The First 1000 Days: a renewed focus

Health and Social Care Committee Open Inquiry
Opened: 21 Mar 2025 Parliament page
The first 1000 days of life, from conception to age two, are widely recognised as a critical period for child development, shaping long-term health, well-being, and life outcomes.The previous Committee examined this period in its 2019 First 1000 days of life inquiryconsidering national strategy, current spending and barriers to investment … Read more
18 Recommendations
8 Conclusions
1 Report
4 Oral sessions
3 Letters
4 Events
Activity timeline 9 events
28 Apr
2026
Correspondence
22 Apr
2026
Report published
22 Jan
2026
Report published
15 Oct
2025
Correspondence
3 Sep
2025
Oral evidence
2 Jul
2025
Oral evidence
2 Jul
2025
Correspondence
4 Jun
2025
Oral evidence
7 May
2025
Oral evidence
Oral evidence sessions 4 sessions
3 Sep 2025
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Oral Evidence
Ashley Dalton MP · Department of Health and Social Care Liz Ketch · Department of Health and Social Care Susie Owen · Department for Education
2 Jul 2025
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Oral Evidence
Anna Bird · Disabled Children's Partnership Dr Amit Aggarwal · Medical Affairs and Strategic Partnerships Dr Claire Fuller · NHS England Dr Doug Simkiss · Royal College of Paediatrics and Child Health Dr Helen Skirrow · Department of Primary Care and Public Health, Imperial College London Dr Helen Stewart · The Royal College of Paediatrics and Child Health Dr Sally Payne · Royal College of Occupational Therapists Jane Harris · Speech and Language UK Janet Cooper · Royal College of Speech and Language Therapists
4 Jun 2025
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Oral Evidence
Alison Morton · Institute of Health Visiting Dr Christine Farquharson · Institute for Fiscal Studies Rachel Roberts · Hull City Council Rukshana Kapasi · Barnardos
7 May 2025
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Oral Evidence
Professor Sir Michael Marmot · University College London (UCL) Rt Hon Dame Andrea Leadsom DBE · Early Years Healthy Development Review
Title HC No. Published Items Response
5th Report - First 1000 days: a renewed focus HC 802 22 Jan 2026 26 Responded
Recommendations & Conclusions
26 results
1 Conclusion Not Addressed
5th Report - First 1000 days: a re…
Family Hubs funding remains significantly below Sure Start levels despite broader remit.
We welcome the additional funding that the Government has announced for Family Hubs and its plans to open a Hub in every local authority. This is a positive step in increasing the support available to families during the critical first … Read more
Government Response
The government's response outlines that guidance has been published defining Best Start Family Hubs, their location and branding, and how local plans should be developed, without directly addressing the Committee's concerns about funding levels being below Sure Start or the broader age range of children served.
Department of Health and Social Care
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2 Recommendation Accepted in Part
5th Report - First 1000 days: a re…
Set out plans to expand Family Hubs with sustained funding and issue guidance for 0-2 services.
We call on the Government to set out plans to further expand the network of Family Hubs to provide access to a Hub every community. This plan must be supported by sustained and ringfenced funding. Previous research on the benefits … Read more
Government Response
The government commits over £200 million over three years to strengthen the Special Educational Needs and Disabilities (SEND) offer in Best Start Family Hubs and sets an ambition for 70% of hubs to be located in the 30% most deprived areas. However, it does not fully commit to expansion to 'every community' or sustained, ringfenced funding for the general network.
Department of Health and Social Care
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3 Recommendation Deferred
5th Report - First 1000 days: a re…
Create dedicated roles to support parents of children from all disadvantaged groups.
Successive governments have rightly focused on targeting Family Hubs and other early year interventions on those with the greatest need. We welcome the announcement that Hubs will have staff specifically trained to support the parents of children with additional needs … Read more
Government Response
The government acknowledges the importance of supporting all families and highlights existing funding for family-facing practitioners in Family Hubs for children with additional needs. It states that local authorities are expected to develop outreach strategies for other underserved groups and that the government will continue to consider how best to support families from all disadvantaged backgrounds as the programme develops.
Department of Health and Social Care
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4 Conclusion Not Addressed
5th Report - First 1000 days: a re…
Perinatal mental health investment remains insufficient and geographically limited to address needs.
Perinatal mental health is as important as physical health, with poor mental health outcomes having potentially significant long-term consequences for both the mother and child. We were struck by how frequently mental health concerns were raised in evidence. Given that … Read more
Government Response
The government's response details the universal offer of Best Start Family Hubs, including support for socio-emotional and language development, co-location of health professionals, and community outreach. However, it does not address the committee's specific concern about the limited scope of the £54m investment for perinatal mental health being restricted to only 75 local authority areas.
