Review of the lessons learned during the Early Years Integration Transformation Programme: summary

The Early Years Integration Transformation Programme (EYITP) started in 2017, with funding ending in March 2024. Non-financial support was provided in the following year until March 2025. The EYITP intended to deliver against the commitment (Prosperity for All, 2016 to 2021) to ‘build on our current early years programmes and create a more joined-up, responsive system that puts the unique needs of each child at its heart’.

The EYITP objectives included firstly, reviewing existing systems to determine if they are efficient and to deliver extended and coherent support for families. Secondly, to utilise effective elements from other Welsh Government early years programmes to create a more responsive system. Finally, to pilot the co-construction approach in pathfinder areas with local authorities and health boards.

EYITP delivery began with the Cwm Taf Public Service Board (PSB) to explore options for reconfiguring the early years system. This indicated a single approach to roll out across Wales was not suitable. The majority of PSBs then voluntarily joined the EYITP on a phased basis as ‘pathfinders’. Pathfinders had project coordinators and project leads to oversee the work. Pathfinders were required to provide business plans and progress reports to Welsh Government as part of the programme.

The Internal Research Programme (Welsh Government) were approached by the Early Years Integration and Transformation branch (Welsh Government) to produce a thematic review of the lessons learned during the EYITP.

Research aims

• Aim 1 is to reflect on examples of good practice and lessons learned by pathfinders participating in the EYITP.
• Aim 2 is to explore enablers and barriers to successful system integration.
• Aim 3 is to develop an understanding of how far system integration has been achieved (‘mainstreamed’).

Methods included a thematic analysis of EYITP evaluative reports submitted by pathfinders and focus groups.

There were 28 documents sampled for inclusion in the thematic review. A coding framework was developed and applied to the reports, from which themes emerged.

Focus groups were arranged by health board region. There were 6 focus groups conducted ranging from 3 to 10 participants. The focus group questions covered services delivered and integration during the EYITP, what has happened since the EYITP ended regarding integration, and needs for future integration.

Considerations

The purpose of the research is to produce a thematic review, so it is not in scope to comment on specific interventions or projects from the documents. The Betsi Cadwaladr health board region submitted the most documents overall and comprised half of the documents in the sample. As such the document findings may be biased towards this region.

Of the 6 focus groups, 4 were missing representation from a local authority or the health board. A focus group with Powys was not conducted as staff had moved to other roles which meant there was a small sample, and the provided sample was not available.

This section is presented according to the research objectives within each research aim and brings together the document review and focus groups.

Aim 1: reflect on examples of good practice and lessons learned by pathfinders

Whether there were improvements in access and availability, and reduced gaps, for early years services

Findings suggest that generally there were improvements locally. This included overcoming barriers to access by introducing services in communities through means such as hubs and extending service hours.

Findings also suggest regional improvements through making changes based on identified service gaps or duplication. An example of this included making Flying Start services available to a wider area through using a needs-led approach. 

However, in some cases local authorities saw reduced access to services, such as reduction in Flying Start contacts due to merged caseloads. Also, when funding ended, services reduced in some capacity, affecting access and availability.

Whether services were delivered in a coordinated manner

Findings show staff across services and teams collaborated on planning and governance, service delivery, data, and workforce training to deliver more coordinated services. The EYITP was felt to have provided opportunities for collaboration that facilitated building and strengthening relationships and networks, understanding the roles of partners, sharing information and best practice, and pooling resources. 

Findings also show coordination of services occurred through drawing on elements of other early years programmes, for example by expanding the Flying Start offer into other geographical areas or expanding the age range. Another example was of joining up services to deliver better outcomes for families, for example removing the distinction between Flying Start and generic health visiting. The capacity and expertise of staff from existing programmes was drawn upon under the EYITP, as well as pulling together funding streams. 

Findings also demonstrate ‘upscaling’ of services, which included starting in a pilot area then expanding to a whole local authority, or upscaling from one pathfinder organisation to others in the region. Training and resources were also shared regionally.

Project coordinators played an important role and provided the capacity for overseeing projects across the pathfinders. They built relationships between different services and organisations, as well as between services and families. However, since the EYITP ended, many pathfinders lost the coordinator role due to an inability to continue funding the post. Much of the coordination work that was achieved under the programme has since reduced or ended.

Whether services were delivered in a timely manner

Overall, the timeliness of service delivery was felt to have improved under the EYITP. More families were provided with support in the right time, way, and place through a focus on a need-led approach instead of geographic, postcode-based approach. Also, through identification of service gaps and duplications. 

