Tackling Health Inequalities in Scotland: an Innovative Approach to Implement the ‘Early Years’ Policy into Practice

Major health inequalities existing across the world and are often closely linked with degrees of social disadvantage. Scotland is fully committed to tackling this major challenge of health and social inequalities. One key focus is ensuring that every child and young person has equal access to opportunities and health improvements. This is supported by a series of national guidelines and ‘early years’ policy drivers. To implement these policies in practice, one National Health Service (NHS) health board (Lanarkshire) in collaboration with the University of the West of Scotland (UWS), adopted an innovative approach to develop the Best Possible Start (BPS) program of focused activity to reshape ‘early years’ services and ways of working. The foundation for the program was the national transformational initiative ‘Getting it right for every child (GIRFEC)’. This is based on the belief that the developments of the child and their experiences in the early years have a major impact on the child’s future life chances. The early nurturing environment is seen crucial in influencing emotional attachment. The BPS program focused on reshaping and streamlining the related health services in the early years between preconception and early school years. This is incorporated in the universal pathway of care encompassing all ‘early years’ services and related professionals. This universal pathway of care is underpinned with evidence based practice, workforce development, building research capacity and influencing leadership in the workplace. This paper presents a detailed overview of the BPS program including the structure, strategic aims and the rationale underpinning the pathway of care.