Priority 1: for every child - the best start to life
Commitment:
We will secure the ‘best start’ for every child through universal access to the Start for Life Programme to ensure that every child and family has access to the resources and support they need to flourish.
When children’s developmental needs are met, they are more likely to thrive emotionally, socially, cognitively, and physically, setting a solid foundation for their future well-being and success. Meeting these needs requires supportive and nurturing relationships, safe and stimulating environments, and access to appropriate resources and opportunities for learning and growth.
Where are we now?
Coventry Joint Strategic Needs Assessment (JSNA) 2023 – Coventry City Council
At birth and in early childhood:
Coventry achieves above the national average for metrics related to child development in infancy. However, by the age of five, fewer children achieve a good level of development than within statistical neighbour localities.
In 2020 to 2021, 73.8% of Coventry newborns received breast milk as their first feed, better than both regional (68.3%) and national averages (71.7%). The prevalence of breastfeeding is also measured using data collected by health visitors when a baby is 6 to 8 weeks old. In Coventry it has remained around 50% in recent years, meaning that half of babies remain at least partially breastfed by that age. While there is some uncertainty because of missing data for a small minority of babies, we can say the 2021 to 2022 rate of about 51% is higher than the England average of 49.2% and it has been better for the last few years, although the gap has narrowed due to an increasing trend for England overall.
In 2021 to 2022, 9.3% of new mothers from Coventry were smoking at the time of delivery. While it would be good to reduce this further, this has been on a downward trend from 15.1% in 2010 to 2011. It is the same as the England average (9.1%) but lower than the regional average (9.8%) and the average amongst Coventry’s statistical neighbour areas.
Infant mortality:
Rates in Coventry are higher compared to England but similar to the regional rate. The infant mortality rate in Coventry is 5.7 per 1,000. In line with the West Midlands (5.6) but higher than for England (3.9).
The child mortality rate (1-17 years) in Coventry, whilst low in number, is 15.0 per 1,000, has remained persistently high compared to both the West Midlands (11.0) and England (10.3) since 2012.
Low birth weight:
In 2021 the percentage of all babies born at low weight (under 2500g) in Coventry was 8.1%, higher than the national average of 6.8%, but similar to the regional average of 7.6%. This could be due to a relatively high number of babies born to Coventry mothers being premature, leading to a higher number of babies born at low weight; for the 3 years 2018 to 2020 1,255 Coventry babies were born prematurely, a rate of 99.7 per 1,000 compared to the national average of 79.1.
Teenage parents:
Under 18s conception rate per 1,000 is 21.2 locally compared to national rates of 16.7.
Oral health:
Data from an oral survey of 5-year-olds indicates that the dental health of children in Coventry is worse than regional and national averages. In 2021 to 2022 over a third of 5-year-olds surveyed had experience of visually obvious dentinal decay, 34.2% compared to 23.8% across the West Midlands region overall and 23.7% across England overall. This is the third highest prevalence out of all local authority areas in the West Midlands. (Child Health Profile 2021).
Childhood obesity:
At reception, Coventry’s obesity rate is similar to the England average; but by Year 6, the city’s obesity rate is higher than the England average. 1-in-5 reception year (aged 4 and 5) Coventry children were measured as overweight in 2021to 2022, doubling to 2-in-5 children in year 6 (aged 10 and 11). There is a clear link between deprivation at age 4 and 5 and age 10 and 11, with successively higher rates of obesity in areas of higher levels of multiple deprivation. The general trend over the last 7 years is of increasing proportions of 10 and 11 years being overweight or obese.
Children in Care:
In Coventry 89.5 children out of every 1,000 are in care. This is higher than England’s rate of 70 but in line with the statistical neighbour average of 89. This has been on a slightly increasing trend in recent years. Coventry has seen an increase in the number of unaccompanied asylum-seeking children, the city has a higher proportion of these children in care than all comparators. If these children were excluded, then a trend of reduction would be shown over the last few years.