However, improving service timeliness was limited by the short-term duration of the programme. For example, recruitment delays meant service implementation started later, affecting project momentum and embedding of services in some cases. There were instances where this time limitation reduced the ability to assess whether families were receiving the right support at the right time, way, and place.

Whether referral pathways were streamlined

Findings were mixed. Streamlining occurred through standardising referrals, more partnership working reducing inappropriate referrals, and earlier identification and intervention.

However, issues with referrals included the complex early years landscape making it hard for some families to navigate referrals and services, and that referral pathways were not always understood by service partners. There was also a lack of information about services available for families. In some cases, referral assessments were still reported as complex.

Whether pathfinders developed a better understanding of need in their local areas

Examples of ways in which pathfinder organisations developed a better understanding of local population need include mapping exercises, collecting and analysing data, speaking with families to gather their views on services, and sharing learning. Where possible, this information was used to identify gaps and duplication in services, re-prioritise services, or to adapt services to meet needs. Where not possible this was due to competing needs between local authorities and resource constraints. Some noted the importance of continuing to incorporate service user needs in service design and delivery in future.

Aim 2: explore enablers and barriers to successful system integration

What are the main themes, and enablers and barriers, to integration

The main themes include governance, collaboration, staff, data, and funding. Sustainability also arose, discussed further at aim 3.

Governance

Enablers relating to governance included strong, stable and visible leadership. Also, governance structures having a clear purpose and accountability, with representative and breadth of membership who have a shared strategic understanding. The ability to leverage existing structures was another enabler, as well as establishing links between structures. Signs of effective governance included developing regional strategy that balanced competing local needs and allowed for local flexibility, and raised visibility of EYITP work at PSBs and Regional Partnership Boards (RPBs).

Barriers relating to governance are the reverse of these enablers. These included having insufficient buy-in and direction from leaders or issues with attendance at governance structures. Also, structures having a lack of accountability and low clarity about remit or ability for decision making, and difficulties identifying the ‘right’ people to involve strategically. Complexity of governance structures was also a barrier, including the inability to leverage existing governance structures and understanding of how EYITP governance fit into the existing governance landscape. This also included misalignment and differing priorities across organisations. Governance challenges emerged through difficulties creating a regional strategy, including not having one at all.

Collaboration

Enablers relating to collaboration included establishing partnerships between local, regional and national partners. This included building relationships that may not have developed otherwise, as the EYITP provided the opportunity to bring partners together, including working on a regional basis. Findings also noted improved understanding of others’ roles and responsibilities. Learning was shared regionally where different approaches were launched or where organisations joined later in the process. Relationships built during the EYITP were reported as important for supporting or committing to future work.

Another collaboration enabler was specific roles which aided collaboration, including coordinators, strategic roles, and delivery roles. Relatedly, supportive leadership was reported as important to build relationships between organisations. Finally, practical factors such as holding regular meetings and networking opportunities, and co-locating teams, were collaboration enablers.

Barriers relating to collaboration included differences between organisations such as cultures and languages, priorities and approaches, changes in leadership, levels of buy-in, and limitations in information-sharing. In some cases, differences in how services are set up across local authorities were reported as creating difficulties for a regional programme of work. Another barrier to collaboration was limited staff capacity which affected time for, and engagement with, collaboration. 

Some barriers reported for governance structures (lack of accountability, issues with remit, and difficulties creating a regional strategy) also impeded collaboration. Also, the short-term nature of the EYITP funding was reported to affect investment in building relationships. The complexity of the funding landscape, with different programmes creating conflicting remits, was also a barrier.

Staff

Enablers relating to staff included having successful recruitment and retention practices in place to ensure the ‘right’ people were in post and to alleviate capacity pressures. Having roles dedicated to integration (such as project coordinators) allowed positive change to occur, as well as clinical and administrative staff who assisted in transforming services. Increasing opportunities for training and development as part of the EYITP was also important, as was delivering training in a strategic, coordinated way. Other enablers included staff working in partnership with other professionals and sharing knowledge. Also, high morale through feeling valued, having supportive and enthusiastic leaders, and staff understanding theirs and others’ roles. 

Barriers relating to staff are the reverse of these enablers. These included challenges with recruiting and retaining staff. Pathfinder documentation reported that recruiting staff is a long process and sometimes they faced delays, which does not align with the short-term nature of the programme. High staff turnover, citing short- and fixed-term contracts, zero hours contracts, and pay were also issues relating to staff. 