Department of Health and Social Care
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5 Recommendation Deferred
5th Report - First 1000 days: a re…
Set actions to improve perinatal mental health access within Family Hubs for ethnic minority women.
The Government should set out what actions it will take to improve access to perinatal mental health care within Family Hubs, supported by specific targets to improve access for women from ethnic minority backgrounds who have disproportionately poorer mental health … Read more
Government Response
The government defers specific actions and targets for improving access to perinatal mental health care within Family Hubs to forthcoming long-term strategies, including the 10 Year Workforce Plan and a professional strategy for nursing and midwifery due in spring 2026. It explicitly states it cannot commit to specific numbers at this stage.
Department of Health and Social Care
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6 Recommendation Not Addressed
5th Report - First 1000 days: a re…
Revise early language funding guidance to cover 0-2 year olds with maximum provider flexibility.
We recommend that the Department for Education revise its guidance on early language and home learning environment funding to allow it to be used to provide support that covers the 0–2-year period, to allow providers the maximum flexibility in how … Read more
Government Response
The government's response discusses health visiting services and local authority performance improvement, including peer reviews and improvement support, which does not address the recommendation to revise Department for Education guidance on early language and home learning environment funding for 0-2 year olds.
Department of Health and Social Care
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7 Recommendation Acknowledged
5th Report - First 1000 days: a re…
Potential overlap between Neighbourhood Health Centres and Family Hubs requires clear management strategy.
We welcome the Government’s intention for Neighbourhood Health Services and Neighbourhood Health Centres to work in partnership with Family Hubs. Given that both models aim to bring together health and broader support services in a “one stop shop”, it will … Read more
Government Response
The government stated it would consider how to improve services as part of the 10 Year Health Plan, but did not provide specific information on how it will manage the potential overlap between Neighbourhood Health Centres and Family Hubs as requested.
Department of Health and Social Care
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8 Conclusion Acknowledged
5th Report - First 1000 days: a re…
Decimated health visitor workforce threatens government ambition for children's early life outcomes.
The Government will fail to deliver on its ambition to give every child the best start in life unless it takes urgent action to rebuild the health visitor workforce, which has been decimated over the last 10 years. (Conclusion, Paragraph 55)
Government Response
The government acknowledges the concern about the health visitor workforce and explains that the 10-Year Workforce Plan, due in spring 2026, will address all relevant staff groups, including health visitors, through a clear roadmap covering recruitment, training, and retention. It also states that overall workforce growth will slow, and precise future numbers will not be set.
Department of Health and Social Care
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9 Recommendation Accepted in Part
5th Report - First 1000 days: a re…
Create plan to rebuild health visitor workforce and recruit at least 1000 additional staff.
The Government must create a specific plan to rebuild the health visitor workforce in its forthcoming NHS Long Term Workforce Plan. This plan must be informed by safe staffing tools to ensure that health visitors have a manageable workload. As … Read more
Government Response
The government confirmed the 10 Year Workforce Plan will include a phased delivery roadmap for health visiting services to address workforce pressures. However, they rejected committing to recruiting a specific number of new health visitors, stating it would not be responsible to fix precise workforce numbers a decade into the future.
Department of Health and Social Care
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10 Recommendation Accepted
5th Report - First 1000 days: a re…
Set out actions to hold poorly performing local authorities accountable for health visit delivery.
We are also highly concerned about the variation in performance amongst local authorities in delivering health visits. While it is clear that the system as a whole needs additional resourcing, it is unacceptable that some local authorities managed 100% uptake … Read more
Government Response
The government highlights improved health visitor service delivery metrics showing less variation and states it is already carrying out rapid performance improvement activity with local authorities. It also details ongoing measures, including assurance of grants, mandating external peer reviews every five years with accompanying improvement support, and launching a quality improvement partnership forum.
Department of Health and Social Care
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11 Recommendation Not Addressed
5th Report - First 1000 days: a re…
Government's health visit ambitions are inadequate compared to other UK nations' provision.
The Government’s ambitions for the number of health visits are woefully inadequate. Children in England receive fewer mandated health visits than children in any other part of the UK. While the Government’s immediate priority must be supporting and growing the … Read more
Government Response
The government's response discusses improving childhood vaccination rates, which does not address the recommendation to increase the number of health visits to a level comparable to other parts of the UK.
Department of Health and Social Care
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12 Recommendation Rejected
5th Report - First 1000 days: a re…
Commit to increasing mandatory health visitor contacts from five to six for children in England.
