Start for Life Outcomes Framework: identifying candidate indicators

Dates

Dates: May 2024 - September 2024

Research Team

Hannah Cann - University of Oxford, Dr Lizzie Ingram - Nesta, Dr Zhen Rao - Nesta, Dr Diane Stoianov - UCL, Professor Jane Barlow - University of Oxford, Claire Powell, Dr Estela Capelas Barbosa - VISION, Professor Lisa Holmes - University of Sussex, Professor Pasco Fearon - University of Cambridge, Professor Jenny Woodman - UCL (project lead)

Why we are doing this study

In 2021, the Government in England publicly committed to publishing a Start for Life Outcomes Framework to support parents to give their babies and young children <2y the best start in life.
The Department of Health and Social Care in England commissioned the NIHR Children and Families Policy Research Unit to undertake a five-month rapid responsive study to identify and provide a commentary on candidate indicators for this framework. The primary focus of this rapid study is to identify candidate indicators to monitor population health of babies, young children, and their families. However, the project has a secondary focus to generate principles for a framework to monitor service performance for this population.

Why this is important?

Use of outcomes frameworks can support the planning and evaluation of services by helping identify the impact of interventions or policies. They can also highlight particular areas or populations for prioritisation and support agencies to work towards a common goal. Outcomes frameworks to monitor or evaluate service performance can be used at a national or local level and can orientate services to prioritised goals and support service improvement, including identifying any unintended harms.

The Early Years Healthy Development Review Report outlines the policy agenda behind a new Start for Life Outcomes Framework, which broadly covers the functions of monitoring population health and wellbeing and monitoring the performance of services for babies and young children. These are two distinct purposes which require specific outcomes with distinct indicators and metrics. A clearly stated policy ambition of a Start for Life Outcomes Framework was to use data to improve outcomes overall and to narrow inequalities.

What we will do

We will conduct two rapid reviews with systematic searches to identify existing outcomes frameworks and core outcome sets that recommended relevant indicators for monitoring a) population health and b) service performance.

To refine the scope and definitions of the framework domains and to generate qualitative commentary about candidate indicators for population health monitoring, we will conduct interviews with key informants from academia and the third sector, chosen from our networks to maximise breadth of expertise.
We will use information collected from the literature review and the searches about data availability and ‘interpretability’ of indicators (whether a rise or fall in the indicator would provide a clear signal about a rise or fall in the health and wellbeing of babies and very young children). We will then apply criteria about data availability and interpretability to create a RAG (red, amber, green) rating for each indicator. This will allow us to identified ‘priority’ indicators for further investigation and consideration for use in any future frameworks.

What we hope to find out

We will generate and annotate a list of candidate population health indicators for use in the Start for Life Outcomes Framework as part of the Government in England’s ambition to support parents to give their babies and young children the best start in life. The Start for Life Outcomes Framework will monitor the health of young children (<2y) at population-level using the high-level domains of Safe, Healthy, Happy, Developing, and External factors. The project will also generate a list of principles for any further work on an outcomes framework to monitor service performance.