Relatedly, there were issues with staff capacity due to existing high workload limiting resource for integration, and understaffing. These barriers had an onward impact on service delivery, as well as stability and sustainability of integration efforts. There were also challenges to meeting the training needs of all staff, including the creation of workforce and training plans, demand for training new staff, and capacity issues hindering staff attendance. Lack of understanding of others’ roles and responsibilities was another barrier.

Wider demographic factors also affected the workforce, for example, challenges in being able to recruit Welsh speakers to deliver services for Welsh-speaking families.

Data

Enablers relating to data included data collection practices where population needs were identified alongside services available. Service delivery data collection, where systems allowed staff to directly input data that could be seen by other professionals working with the same family, was also effective. Enablers for data sharing practices included privacy notices, data sharing agreements and information sharing protocols. These enablers supported identification of needs and families not having to repeat themselves.

Barriers relating to data spanned not collecting the data needed, and not analysing the data collected or disseminating the analysis. Data quality issues arose, such as inconsistencies in data collection, sampling issues such as self-selection bias, or evidence gaps. Lack of knowledge of how to share data under GDPR was also a barrier, as well as the IT systems in place. Many of these problems were too resource intensive to resolve during the EYITP.

Funding

Enablers relating to funding included maximising funds and budgeting through providing training internally and offering training across the early years workforce. Enablers also included bringing funding streams together, redistributing budgets for service delivery, and increasing access to services at no additional cost through streamlining delivery. Being able to adapt plans in response to financial challenges was also important.

Barriers relating to funding mostly related to the short-term nature of the EYITP funding negatively impacting integration efforts. For example, the ending of Welsh Government funding was seen to signal the de-prioritisation of integration and transformation of early years services. Other barriers included reduced engagement from leaders, instability in staffing, and lack of time to embed change alongside pressures on core services. 

Another barrier pertains to funding and sustainability, with the lack of funding to continue integration work post-EYITP and the resulting risk to the legacy. Reported concerns included that the needs of children and families would not be met due to a lack of funding.

During the programme, Welsh Government funding processes were also cited as a barrier in pathfinder documents. This included reported issues with communication from Welsh Government, with delays in receiving funding and decisions being made. Also, there were issues with the funding being fixed to each financial year. Combined, these delays and inflexible structure affected service delivery. Examples of areas affected included having to wait to start service delivery and having short delivery timescales, needing to spend a year’s worth of funds in a shorter timeframe, the ability to recruit and train staff, and the ability to progress towards programme goals.

What are pathfinders’ experiences of monitoring and evaluation requirements

Monitoring and evaluation successes included setting measures and monitoring outcomes and impact of interventions. Supporting decision making through access to analyses using quantitative and qualitative methods was also reported. Coordinators were important for supporting data collection and evaluation.

However, there were also challenges that impacted monitoring and evaluation as discussed in the ‘Data’ section. In addition, establishing monitoring and evaluation early on was a challenge due to the limited overall time for the EYITP and service delivery. This sometimes meant from the outset there was a lack of consideration of the data needed or collection of a baseline. This affected the ability to do useful evaluation and meant evaluation was done retrospectively. In some cases, within organisations it was felt there was too much reliance on their service targets, with a need for more qualitative information to capture lived experience.

Another challenge was that the short-term nature of the EYITP meant that delivery was prioritised over evidencing work. Focus group findings showed that there was not enough time built into the programme for pathfinder organisations to test their work and gather evidence on effectiveness and other outcomes. Impacts were reported as hard to capture if they were not expected to be realised until the long-term future, after the EYITP was closed.

For the future, research participants felt that there was need to set clearer outcomes with Welsh Government, and with flexibility in how these are achieved and measured.

Aim 3: develop an understanding of how far system integration has been achieved

The extent to which the EYITP helped to implement an integrated system

The EYITP was largely regarded as helping take steps towards integration, but that system-wide integration was not achieved during the lifetime of the programme. 

It appears there are specific pockets of integrated working, rather than the whole system being integrated. Elements of integration included developing relationships and networks, thinking regionally across services about needs and changes, and sharing learning regionally about different projects trialled across organisations.

Some felt the EYITP supported integration through supporting prioritisation or buy-in from senior leaders, and that regional direction provided influencing power within individual organisations. For others however senior buy-in was a challenge for integration due to lack of alignment of organisational priorities, appetite for change, and challenges identifying who should be involved strategically.

The EYITP approach being too short term is a factor that affected the extent of system integration. The programme did not factor in the time it takes for planning and recruitment. This meant the implementation window was short. As a result, some projects chosen were not transformational.

Findings indicate that clarity is needed on what an integrated system means, in particular within the context of the available time and budget. Some reported regional standardisation of services is not always suitable due to differences across local authorities and that integration should allow for this variance.