We recommend that the Government commit to increasing the number of mandatory health visitor contacts for children in England from five to six. To help it deliver this it should look at the approach that the devolved administrations have taken, … Read more
Government Response
The government rejects increasing the number of mandatory health visitor contacts, defending the existing five statutory reviews as occurring at crucial developmental points. It states that three additional contacts are recommended where possible, and that further improvements will be considered as part of the 10 Year Health Plan.
Department of Health and Social Care
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13 Conclusion Not Addressed
5th Report - First 1000 days: a re…
Significant shortages across children's health workforce are impacting care delivery and patient safety.
Throughout this inquiry we heard that the children’s health workforce is being stretched to breaking point. There are significant shortages across multiple disciplines which prevent professionals from delivering the care young children and their families need and that, in some … Read more
Government Response
The government's response discusses the publication of demographic data within the waiting list minimum data set (WLMDS) and future data granularity, which does not address the committee's conclusion about the children's health workforce being stretched and experiencing significant shortages.
Department of Health and Social Care
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14 Recommendation Accepted in Part
5th Report - First 1000 days: a re…
Create sustainable children's health workforce with specific recruitment targets in the NHS Plan.
The Government must take the opportunity presented by the forthcoming NHS 10 Year Workforce Plan to create a sustainable and well-resourced children’s health workforce. While we understand the Government’s desire for the workforce plan to go beyond numbers, a plan … Read more
Government Response
The government states the 10-Year Workforce Plan will provide a sustainable approach with a phased delivery roadmap for relevant staff groups, including actions across recruitment, training, and retention. However, it rejects setting precise workforce numbers or specific recruitment targets a decade into the future, deeming it irresponsible due to evolving demands.
Department of Health and Social Care
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15 Recommendation Not Addressed
5th Report - First 1000 days: a re…
Set plans to support non-NHS children's health professionals and review multidisciplinary team guidance.
Many professions which play a key role in delivering children’s health care are not entirely or primarily employed by the NHS. We recommend the Government sets out how it plans to support those professions in non- NHS settings, particularly allied … Read more
Government Response
The government's response focuses on a shared outcomes framework and cross-departmental working for early years, but does not address the recommendation to set out a plan for supporting non-NHS health professions or reviewing guidance on multidisciplinary teams.
Department of Health and Social Care
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16 Conclusion Accepted
5th Report - First 1000 days: a re…
Declining childhood vaccination levels represent an ongoing public health crisis requiring urgent action.
The continuing decline in childhood vaccination levels since 2012 is a national disgrace; children should not be dying of entirely preventable diseases. The continued failure to effectively grapple with this is a significant and ongoing public health crisis and will … Read more
Government Response
The government acknowledged the vital importance of vaccinations and the need to improve uptake, outlining a comprehensive plan including a national communication campaign, exploring new delivery methods, improving school consent, and providing NHS App access to vaccination records by 2026-27.
Department of Health and Social Care
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17 Conclusion Rejected
5th Report - First 1000 days: a re…
Government dropping 95% vaccination target from NHS guidance causes concern.
We are disappointed that the Government has dropped the 95% vaccination coverage target from NHS planning guidance and were unconvinced by the Minister’s arguments that it remained an “expectation” despite its removal. While we agree with the Government’s desire for … Read more
Government Response
The government rejected the committee's premise by asserting that the 95% vaccination coverage target has not been dropped but remains an established NHS target, as evidenced in the NHS public health functions agreement 2025-26 and is included in planning guidance.
Department of Health and Social Care
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18 Recommendation Accepted
5th Report - First 1000 days: a re…
Reinstate 95% vaccination coverage target in NHS guidance for all vaccinations.
We recommend that the Government immediately reinstate the 95% vaccination coverage target in NHS planning guidance for all vaccinations, including those given during the first 1000 days to mothers and children. We also call on the Government to commit to … Read more
Government Response
The government states that the 95% vaccination coverage target remains an established NHS target for a variety of childhood vaccinations, as included in the 2025-2026 public health functions agreement and planning guidance. It does not explicitly commit to hitting the target by the end of Parliament.
Department of Health and Social Care
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19 Recommendation Accepted
5th Report - First 1000 days: a re…
Develop new vaccination plan to improve early years uptake, with named ICB leads.
Despite the measures contained in the Government’s vaccination strategy, vaccination rates are continuing to fall and the strategy is failing to deliver the improved coverage that is so desperately needed. The Government should brand the currently strategy a failure and … Read more
Government Response
The government defends its current NHS vaccination strategy and details ongoing commitments from the 10 Year Health Plan to improve uptake, rather than branding it a failure or developing a new plan. It notes that named executive directors for vaccination are already in place in ICBs, and highlights improvements in maternal pertussis and MMR uptake due to existing initiatives.
Department of Health and Social Care
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20 Recommendation Rejected
5th Report - First 1000 days: a re…
Accelerate health visitor vaccination pilot programme and report findings within six months.
