Healthy Start scheme fully digitalised with prepaid card replacing paper vouchers

The NHS Healthy Start scheme finished moving from paper vouchers to a prepaid card in March 2022, after a rollout that ran from September 2021¹. During that period the participation rate rose from 60% to 72% across England, Wales and Northern Ireland¹.

Healthy Start began in 2006 and provides pregnant women or families with children under 4 who are on qualifying benefits or tax credits with money towards some healthy foods, including milk, infant formula and fruit and vegetables¹. It operates in England, Wales and Northern Ireland; Scotland has a comparable scheme, Best Start Foods¹.

Payments have been worth £8.50 per week for children aged 0 to 1 and £4.25 for all other recipients since April 2021, the last time the value was increased¹. The participation rate was 73% in 2015 but fell to 51% in 2020¹. The briefing says it is not possible to say what has happened to the participation rate since the scheme was fully digitalised, because of data issues: the number of eligible and active participants is not available between April 2022 and December 2022, and since January 2023 only data on active participants is available¹.

As at December 2024 there were around 354,000 participants across the UK excluding Scotland, a fall of 2.3% since the beginning of January 2023¹. The change varies by nation:

At local authority level, Crawley recorded the largest decline, an 18% decrease between January 2023 and December 2024, while South Tyneside and Torbay fell by 17% and 16% respectively¹. Over the same period participants grew by 20% in Pendle, 19% in Rushmoor and 18% in Forest of Dean¹. The briefing says the causes of this variation are not certain, and that comparing the change in active participants with local authority population data for children aged 4 and under showed little correlation, indicating the change is likely not due to population change¹.

On value, the briefing estimates that the average prices of recommended Healthy Start foods rose by 31.3% between April 2021 and November 2024¹. It says payments would need to be uplifted from £4.25 to £5.58 per week to keep their value, a difference of £1.33 per week or over £69 over a year, and from £8.50 to £11.16 for those with children aged 0 to 1, a difference of over £138 per year¹.

Why it matters for households

Eligible families in England, Wales and Northern Ireland receive £4.25 a week, or £8.50 where there is a child aged 0 to 1, loaded onto a prepaid card rather than paper vouchers¹. The card has been the only format since March 2022¹. Participation is not automatic and eligible families must apply¹.

The payment amounts have not changed since April 2021, so the same weekly sums now buy less: the briefing puts food price inflation for the recommended items at 31.3% over the period to November 2024¹. Its estimate of the shortfall is £1.33 a week for standard recipients and over £138 a year for those on the higher rate¹.

The number of people receiving the payments has fallen since January 2023, by 2.3% overall and by more in Wales and Northern Ireland than in England¹. The briefing says that because eligibility data is lacking, it cannot be certain whether this reflects fewer people qualifying or fewer people joining¹. Scotland's Best Start Foods was uplifted in April 2024 from £4.95 to £5.30 per week, and differs from Healthy Start in that it ends when a child turns 3¹.

What happens next

The briefing says the government should up-rate Healthy Start payments to account for food price inflation since April 2021, and that once the scheme has moved away from paper vouchers there is no reason the payment should not be automatically uprated in line with inflation as other welfare payments are¹. It also says the government has announced plans for a national food strategy, and that it sees a case for extending eligibility¹. No government decision on uprating Healthy Start has been reported in these documents.