Starting and Developing Well (2025)
Starting and Developing Well in the Joint Strategic Needs Assessment (JSNA) focuses on the health and wellbeing of children from conception through to adolescence. These phases of a child and young person’s life is crucial as it encompasses key developmental stages that significantly influence a child’s future health and wellbeing, education and social outcomes.
JSNA Headline Dashboard Observations
Children and young people aged 0-24 years account for approximately a quarter of the Devon population. The overall demographic structure for these age groups is projected to remain relatively stable, with no major growth anticipated in these younger age groups.
There are positive trends overall in maternal and infant health such as rates for breastfeeding rates at 6-8 weeks, and low birthweight at term which reflect the continued improvements in health care and early interventions, as well as better prenatal and postnatal care and support. However, continued work is still required to further improve on early years outcomes, particularly smoking status and hospital rates for infants.
The majority of children are well-prepared for school by the end of reception, but there is a notable difference for those receiving free school meals and those who are not. There is significant opportunity to improve academic achievement and pupil absenteeism which could impact learning outcomes and learning and employment prospects in the future. The differences in educational outcomes are even more pronounced for specific vulnerable groups, such as children in care. The percentage of 16 and 17 years olds not in employment, education or training (NEET) is broadly in line with national averages, though vulnerable groups are disproportionately more likely to be NEET, this includes those living in coastal and rural areas, care experienced young people and those with special educational needs and disabilities (SEND). Devon’s Brighter Futures Strategy (2025-2030) sets out a comprehensive, multi-agency strategy to address these gaps and reduce the NEET rate.
Vaccination coverage among children has remained relatively stable over recent years, however uptake continues to fall short of NHS recommended benchmarks, particularly for flu in primary school aged children and Human Papillomavirus (HPV) vaccines.
There are significant areas for improvement in children’s behavioural habits which include diet, sleep, food consumption and physical activity. However, almost 1 in 5 Devon households experience very low food security. Excess weight in primary and secondary school children is a significant concern (approximately 1 in 4, and 1 in 3 respectively) but the fact that there is a disparity for certain vulnerable groups, including disadvantaged children highlights the compounding complexities that impact on children’s weight.
Children with poor mental health experience poorer health and wellbeing outcomes. In Devon, hospital admissions for mental health conditions, self-harm, and injuries are significantly higher among children and young people. This disparity is even more pronounced for vulnerable groups, including economically disadvantaged and children in care. Bullying, body image, pressure to have sex, and knowledge of sexual health were issues also identified amongst secondary school children in Devon who took part in a locally commissioned survey.
Unemployment rates in Devon are relatively low compared to national average, however there are pockets of higher unemployment which can significantly impact families leading to financial instability affecting children’s wellbeing and development. While urban centres may have lower unemployment rates, rural and coastal areas across Devon may experience higher rates of unemployed due to more limited employment opportunities. Children living in relative poverty is increasing across Devon despite levels being lower compared with the national average.
Almost 1 in 2 households in Devon are within the most deprived 20% nationally for indoor environment quality, indicating issues such as poor housing conditions and inadequate heating. Most rural areas of Devon fall within the most deprived 20% nationally for indoor environment.
Local Insights, Lived Experience and Research: Starting and Developing Well
🧠 1. Children and Young People’s Mental Health
Insight questions:
• What do young people say about accessing mental health support?
• How do they experience transitions between services?
Sources: Youth Voice Action Tracker, Eclipse feedback, MAPS study, Children in Care and Care Experienced HNA Devon
Insight: Young people report challenges with body image, bullying, disordered eating, and navigating neurodevelopmental conditions. Access to mental health support is often delayed, and transitions between services can be disjointed. Youth voice highlights the need for inclusive, identity-affirming environments and trauma-informed care. Emerging data suggests gender and neurodevelopmental factors may be more predictive of poor outcomes than economic disadvantage.
🧒 2. Early Years and Infant Mental Health
Insight questions:
• How do families experience attachment, bonding, and early support?
• What barriers exist to secure infant mental health?
Sources: Children and Family Health Devon, Attachment-Based Mentoring (Devon Education Services), Building bonds programme, Parent-Infant Foundation
Insight: Families in Devon face barriers to secure attachment and bonding due to trauma, mental health challenges, and inconsistent access to early support. Services like Children and Family Health Devon offer targeted help, while mentoring and CPD programmes promote emotional safety and co-regulation. However, gaps remain in continuity of care and culturally responsive support.
🚭 3. Maternal Smoking and Infant Hospital Admissions
Insight questions:
• Why does maternal smoking persist in Devon?
• What drives infant hospital admissions?
Sources: Smokefree Devon Alliance, Devon Early Years Health Needs Assessment, HRSA Enhancing Maternal Health Initiative, National Vital Statistics Reports
Insight: Maternal smoking is more prevalent among younger mothers and those in deprived or rural areas, often linked to stress, trauma, and limited access to cessation support. Infant hospital admissions are driven by feeding difficulties, jaundice, and respiratory issues, often preventable with better postnatal care. Parental anxiety and gaps in community support also contribute to early admissions.
🏫 4. Education and SEND
Insight questions:
• How do children with SEND experience school readiness and transitions?
• What does it feel like for young people with SEND to navigate transitions between education phases or services?
• What barriers do families face?
