A decade ago, the Cross-Departmental Review of Services for Young Children concluded that disadvantage among young children was increasing and it was more likely that poor outcomes could be prevented when early intervention was undertaken.1 The review also noted that current services were uncoordinated and patchy, and recommended that there should be a change in service design and delivery. It suggested that programmes should be jointly planned by all relevant bodies and be area based, with all children under 4 years old and their families in an area being clients. In July 1998, the then Chancellor of the Exchequer, Gordon Brown, introduced Sure Start, which is aimed at providing quality services for children under 4 years old and their parents.2 The original intent of the programme design was to focus on the 20% most deprived areas, which included around 51% of children in families with incomes 60% or less than the national median (official poverty line).3

Over 3 years, £542 million was made available, with £452 million designated for England. In England, 250 programmes were planned by 2001–2002to support 187 000 children, 18% of poor children under 4 years old. Typically, a programme was to include 800 children under 4 years old, with £1250 per annum per child at the peak of funding. Programmes were to run for at least 10 years with funding peaking at year 3 and declining from year 6 to none at year 10. Some funding would fall to local authorities, made available by “reshaping” services. This investment utterly transformed early-year services while representing a relatively small contribution from the perspective of treasury—just 0.05% of public expenditure.

In this brief summary, we cover the history and impact of this ambitious initiative. While more than 40 reports and peer-reviewed publications have documented the different …