Whether and how work under the EYITP has been mainstreamed into usual practice

Overall integration work had reduced since the end of the EYITP. Some felt continued integration was not possible without EYITP support.

In general, there tended to be specific areas where the EYITP work had a legacy in regular practice. In only one instance had the entire delivery model developed during the EYITP remained embedded.

Specific areas where the EYITP work had a legacy in regular practice included approaches to ways of working and service planning, certain support available to families based on needs, sharing learnings within and outside regions, and continued access to consistent regional training.

Factors that supported the areas of continued integration included:

• continued partnership working and understanding of others’ roles
• staff dedication
• moving staff into other early years programmes
• support from leadership, and strong or visible staff voices to get this support
• maintaining approaches to information sharing
• securing alternative funding

An area not continued into regular practice included governance structures, as discussed at the following sub-heading. Other areas included less collaborative working, less working regionally, and not being able to offer regionally consistent training. There were also projects or services not continued into regular practice, and this reduction in support was felt to have impacted children and families.

Factors that impeded continued integration included:

• inability to secure alternative funding or stretch funding from other sources
• staff capacity, operationally and strategically
• loss of certain roles or staff and their knowledge
• reduced support from leadership
• conflicting priorities across the region
• unsuitable data and information systems
• difficulties evidencing the impact of EYITP work

Pathfinder experiences of governance structures, and whether these are in place for future integration

New governance structures were created for the EYITP that included central EYITP boards which provided delivery oversight and strategic direction. Top-level governance which central boards report into and makes regional links. Lower-level governance which includes topic specific or workstream groups.

The importance of governance in sustainability was reported, including maintaining the structures set up under the EYITP and to continue to use these as a mechanism to drive integration work.

However, the findings show some structures were not maintained, or where still in place were described as ‘diluted’.

Challenges in ongoing governance included bringing people together and getting partners and leaders to prioritise integration without dedicated funding and strategic direction from Welsh Government. Another need was continued development of local and regional governance, including strategies, to support engagement from leaders and partners.

Another challenge was the lack of clarity for some as to where early years integration fits in relation to existing governance structures, as well as needing guidance on what ‘good’ governance looks like for a cross-sector programme. Some felt that the RPB structure is the appropriate mechanism. Some felt that if a future programme was in place, the use of PSBs should be reviewed as the effectiveness of this funding mechanism was questioned.

From a different angle, there were also challenges relating to programme governance with Welsh Government during the EYITP. This included a lack of clarity and guidance on what Welsh Government wanted to achieve in terms of integration, and a lack of ongoing support. This also included issues with timescales like funding delays and not being given enough time to submit business plans to Welsh Government. Monitoring and evaluation requirements for the EYITP were also reported as unclear, or that they were onerous.

One research objective was to provide recommendations for how future integration and transformation work can be taken forward. The full recommendations can be found in the main report.

Recommendation 1 is for Welsh Government to consider the future needs for integration reported by pathfinders. The findings highlighted needs for Welsh Government to put certain funding, strategies, agendas and guidance in place for the early years system. These should be reviewed and discussed with necessary colleagues, with a plan in place to take forward where appropriate and feasible.

Recommendation 2a is for Welsh Government to consider the needs regarding funding processes if there were to be a future version of the EYITP. These include timeframes, exit strategy, flexibility in adapting work and managing spending, and the funding mechanism.

Recommendation 2b is for Welsh Government to consider the approach to monitoring and evaluation if there were to be a future version of the EYITP. Research support should be sought at the outset by the policy team administering a future programme to help develop monitoring and evaluation plans. Outcomes and measures should be agreed from the outset, and it would be beneficial to set up an evaluation framework so there is greater consistency in reporting.

Recommendation 3 is for pathfinders to consider local and regional approaches for future integration. Findings highlight areas to develop, with input and support from any national direction, guidance and funding as per recommendations 1 and 2a. Areas include governance, strategies and buy-in from leaders and partners. Also, using learnings from the EYITP, and using feedback from service users. In addition, having dedicated staff capacity, and re-building or maintaining collaborations. Finally, developing means for information sharing.

Report author: Smith, H., Findlay, S., and Folland, A.

Views expressed in this report are those of the researchers and not necessarily those of the Welsh Government.

For further information please contact:

Internal Research Programme
Social Research and Information Division
Welsh Government
Cathays Park
Cardiff
CF10 3NQ

Email: RhYF.IRP@gov.wales

Social research number: 35/2026
Digital ISBN: 978-1-83745-134-0