The plan for delivering vaccination by health visitors has real potential to help the Government achieve the 95% coverage vaccine target. We recommend the Government explore ways to accelerate the pilot programme and to report back on its findings within … Read more
Government Response
The government rejected accelerating the pilot programme or reporting findings within 6 months, stating they are conducting a 12-month evaluation of 12 pathfinder sites to gather robust evidence on operating models, cost implications, and support needs before wider rollout.
Department of Health and Social Care
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21 Recommendation Accepted
5th Report - First 1000 days: a re…
Single Unique Identifier pilots demonstrate potential for simplifying early years data sharing.
The introduction of a Single Unique Identifier has the potential to significantly simplify data sharing across the early years landscape and we hope that currently planned pilots proceed smoothly and at pace. We ask that the Government commit to providing … Read more
Government Response
The government states that DfE, DHSC, and NHS England are jointly overseeing single unique identifier pilots, with two ongoing and a third planned for 2026, and commits to providing biannual updates on their progress.
Department of Health and Social Care
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22 Conclusion Acknowledged
5th Report - First 1000 days: a re…
Government lacks essential data on children's health outcomes in first 1000 days.
The Government does not have access the data it needs on children’s health outcomes during the first 1000 days. Without this data it will struggle to deliver meaningful improvements or implement a shared outcomes framework. (Conclusion, Paragraph 116) Read more
Government Response
The government acknowledges the need for improved data granularity and states that work is underway to transition to record-level data reporting for community health services, which will eventually include demographic data. However, it notes there are currently no plans for further national disaggregation of waiting list data for children under 2 due to disclosure rules, although local providers have access to this data.
Department of Health and Social Care
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23 Recommendation Accepted in Part
5th Report - First 1000 days: a re…
Produce plans for disaggregated children's outcome data and introduce separate waiting time reports for under-twos.
We recommend that the Government work with all NHS and early-years settings to produce plans for greater disaggregated data concerning service delivery and outcomes for children. This should include data broken down by age group, as well as ethnicity, disability, … Read more
Government Response
The government stated work is underway to collect record-level demographic data for community services. However, they rejected publishing separate national reports on waiting times for children under two, though the data will be extractable, and noted no current plans for further national disaggregation of WLMDS data.
Department of Health and Social Care
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24 Conclusion Acknowledged
5th Report - First 1000 days: a re…
Concerns about data sharing legislation act as a barrier to effective partnership.
Throughout this inquiry we heard that concerns about the legislation around data sharing was acting as a barrier to partners working effectively together. While some local areas have developed their own systems to support effective data sharing, stakeholders were clear … Read more
Government Response
The government acknowledges concerns regarding data sharing barriers by outlining existing information governance guidance from NHS England and detailing planned central support initiatives. These include developing a model data-sharing agreement for safeguarding data, piloting IG surgeries for professionals, and making changes to the Control of Patient Information Regulations to facilitate data sharing.
Department of Health and Social Care
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25 Recommendation Accepted
5th Report - First 1000 days: a re…
Simplify data sharing guidance with Integrated Care Systems to improve provider collaboration.
We recommend that the Department of Health and Social Care work with Integrated Care Systems to simplify data sharing guidance to improve data sharing between providers. (Recommendation, Paragraph 124)
Government Response
The government accepts the recommendation, outlining several initiatives to simplify data sharing, including developing a model data-sharing agreement for safeguarding data, piloting IG surgeries, and making changes to the COPI Regulations to facilitate data sharing for operational purposes.
Department of Health and Social Care
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26 Recommendation Acknowledged
5th Report - First 1000 days: a re…
Support shared outcomes framework with implementation plan and clarify ministerial responsibility across departments.
The absence of a shared outcomes framework undermines accountability and hinders strategic planning across local systems. We welcome the Government’s plans to produce a shared outcomes framework. We recommend that the final framework be supported by an implementation plan that … Read more
Government Response
The government welcomed the committee's recognition and noted the recommendation regarding implementation and accountability. They referenced the existing Local Outcomes Framework (LOF) but did not commit to an implementation plan for the final framework or clearly set out ministerial responsibilities for it.
Department of Health and Social Care
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Government Response AI assessment · 26 of 18 classified
Accepted 6
Accepted in Part 4
Acknowledged 5
Deferred 2
Not Addressed 6
Rejected 3
Total 18 recs + 8 conclusions
Correspondence 3 letters
28 Apr 2026 Correspondence from Minister Hodgson - First 1000 Days Response
Parliament page
15 Oct 2025 Correspondence from Minister Dalton re First 1000 days evidence session
Parliament page
2 Jul 2025 Correspondence from Minister Daby re the First 1000 Days
Parliament page