Sources: Devon Local Area SEND Strategy 2024–2027, Devon SEND Transformation Programme – Exeter Consortium, Devon Information Advice and Support (DIAS), Devon County Council – Transition Support
Insight: For many young people with SEND in Devon, transitions feel like a battle, emotionally overwhelming, confusing, and often isolating. Families describe the process as a “fight” against bureaucracy, poor communication, and fragmented services. Young people report anxiety about new environments, fear of losing trusted adults, and frustration at having to retell their story repeatedly due to poor handovers. The lack of consistent, person-centred planning leaves many feeling unsupported and invisible. Some describe transitions as “not just a change – it’s everything,” highlighting the emotional toll of moving between schools, services, or into adulthood. While initiatives like DIAS, Early Help pilots, and the SEND Local Offer aim to improve experiences, gaps remain in mental health support, continuity of relationships, and practical preparation (e.g. visits, visual aids, peer mentoring). The emotional impact is compounded when transitions are rushed, poorly explained, or lack empathy, leading to disengagement, school avoidance, and loss of confidence.
🥫 5. Food Insecurity and Healthy Behaviours
Insight questions:
• What does food insecurity feel like for families in Devon?
• How does it affect children’s health and wellbeing?
Sources: The Face of Food Insecurity in Devon – Devon Community Foundation 2024, Food and Fuel Insecurity in Devon – Transform Research 2023, Devon Food Insecurity Hub Summary – May 2023
Insight: Food insecurity in Devon is described by families as a daily stressor that affects dignity, health, and emotional wellbeing. Parents talk about skipping meals, eating less, or relying on low-cost, low-nutrition food to stretch budgets. Many feel ashamed or anxious about seeking help, especially when food support is perceived as poor quality or hard to access. Families with young children, those with mental health challenges, and people in rural areas face compounded barriers, including lack of transport, cooking facilities, or information about available support. The cost of housing and energy bills often force trade-offs, with food being the most flexible expense. For some, food insecurity means missing out on social activities, avoiding hosting meals, or feeling isolated from community life. Despite these challenges, many rely on community hubs, food clubs, and peer networks to cope, though stigma and inconsistent provision remain significant hurdles.
🏠 6. Housing and Indoor Environment
Insight questions:
• What does it feel like for families living in poor housing conditions in Devon?
• How do housing quality and heating issues affect children’s wellbeing?
Sources: Devon Housing Commission Report – University of Exeter & Devon Local Authorities, Poverty in Devon 2024 – Devon Health and Wellbeing, Devon Community Foundation Overview, Great British Life – Housing Crisis in Devon
Insight: For many families in Devon, poor housing feels like a daily struggle with cold, damp, and overcrowded conditions. Parents describe having to choose between heating and food, or leaving home during cold spells to avoid high energy bills. Children living in substandard housing face increased risks of respiratory illness, anxiety, and disrupted sleep. In rural and coastal areas, homes are often poorly insulated, off the gas grid, and far from services. Families placed in temporary accommodation report instability, lack of privacy, and emotional distress. These conditions not only affect physical health but also undermine children’s emotional development and educational engagement. The housing crisis is compounded by high property prices, under-occupation, and the conversion of long-term rentals into holiday lets, leaving many families with few options and a sense of being pushed out of their own communities.
| Gaps in insights and local research The Starting and Developing Well chapter provides valuable insight into the health and wellbeing of children and young people in Devon. However, there are areas where lived experience data is limited or could be expanded to strengthen understanding and inform service design. These include: Maternal Smoking and Infant Hospital Admissions: While flagged as priority issues, there is limited qualitative insight into why maternal smoking persists and how families experience early hospital admissions. More lived experience from maternity services, young parents, and health visitors could help. Vaccination Uptake: There is a lack of insight into parental attitudes, access barriers, and misinformation around childhood vaccinations, particularly flu and HPV. Understanding trust and cultural responsiveness in immunisation programmes could be helpful. Housing and Indoor Environment: Although data highlights deprivation in indoor environment quality, there is limited lived experience from families in poor housing, temporary accommodation, or fuel poverty. Emotional and developmental impacts are underexplored. Food Insecurity: Quantitative data is strong, but more insight is needed into how food insecurity affects dignity, mental health, and family dynamics. Lived experience from food hubs, schools, and VCSE partners could enrich understanding. |
Starting and Developing Well Priorities for Devon
- Champion Youth Voice and Opportunity: Empower young people to shape services and decisions. Address barriers like transport, housing, and service access, especially in rural areas.
- Support Neurodiverse Children and Young People: Promote inclusive education, mental health, and young services that are sensory aware, strengths-based, and co-designed.
- Early Years Health: Continue improving maternal and infant health, focusing on reducing smoking rates and hospital admissions for infants. Strengthen support for secure attachment and bonding through trauma-informed early years services.
- Educational Outcomes: Address the gap in school readiness and academic achievement, particularly for children receiving free school meals and those in care. Reduce pupil absenteeism to improve learning outcomes.
- Healthy Behaviours: Promote better dietary habits, sleep, and physical activity among children. Address food insecurity, especially in vulnerable households.
- Mental Health: Improve mental health services and support for children and young people, with a focus on reducing hospital admissions for mental health conditions, self-harm, and injuries. Expand early intervention and identity-affirming environments.
- Employment: Target areas with higher unemployment rates to provide job training and support, particularly in rural and coastal areas, to improve family financial stability.
- Housing Conditions: Improve housing quality, particularly in areas with poor indoor environment quality, to ensure adequate living conditions and heating.
- Vaccination Rates: Increase efforts to improve vaccination rates across all age groups to meet NHS targets and ensure better public health outcomes.
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