Increasing uptake of the Healthy Start scheme in Hounslow

In January 2022, the uptake rate of the Healthy Start scheme in Hounslow was 49 per cent. The scheme is not promoted nationally, so it rests with local publicity and engagement with families to raise awareness and encourage eligible families to apply. Prior to 2022, there was limited capacity in the public health team to promote the scheme. Additionally, in March 2022, the scheme changed from paper vouchers to plastic store cards, and many families who had previously received vouchers needed to reapply for the scheme to continue receiving their entitlement, so it was vital that the scheme was promoted.

An action plan was developed taking on a two-pronged approach, aimed at training health and social care professionals and other stakeholders (e.g., Children’s Centre staff, early years providers, community food banks, advice organisations) who meet pregnant women and families with young children, particularly in areas of deprivation. This aimed to improve their knowledge of the scheme, encouraging them to pass the information on and support anyone wishing to apply. There was also a push for widespread communications to eligible families to raise awareness of the scheme and encourage them to apply.

In April 2022, a series of engagements and communications took place, including:

• the delivery of the training sessions for health professionals/stakeholders.
• working with caretakers in local estates to place posters on council noticeboards.
• an item on Healthy Start in Hounslow Matters magazine (delivered to all Hounslow homes).
• placing Healthy Start stickers in shop windows.
• using translated resources in the most common languages spoken in Hounslow to reach residents whose first language was not English.
• running engagement sessions in Early Years settings.
• sending out information via school newsletters, aimed at parents with younger children/pregnant mothers.
• contacting all nurseries offering free places for two-year-olds as the eligibility is very similar – we asked that this was raised with each family, and they were signposted to the Healthy Start website.
• including Healthy Start in the Hounslow Family Service Directory webpage and on the Hounslow Connect webpage.
• promoting via flyers and posters in Family Hubs.

Following this, we undertook some more focused work, obtaining postcode data from Healthy Start to identify areas of low uptake that could be targeted.

This included:

• fixing large promotional banners in playgrounds in the target areas.
• sending further promotional material to all early year’s settings and schools in these areas.
• sending information to GPs in target areas (summary of the scheme and flyers).

The impact:

Since the beginning of the project, we have seen an increase in uptake of 22 per cent. We plan to do some follow up engagement with families who use the scheme and health care professionals who have promoted the scheme to seek feedback on promoting the service and encouraging increased sign ups by eligible families.

We are planning refresher training for health and social care professionals and other stakeholders in April 2024. We are also working with GP Primary Care Networks for texts to go out to all women who are pregnant or have children under four via their GP, to raise awareness, with care taken to avoid wording that may upset families who have recently lost children or experienced miscarriages, as consulted by Sands. As the scheme has a churn of eligible families, with new families becoming eligible all the time, and a turn-over of healthcare staff who have contact with eligible families, it is important that there are plans in place to ensure up to date information is shared regularly.

Due to the eligibility turn-over, any project to do with promoting the Healthy Start scheme has to be live and dynamic. We learnt that assets and interventions that are useful and visible over an extended period of time, such as the banners in playgrounds, are a good way to reach a large and changing audience. The scheme is also frequently changing and has been plagued with some tricky issues such as long wait times on expensive phonelines and families wrongfully being rejected for the scheme despite being eligible due to small spelling errors. We have learnt that our approach therefore must remain dynamic as well. We also must stay aware of any issues that are currently causing problems in the scheme to let professionals and families know.

Liza Ctori [email protected]

Poppy Lane [email protected]