Summary of a case study published in 2019
The 2018 London Mayor’s Health Inequalities Strategy promised every London child the best start possible in life. To support this objective, and in recognition of the links between health and other areas of development, the Office of the Mayor of London designed a programme that allowed early years childcare settings to address health, education and equality simultaneously: the Healthy Early Years London (HEYL) awards scheme.
The HEYL scheme aimed to help reduce health inequalities by supporting a healthy start to life through diet, physical activity and early cognitive development. It used a whole-settings approach, teaching not just young children but also parents, caregivers and nursery staff about the importance of good nutrition, staying active, and sleep, making sure children receive all of these at childcare and at home. The programme incentivized participation by using an awards scheme, offered to settings based on their achievements at four levels: First Steps, Bronze, Silver and Gold. By providing a public form of recognition from the Mayor’s Office, the scheme acts as a quality mark for settings’ commitment to health, well-being and development.
The scheme was launched in 2018, and by the following year 31 of 33 London boroughs had joined it, representing a 94% uptake rate. With support from the Partnership for Healthy Cities, the HEYL programme developed a quality assurance framework to help boroughs evaluate programme outcomes. The framework design was strategic because it integrated health and non-health outcomes. It helped local boroughs and settings show not only how they were meeting the requirements of the HEYL scheme in terms of health – such as how many children were receiving healthier food – but also how they were meeting requirements for education standards. Its emphasis on relevance may partly explain the programme’s rapid uptake.
Measuring inequality was built into the programme’s key metrics. As part of the Mayor’s Health Inequalities Strategy (2018), the programme aimed to show how it particularly supported the health and well-being of children from the most deprived communities. Programme reach and impact was tracked against the Health Inequalities Index, which helped boroughs assess how their HEYL work was supporting children from more disadvantaged backgrounds, emphasizing its commitment to equality through health. By 2019, 94% of the most deprived boroughs in the city had signed up.
As of July 2019, over 1302 settings had already signed up to the programme and some already achieving Bronze, Silver and Gold awards in recognition of their achievements. Overall, the HEYL experience highlighted the potential benefits of linking health and well-being to other issues such as education. It also indicated how health outcomes data could be collected and compared against inequality metrics, to show how a programme was supporting hard-to-reach communities within a city.