The total cost of the vouchers that were redeemed in 2014/15 was £82.8 million, whereas in 2013/14 it was £93 million. The overall total spend has reduced since it was introduced in 2006 when the cost was estimated to be around £142million/year, despite an increasing birth rate. The government’s position is that this “reflects a decline in the number of households meeting the qualifying criteria” . However, it is not clear why eligible women and children are reducing in number, when overall claimant numbers have not declined significantly, or which qualifying criteria are affected, and we are looking into this.
Healthy Start replaced the Welfare Food Scheme in 2006. The main differences between Healthy Start and the Welfare Food Scheme (which was often referred to as the ‘milk token’ scheme) are:
To access Healthy Start, beneficiaries are required to have their application form signed by a Health Professional. This process was intended to manufacture an opportunity for Health Professionals to talk to beneficiaries about diet and health.
Healthy Start food vouchers can be spent on fresh or frozen fruits and vegetables in addition to milk or infant formula.
Healthy Start has its own website which provides information about the scheme for potential beneficiaries and for health professionals. www.healthystart.nhs.uk
Current Developments in Healthy Start
How are we related
to Healthy Start?
Who manages Healthy Start
in the UK?
The aim of the Alliance is to act as an external and independent advocacy group for Healthy Start.
In the USA their welfare food scheme, known as the supplemental nutrition programme for women, infants and children (WIC) has had an external advocacy group The National WIC Association for many years.
The scheme is a UK wide scheme, but is currently managed by The Department of Health in England. The Department works with the Department of Work and Pensions to verify eligibility. There are some differences in how
Healthy Start works in England, Scotland, Wales and Northern Ireland. To access the scheme potential beneficiaries must have a form signed by a health professional (GP, Midwife, Health Visitor or other nurse) to confirm they are 10 weeks pregnant or more or have children under the age of 4 years.
Eligibility criteria in terms of income and benefits received can be found on the Healthy Start website. Families claiming income-based benefits, or claiming child tax credit without working tax credit (unless it is working tax credit run-on) with an annual family income of £16,190 or less are currently eligible as well as all pregnant women under 18 years of age.
From 1st November 2016 families claiming Universal Credit with a take-home pay of £408 or less per month also qualify for Healthy Start.
Healthy Start is a passported benefit, considered to be a ‘benefit in kind’ alongside free school meals and free prescriptions.
Universal Credit has recently been added to the eligible benefits and families currently receiving UC should have received a letter with an application form. Claimants can call the Healthy Start helpline on 0345 607 6823 or email on firstname.lastname@example.org
A NICE expert panel has recently reviewed the cost effectiveness of offering free Health Start Vitamins to all pregnant women, breast feeding women, infants and children under 5 years. Papers from this review can now be found on the NICE website.
Currently beneficiaries receive:
Recent reviews and evaluations of the Healthy Start scheme have been unable to consider how the scheme may meet its objectives but have reported that:
Much of the focus in delivering Healthy Start has been on promoting the vitamin component rather than the food vouchers, but despite this, vitamin take-up remains low and many healthy start coordinators have spent much of their time dealing with distribution issues related to the vitamin component.
Universalise Healthy Start vitamins
All three recent evaluations emphasise that Healthy Start is a valuable policy that can help vulnerable families access a healthy diet and to support good nutrition among vulnerable women and children.
Registered charity no:
Limited support or guidance for Healthy Start food vouchers is given at a local level and little training or support is given to health professionals to support eligible beneficiaries.
Most parents reported receiving minimal information from health professionals about how they could use their food vouchers to improve their family’s health.
Limited evidence is available on how vouchers are spent and how they contribute to family eating patterns and health outcomes.
Families appear to value the Healthy Start scheme highly reporting that it makes a significant contribution to their weekly shopping budget. Infant formula and fresh cow’s milk are the most commonly bought items, but many families also report an increase in the purchase of fruit and vegetables. Only a few parents perceived that taking part in the scheme had considerably improved their diet, but more parents said that it had broadened food experiences for their children.
Good local management of Healthy Start should involve promoting take-up, and maximising the health benefits of the scheme. The devolution of health commissioning, and the movement of public health to local authorities in England may create new opportunities for groups who could take responsibility for Healthy Start.
Local areas should make better links between Healthy Start recipients and local services such as children’s centres which can provide support around healthy eating
Awareness of Healthy Start should be raised across health and social care
Train any health professional who has contact with potentially eligible women and families about their role in Healthy Start
Healthy Start food vouchers are issued four-weekly by post and Healthy Start vitamin vouchers are sent every 8 weeks.
Lucas, P.J., Jessiman, T., Cameron, A., Wiggins, M. & Austerberry, K.H.C. 2013, "Healthy Start Vouchers Study: The Views and Experiences of Parents, Professionals and Small Retailers in England", University of Bristol, Bristol.
McFadden, A., Fox-Rushby, J., Green, J.M., Williams, V., Pokhrel, S., McLeish, J., McCormick, F., Anokye, N., Dritsaki, M. & McCarthy, R. 2013, Healthy Start: Understanding the use of vitamins and vouchers, University of Dundee. Dundee.
The latest data we have obtained (from a Freedom of Information request) has revealed the following:
An average of 429,425 beneficiaries received the Healthy Start vouchers in 2015/16 and the total cost of vouchers that were redeemed by beneficiaries in 2015/16 was £72million.
The government has previously stated: “It is not possible to give an exact annual figure for the number of parents who received Healthy Start vouchers. The number of parents receiving Healthy Start vouchers fluctuates through the year as people’s circumstances change. Families leave the scheme, some join for the first time, others rejoin the scheme; data is not automatically held indicating whether new applicants have been in receipt of Healthy Start at an earlier point in the year. However, monthly figures are collected that provide a snapshot of the numbers of beneficiaries receiving vouchers at any point in time, …”
(Note not all eligible pregnant women are included in qualifying numbers, therefore take-up rate is likely to be lower in reality)
Snapshots at a single point in each 4 week cycle.
Take-up is calculated as a percentage of families sent HS vouchers over families who qualify for HS.