Children and Families Policy Research Unit


NIHR Children and Families Policy Research Unit


The impact of the COVID-19 pandemic on services from pregnancy through age 5 years

Responsive Facility: The impact of the COVID-19 pandemic on services from pregnancy through age 5 years for families who are high risk or have complex social needs (April - July 2020)

Research Team

Professor Jane Barlow, Anders Bach-Mortenson, Olha Homonchuk and  Dr Jenny Woodman


Early interventions for children across the life course and their families


In addition to the immediate physical health consequences of COVID-19, there is increasing concern about the secondary impact on preschool children and families through the predicted, significant increases in risks (e.g. domestic violence and mental health problems), and reduction in service contact as a result of social distancing measures.

What we did

In Stage 1 of this study we conducted a survey of 871 professionals delivering or commissioning community-based services to preschool children across England. We found that the changes to practice that were implemented in response to the Covid-19 pandemic were perceived to have increased the risk to children living in families dealing with complex problems (and in particular those just below the threshold for children’s social care) and to have increased stress on staff. Stage 2 of this study used in depth interviews with a 22  of the survey respondents to explore the survey findings in more detail and to identify practitioners’ views about service provision. From the interviews we made key recommendations, some of which have already been addressed by the changes issued by NHS England at the end of July 2020.


Emergence from lockdown:

a) all services supporting vulnerable families with preschool children be re-instated as a matter of urgency (including face-to-face with appropriate protection);

b) plans be put in place for urgent review of all known vulnerable preschool children and children new to the service;

c) practitioners be consulted about all future changes to working practices (see below).

Implications for future lockdowns:

a) future lockdowns take account of the potential impact of changes to practice on children;

b) frontline practitioners with key roles in safeguarding vulnerable children should not be redeployed;

c) face-to-face visits/clinics (with necessary protections) for all vulnerable families should be continued by practitioners delivering statutory services;

d) virtual services should only used with this population in the event of exceptional family circumstances;

e) face-to-face wider services should continue to support high risk caregivers (e.g. with mental health or substance use problems and domestic abuse);

f) frontline staff should be consulted and involved in all decision-making with regard to changes in practice;

g) pre-existing challenges for early years services could be addressed in order to make the service more robust to future lockdowns.