at the most deprived areas, the programme was expanded in 2004 to cover a much wider range of neighbourhoods, with the aim to have a centre in every community. These rebranded ‘Sure Start Children’s Centres’ grew to become a network of over 3,000 service points across England by 2010, accounting for one third of all public spending on under 5s and costing £2.5 billion per year (2023 prices).

In 2010, it was estimated that the 3,290 Sure Start Children’s Centres had a wide reach, with 83% of the nation’s 4 year olds living within 2.5km of their local centre.

Sure Start did not fare particularly well in austerity. From 2010 to 2022, nearly half of these centres closed and funding overall fell by 75%, so the original service is no longer recognisable. As we will see, this may be a significant missed opportunity.

Did it work? Here is a abridged version of the article:

1. Educational achievements

A 2024 IFS report evaluated the impact of Sure Start on the academic achievement of children at age 5, 7, 11 and 16. It showed that, for children who had access to Sure Start before the age of 5, there was “strong evidence” of a significant improvement in their academic achievement at the age of 11 and 16 in particular. It gave an average increase of 0.8 GCSE grades per child overall. 

The evidence also suggests that children from lower-income households (those who qualified for Free School Meals) benefited the most. At age 16 these children showed improvements in academic achievement, on average, equivalent to 3 GCSE grades higher than expected. That is a huge difference.

Sure Start also made it more likely that any special needs in children would be identified and addressed at an earlier stage, with the result that the incidence of more severe special needs amongst these children by the age of 16 was actually lower than previously reported.  

2. Health

A 2021 report explored the long-term health benefits from children and their families engaging with Sure Start. By the age of 5, and even more so as teenagers, the rate of hospitalisations reduces substantially. Young people who benefited from Sure Start through stronger immune systems, better advice on healthcare, safer home environments and stronger mental health, were less likely to go to hospital each year when they were aged 11-15. They estimated that over 13,000 hospitalisations per year were prevented amongst those 11-15 year olds. The financial ‘saving’ from this alone would have covered 31% of the total cost of running Sure Start each year at its peak.

3. Offending

Another 2024 study looked at the impact of Sure Start on the behaviour of children. It also offers some striking results. The evidence suggests that children who engaged with Sure Start before the age of 5 were significantly less likely to be involved in serious offending. The evidence showed they were 13% less likely to receive a criminal conviction and 20% less likely to receive a custodial sentence by the age of 16. The study also suggested that children were less likely to spend time in care. The report highlighted that the substantial savings in criminal justice costs would have been sufficient to cover 20% of the costs of Sure Start at its peak. 

4. Cost-Benefit

The IFS estimate that in 2010, at its peak, Sure Start’s overall costs amounted to an average of £1300 per child. Just considering one outcome alone – educational achievements – and not including health or offending or other outcomes, the cost-benefit analysis shows a positive benefit. For every £1 invested in Sure Start, they estimated £1.09 in benefits.

Sure Start looks like a good investment for the taxpayer. Not just a ‘cost’, but an investment which reduced some future public costs (SEN) and increased the earning potential of young people as they entered their careers.

When you take the savings identified for the health service (31% of the cost of Sure Start) and the savings identified for criminal justice (20% of the cost of Sure Start), and add them together with the benefits of improved educational outcomes, it does not seem fanciful to suggest that this programme represents a solid investment and pretty good value for money.

5. Foundations

Our economy’s greatest asset is the people who work within it. There is a rather unlovely phrase - ‘human capital’ – which sums up the knowledge, skills and experience that each person brings to work. The more we invest in our human capital, the better our economy will work. The better educated and skilled our workforce, the more they can do and the more they can earn.

Sure Start was a programme aimed at new parents, babies and young children, seeking to support the development of children so that they would start primary school, at the age of five, healthier, happier and more equipped to learn. It was an early investment in ‘human capital’ and it worked. Additionally, the programme was particularly effective in deprived areas, where the UK has wasted a huge amount of human potential through decades of neglect. 

Tim then suggests lessons for future interventions and you can read these in the full article here.