Shaping future early years policy through data-led evidence on Sure Start
How linked data revealed the lasting benefits of early years support, from better health to improved educational outcomes.
ADR UK-funded research, using linked administrative data to track children for over a decade, provided the first robust evidence that Sure Start delivered lasting benefits for children's education, health and life chances, particularly for those in disadvantaged areas, alongside the resulting economic benefits to the UK.
This evidence has directly shaped government thinking on the future of early years support, including informing the design of Family Hubs.
The challenge
Sure Start brought together health visits, parenting support, early learning and family services in one place, for families with children under five. While it was clear that families used and valued these services at the time, there was little data-led evidence about whether the benefits lasted.
Did Sure Start make a real difference to children's lives as they grew up, and was that difference big enough to justify re-investment? Answering this would be crucial for policy decisions about the future investment in early years support in England.
What the research found
Linked administrative data has allowed researchers to follow children from early childhood into their teenage years. Using these detailed records let them compare children growing up in the same neighbourhood but with different levels of access to Sure Start, because centres opened at different times across the country. This new data meant they could see the genuine effect of Sure Start, rather than differences that might be down to other factors.
The results were striking. Children with greater access to Sure Start:
Did better at school and were more likely to achieve good GCSE grades.
Spent less time in hospital as they grew older, with 8 to 10 percent fewer hospital admissions by early adolescence in areas with strong Sure Start provision.
Missed fewer days of school and were less likely to be excluded.
Were more likely to have additional needs picked up early, but less likely to need intensive, ongoing special educational needs support later on.
Reported better physical health and fewer emotional difficulties as teenagers.
These benefits were felt most strongly by children growing up in disadvantaged areas, showing just how valuable integrated, local support can be for the families who need it most.
The research also found that Sure Start paid for a large part of its own costs, through savings elsewhere in public services and higher earnings for people later in life, and this is likely to be a significant underestimate of the programme's overall value.
The impact on policy and practice
The findings have been shared with the Department of Health and Social Care, the Department for Education, NHS England, and a range of parliamentary and cross-government groups. The evidence is helping to shape current thinking on related projects, such as ‘Family Hubs’ and how early years support should be delivered in local communities. Local authorities have used the findings to guide their own early years strategies, joining up services and making funding decisions.
Lead researchers: Dr Sarah Cattan, Institute for Fiscal Studies (https://ifs.org.uk)
This research used data made available via the Office for National Statistics (ONS) Secure Research Service, which is being expanded and improved with ADR UK funding.
Background information and further reading
Publications and reports
Capstone Report: An evaluation of Sure Start's impacts on education, health, absences, special educational needs, crime and social care, plus a cost–benefit analysis.
IFS Report (2025): The short and medium term effects of Sure Start on children's outcomes.
Working Paper (2025): The Health Effects of Universal Early Childhood Interventions: Evidence from Sure Start.
Policy Briefing (2026): Early years services and long term outcomes.
Data used
To study the effects of Sure Start, the research used a range of administrative datasets accessed securely through the ONS Secure Research Service. Health outcomes were analysed using Hospital Episode Statistics (HES), covering inpatient admissions for children born between 1993 and 2006, with follow up records available into adolescence. This allowed hospital use to be tracked before, during and after the national expansion of Sure Start provision.
Office for National Statistics; NHS Digital, released 03 July 2023, ONS SRS Metadata Catalogue, dataset, Public Health Research Database - England and Wales, https://doi.org/10.57906/b8zx-6x19
Educational outcomes, school absences, exclusions, special educational needs and interactions with children's social care were analysed using linked records from the National Pupil Database and associated administrative sources. A bespoke education and justice linked dataset was also used to track criminal behaviour, specifically focusing on crime committed up to the age of 16. These data were combined with detailed information on the opening dates and locations of more than 3,300 Sure Start centres.
The centres offered integrated support for families with children under five, including health services, parenting support, early learning activities and links to childcare and employment support. Additional contextual information was drawn from the Index of Multiple Deprivation and from national longitudinal surveys, which were used to explore self reported health and wellbeing in adolescence.
Methods used
The analysis compared children born in different years who grew up in the same neighbourhoods, taking advantage of the fact that Sure Start did not open everywhere at the same time. This staggered rollout created variation in access across birth cohorts within the same local areas.
The study used a difference in differences approach with fixed effects for neighbourhood and birth cohort. This allowed the researchers to isolate the impact of access to Sure Start from systematic differences between families accessing the programmes in different areas and broader changes affecting children over time. For most outcomes, access was defined as living within close proximity of a Sure Start centre during the first five years of life. For health outcomes, access was measured using local authority level provision, reflecting the structure of the hospital data.
The researchers tested whether trends in outcomes were already changing before Sure Start centres opened and conducted robustness checks using outcomes that should not have been affected by the programme. Survey data was analysed using sibling comparisons, allowing outcomes for children within the same family who experienced different levels of early exposure to be contrasted.
