Protocol for the Start for Life National Evaluation: What works, for whom, under what circumstances?

<ns3:p>Background Launched in 2021, the joint Department of Health and Social Care and Department for Education Family Hubs and Start for Life (SfL) programme aims to improve support through pregnancy and early childhood. Funding is provided to 75 local authorities (LAs) with high levels of deprivation. As part of this, £170m DHSC funding was allocated for Start for Life services which focus on the 1,001 days between pregnancy and age 2. In January 2025, £57 million was announced for the continuation of Start for Life services in 2025/26. The programme seeks to improve key outcomes for parents and infants. This paper describes the national evaluation of the programme. Methods This study uses a mixed-method multilevel triangulation design to assess the impact and cost-benefit of SfL, and to determine which interventions are effective, for whom, and in what contexts. The evaluation consists of two main components: 1) a process and outcome evaluation: to assess changes at both service and individual levels. Qualitative data will be analysed thematically, while quantitative process data will be examined descriptively and triangulated with longitudinal qualitative data and broader process evaluation findings. System-level factors (e.g., workforce attitudes and practices) will be explored to determine their impact on parents and infants; 2) an impact and economic evaluation: this component will use the Synthetic Difference-in-Differences method to construct counterfactuals and evaluate whether the programme affected key parent’s and children’s outcomes, using both individual and LA-level data; it will also include a cost analysis, in which the study will monetise SfL benefits and compare them against the cost of the programme to assess whether it is more effective than usual care, with associated net cost savings.</ns3:p>