Childhood vaccination take up rates in Coventry are relatively low and have decreased:
In the 2020 to 2021 period, 81.7% of children in Coventry received their first dose of the Measles, Mumps, and Rubella (MMR) vaccine by their second birthday. Health authorities aim for a 95% vaccination coverage to ensure herd immunity and prevent outbreaks. In the 2023 to 2024 period, there is significant improvement. 86.5% of children in Coventry received their first dose of the Measles, Mumps, and Rubella (MMR) vaccine by their second birthday. This figure is slightly below the regional average of 88.2% and the national average of 88.9%. Source: eDemocracyFingertips.
The current uptake in Coventry falls short of the 95% target, highlighting the need for continued efforts to increase vaccination rates. To address this, the NHS and local health partners are implementing strategies to improve MMR vaccine uptake, including public awareness campaigns and making vaccinations more accessible. Parents and guardians are encouraged to ensure their children receive both doses of the MMR vaccine at the recommended ages to protect against these preventable diseases.
Poverty:
The percentage of children under the age of 16 who live in absolute poverty is greater when compared to the rest of England. In Coventry in 2021 to 2022, 21.4% of children under the age of 16 live in homes with ‘absolute’ low incomes, compared to 15.3% in England.
The percentage of children living in ‘relative poverty’ in Coventry is 26.7%, amounting to an estimated 18,267 children. This compares to 27% throughout the West Midlands and 19.9% in England. This has been an increasing trend in Coventry, and elsewhere, since 2014 to 2015.
The extent of ‘child poverty’ can be measured in other ways, the End Child Poverty campaign attempts to model the number of children who live in households with a relatively low income (less than 60% of the national median household income), calculating income after the costs of housing are taken away. Rates are higher when calculated this way. For 2021 to 2022 they estimate that 31,458 of Coventry children (0 to 15) live in poverty, which amounts to over one-third of all children living in Coventry, 39.6%.
Children who access Early Years Education
In 2024 the take-up of early education funded places for eligible 2-year-olds was 67.2%. This was below national (74.8%) and our statistical neighbours (72.5%).
The take-up of the universal entitlement places for 3- and 4-year-olds highlights a relatively consistent picture within like for like terms e.g. Autumn to Autumn. This dataset shows an ongoing, fluctuating picture across the year which could be linked to the level of transience within the population and cultural influences within communities who cite that they prefer to admit children into nursery education later than their UK counterparts.
In Autumn 2024 89.6% of 3- and 4-year-olds in the city accessed early years education compared to 94.9% nationally and 95.7% for statistical neighbours.
Note: LAIT Data January 2024 statistics do not cover the expanded entitlements for children of eligible working parents which includes, from April 2024, the 15-hour entitlement for 2-year-olds and, from September 2024, the 15-hour entitlement for children aged 9 to 23 months.
Take up of Extended Entitlements (30 Hours) for 3 & 4 year olds
From September 2017 eligible families were able to access an additional 15-hours per week of early education, up to a maximum of 38 weeks across the academic year. By October 2017, 1143 places were taken up across both PVI providers and school nursery classes.
Since the introduction of the initiative in 2017, the overall take up of places has increased to 2,411.
The largest increase in the delivery of places has been seen in school nursery classes where we have seen a growth of 178%. This is due in the main to increase in a commitment from schools to provide this offer in order meet the needs of working families and to remain competitive in the childcare market.
Overall Coventry has seen an increase of 111% in the take up of places since the initiative began. Spring 2024 saw a take up of 3240 children, or 39%, accessing extended early years education across the city.
Priority one: what this means for every child
Marmot principles
- ensuring access to effective universal services including healthcare parenting programmes, and early years education meeting the level of need across the City
- the benefits of Early Education reaching more children, using different approaches to encourage take up of 2, 3, and 4-year-old funded places for targeted groups
What will we do?
