We have co-produced a blueprint of an equitable early years system to improve outcomes in the critical early years of development. The outputs have been intentionally designed to be applicable and relevant to services across England, enabling creation of an impactful and feasible delivery plan.
The first years of a child’s life are important. What happens in this time affects their health, wellbeing, and success at school. Not all children have a good start in life and this reduces the chances of them reaching their full potential.
The UK Government has launched a programme called Best Start in Life which will provide more support to children who need it most, helping them to get the best possible start in life.
Many different services support families during the early years, including midwifery, health visiting, nurseries, early help, and family hubs. These services are delivered by different organisations and funded in different ways. This can make it difficult for services to work together effectively. As a result, families can find the system confusing to navigate and may not get support.
In this project we worked closely with over forty local parents, researchers, and professionals from lots of different early years services to find out how we could make it easier for families to get support in the early years.
Participants agreed that the current early years system is too complicated and difficult for families to navigate. Participants described a future system using the image of a Ferris Wheel journey. Families get on the wheel at the beginning of pregnancy and move smoothly through early years services as their child grows. They get off the wheel when their child is ready to start school.
For this Ferris Wheel to run smoothly, services need to work together as the engine that powers it. Four important “gears” and three vital “levers” were identified as needed to make the engine work well. This paper describes these gears and levers to help early years services across England design a system that works better for children and their families.

Research Article
Dickerson J, Henderson H, Durkin K et al. A Blueprint of an Early Years System to Improve Equity in Children’s School Readiness: A Co-Produced System-Level Model. [version 1; peer review: 1 approved with reservations, 1 not approved]. NIHR Open Res 2026, 6:107
Interactive Theory of Change
A theory of change is a map that joins the dots from what the problem is, to the planned solutions.
Check out an interactive version of our co-produced blueprint, which bridges the gap between the core problem and solutions that promote equitable school readiness.