Number of children under five: 10,075 (data from 2021 census).

Index of Multiple Deprivation: out of 317 local authorities (LAs) in England, Westminster was ranked 134th (average rank) and 137th (average score) (based on English indices of deprivation 2019, where rank first = most deprived).

Ethnic diversity: in 2021, according to Census 2021, 55.2% of people in Westminster identified their ethnic group within the "White" category, 16.8% within the "Asian, Asian British or Asian Welsh" category, and 13.5% within the "Other" category ("Arab" or "Any other ethnic group"). 

Proportion of children eligible for free school meals (FSM) reaching a good level of development (GLD) measured by the Early Years Foundation Stage Profile: in 2022-2023, Westminster had 59.5% of children on FSM reaching a GLD, which was among the highest quintile (20%) in all LAs in Cluster 3 based on Nesta’s previous work (on average, 58.1% children eligible for FSM reached a GLD in this cluster). LAs in Cluster 3 were all London boroughs (except Richmond-upon-Thames, Bromley and Greenwich), characterised by significantly higher than average pollution.

In this case study, we have highlighted some key elements of practice that staff in Westminster reported as contributing to good early-years outcomes. These include understanding a parent's earlier life, supporting parent-infant relationships, and working with the whole family instead of the individual. Westminster also used childcare champions to increase service outreach and supported parents of children with special educational needs and/or a disability through parent forum.

This case study is based on an interview in October 2022 with Westminster Council's Head of Early Years and Childcare, as well as an online survey completed by representatives from Westminster Council before the interview.

We have selected this case study because Westminster had higher percentages of children eligible for FSM reaching a GLD compared to other LAs in the same cluster identified by Nesta’s previous work (please see figures above). 

Between 2019 and 2022, Westminster provided a variety of parenting programmes for families with children under age five. These included Family Nurse Partnership, Triple P, PEEP (Learn Together Programme), Incredible Years, Parent Child +, and ASD-specific courses. 

Two universal interventions were mentioned by participants from Westminster as particularly impactful for supporting parent-infant relationships. The first one, Theraplay, was for parents of children aged 6-12 months, and addressed babies’ behavioural, emotional or developmental issues through play and interaction. The second one, Circle of Security, was for parents of children aged 12-24 months, and focused on helping caregivers reflect on children’s attachment needs to promote a secure attachment. 

The interviewees highlighted the ‘whole child, whole family’ approach that Westminster adopted, including having a designated practitioner working with a family and ensuring there was one point of contact for the whole family. In addition to Early Help and Early Years practitioners, there were also ‘family navigators’ who offered parents a range of support, including helping them to navigate housing concerns or identify schools. 

An integrated service – a programme called ‘pre-birth to five pathway’ – was co-designed by parents and professionals in Westminster to deliver the Healthy Child Programme. Health visitors were co-located within their family hubs to work alongside the early help professionals. Health reviews and clinics took place within these hubs, in addition to community and health settings. Overseen by integrated management, this ‘pre-birth to five pathway' programme had positive feedback from parents, who value being able to have everything in one place. 

Westminster also introduced ‘childcare champions’ to promote early-years services and programmes. These champions were health visitors who took the lead on informing their colleagues and reminding families about all the services and programmes that were available, for example, the two-year-old Free Early Education (FEE) entitlements and funded places. In addition, Westminster used the Early Years Toolkit designed by Nesta to review its outreach strategy to increase FEE take-up.

To support diverse communities, Westminster’s family hubs employed staff who spoke some of the key languages within these communities. For example, there was a large number of families arriving from Afghanistan and Ukraine, so providing language support for these groups was important. The early-years staff also engaged with the community through speaking with faith leaders and reaching out to places where people gathered.

A variety of support was offered to children with special educational needs and/or a disability (SEND) in Westminster. For example, Short Break was the first service that would get involved with SEND children. The team received referrals from hospitals and early health notifications, and offered direct support to the families. Additionally, early-years practitioners could support families based on their needs (for example, at-home teaching, similar to the Portage service offering parenting support). 

Family hubs and centres in Westminster also offered support for SEND families through Make It Happen, a parent forum where families can meet others in the same position as them. They invited different professionals into regular meetings, so any issues (especially with under-fives) can be discussed with the relevant staff members. An autism advisory service also supported the school setting if a child was diagnosed with an ASD diagnosis or a disability later on. 

Westminster used the speech and language toolkit WellComm to identify children’s needs early on. It offered a range of resources and training for early-years settings and schools, allowing staff within these environments to develop the skill sets to support a child with speech, language and communication needs (SLCN). They also introduced a six-month project with speech and language therapy assistants, who supported schools and early- years settings where there was a higher number of SLCN cases.

Westminster rearranged the health visiting service to establish closer links with the maternity services, and created a specialist perinatal mental health and health visiting lead post whose responsibilities included identifying family needs and signposting families to additional support. Health visitors in Westminster used the Edinburgh Postnatal Depression and Scaling Questionnaire to gauge the mental health of mothers after birth and highlight if additional support was needed (for example, a GP referral or a specialist). 

Practitioners, including health visitors, nursery nurses and midwives, were informed about motivational interview learning, which focused on asking the right questions and developing an understanding of a parent's earlier life, and helping to understand any impact this may have. There was also a parenting strategy that helps practitioners understand what programme to signpost to when considering support for infant-parent attachment and reducing conflicts in the home. Additionally, Westminster launched an emotional wellbeing and mental health strategy, to have more mental health practitioners within the system, including in schools. 

To help identify families who “slip through the net” (for example, families that may not attend health visitor appointments or Family Hubs), Westminster also joined the pilot group for the Northwest London Demonstrator Programme, which aimed to increase access to health services by putting them in community settings.