- Family Hub development and accessibility:
- champion Family Hubs as central access points for Start for Life services
- expanding birth registrations within Family Hubs (from 2 to 4 hubs) to increase engagement
- roll out Bump to Baby interventions across all 8 localities
- develop the digital front door to support early learning
- co-design our Start for Life offers with Parent and Carer Panels
- embed a universal and universal+ offer for all families, with enhanced support for vulnerable groups
- Integrated Health & Developmental Support:
- multi-disciplinary teams will deliver joint sessions with health and SEND professionals to improve early identification and reduce referrals
- expand the 2-year integrated developmental review into more private, voluntary, and independent (PVI) nurseries
- ensure any 2-year-old check with concerns triggers Health Visitor follow-up
- strengthen links between every nursery and a designated health professional (e.g. health visitor)
- Health Promotion & Early Intervention:
- increase MMR vaccination uptake to match national averages
- narrow breastfeeding inequality by targeting traditionally underrepresented groups in (6 to 8 week) breastfeeding rates
- scale up access to toilet training sessions to reduce nappy use at school entry
- boost uptake of Healthy Start vouchers, including early access from 10 weeks pregnancy
- Parenting Support & Inclusion:
- expand the range of parenting support across the parenting journey
- ensure targeted parenting support reaches:
- under-21 first-time parents (via FNP)
- parents of children aged 0 to 2 (the “1001 days” window)
- ethnic minority families
- dads and male carers
- promote oral health, increasing the number of settings achieving the Early Years Oral Health Award
- Access to Childcare & Early Education:
- plan for expanded early entitlements and wraparound care to meet growing demand
- maintain and improve take-up of targeted 2-year-old funded places
- maximise Early Years Pupil Premium uptake across all provider types
- provide brokerage support for families seeking childcare to enable work or training
- Inclusion & Additional Needs Funding:
- monitor applications and awards for Special Educational Needs Inclusion Funding (SENIF)
- increase awareness and claims for Disability Access Funding (DAF) through strategic communication, training, and termly data analysis
Outcome flourish - we will know that we have been successful when:
Outcomes
- our early childhood needs are met, because our parents and carers know how ask for help, even before we are born
- more of our family members access resources to help them with looking after us. This is successful because up-to-date information, is shared through clear and effective communication systems, made available in a wide range of different ways, in person, in writing, audibly and electronically
- more of our parents and carers access regular healthcare checks and routine immunisations, regardless of our background or starting points
- where we need help, assessment and intervention is timely and acted upon. This ensures that we reach age-appropriate developmental milestones and maintain optimal health
- more of us attend 2,3- and 4-year-old provision, particularly from priority groups
Performance measures
- between 2025 and 2028 increase in the number of parents who access digital start for life services at universal and targeted level
- more parents of children aged 2–4, access HLE programmes delivered by a range of professionals including health and early years practitioners, and VCFS organisations
- more parents access targeted Family Help services receiving the support they need to thrive as a parent, when they need it
- increase attendance rates in reception across the local authority by 2% by 2028 through the implementation of a family engagement strategy
- increase the number of parents and practitioners who have accessed Thrive Training
- between 2025 and 2028 the number of completed integrated 2-year reviews will increase by 25%
- between 2025 and 2028 increase the percentage of children receiving the MMR vaccination by their second birthday to be in-line with national figures
- promote and increase engagement and success with breastfeeding from groups traditionally not breastfeeding
- to increase the number of practitioners accessing training, to support SEND in mainstream provision, to ensure accurate and early identification of need
- increase the number of early years practitioners across the LA achieving the Early Years SEND qualification by a further 10% by July 2028, to enhance inclusive practice and support more children with SEND to thrive in mainstream settings
- between 2025 and 2028 increase the take up of targeted 2-year old Early Years Education entitlements. (67.2%)
- maintain current take up of Early Years Education Universal Entitlement for 3- and 4-year-olds (90%) and move closer to statistical neighbours (95.7%)
- workforce development -PSED / SEML. 30% practitioners access training to support children with SEML needs in the early years foundation stage