Is there a future for Healthy Start supermarket top-ups?

Supermarkets and ministers are in talks to bring back retailer top-ups to the government’s Healthy Start voucher scheme to help struggling families, The Grocer revealed last week.

But despite retailer willingness, there are barriers.

In an age of AI-powered loyalty schemes and hyper-personalised offers, few would guess supermarkets would find it impossible to provide top-ups to the NHS payment cards used by low-income claimants.

With both food retailers and the government spending tens of millions on advertising every year, it seems equally unlikely that hundreds of thousands of families would be unaware they are even entitled to help in providing their kids with healthy fruit & veg.

Yet these are the problems facing supermarkets and ­ministers in the renewed talks over boosting the scheme, after the last retailer attempts to do so were dogged by disastrous technical and marketing problems during the pandemic.

So what can food retailers do to help, and are there solutions to the barriers?

The government’s Healthy Start scheme has been in place since 2006. It aims to reduce dietary inequalities through the use of financial support to provide healthy food for low-income families and pregnant women in England, Wales and Northern Ireland. Since switching to a fully digital system in 2022, the voucher takes the form of a payment card.

The maximum currently available is £8.50 a week for fruit, vegetables, milk, infant formula and pulses.

Aldi, Asda, Lidl, Tesco, and Sainsbury’s are in new talks with government about bringing back the top-ups many retailers offered in the pandemic, to give more help to the most vulnerable families.

Sainsbury’s CEO Simon Roberts has been spearheading the moves to provide extra help as part of talks over the government’s food strategy. The supermarket has said it is willing to offer £2 top-ups to the scheme, but warned of major barriers presented by the switch to a digital system.

Sainsbury’s head of health and sustainable diets Nilani Sritharan told MPs supermarkets had no way of identifying an eligible customer in their systems in order to generate the necessary top-up coupons – either digital or physical – though this would not apply if the scheme moved back to the old paper system.

Aldi and Lidl also said that while they were willing to help, having also been involved during the pandemic, they did not have a way to generate top-ups to the payment card provided by the NHS.

Asda, meanwhile, expressed concern that retailers would have no way to control what categories customers used top-up coupons for – raising the prospect that instead of healthy fruit & veg for their children, parents could claim them against luxury or unhealthy items for themselves.

However Mark Game, founder of food redistribution charity The Bread & Butter Thing and co-chair of the Greater Manchester Food security Action Network, says it is unrealistic to expect a return to paper vouchers, claiming they presented a huge bureaucratic challenge for companies and NGOs taking part in the scheme.

“The scheme needed to go digital because it was such a huge administrative burden,” Game says.

He says The Bread & Butter Thing, which accepts the vouchers at all its food hubs, “had to collect thousands of paper vouchers and send them to the NHS to claim the money back”.

“It was archaic,” he adds.

Sainsbury’s Sritharan suggests there could be alternative solutions to a simple return to paper, including exploring other ways to allow the private sector to top up the government’s system.

Awareness problem

Either way, Game says any solution must also tackle the chronic problem, as highlighted during the pandemic, of families not realising they are eligible.

He claims that in some areas of Greater Manchester, up to 56% of those entitled to the vouchers have not registered.

Tesco, another retailer to offer top-ups during the pandemic – backed by a high-profile partnership with then Manchester United footballer Marcus Rashford – has told MPs any new initiative must tackle both the technical and awareness problems.

“A lot of work needs to take place to make sure the people who are able to access the scheme get the scheme,” says Oonagh Turnbull, Tesco head of heath and sustainable diets.

As supermarkets and ministers scratch their heads over the barriers, there is plenty of evidence to show retailer top-ups to Healthy Start not only help provide food, but also to shift the diets of poor families to healthier alternatives.

In October 2022, IGD commissioned research from the University of Leeds into Sainsbury’s trial of top-ups, which ran between February and August 2021. The supermarket offered customers a £2 top-up every time they used a government Healthy Start voucher, which could be printed in any of Sainsbury’s 800 supermarkets, but not in convenience stores or online, and were redeemable for any fresh, canned and frozen fruit & vegetables.

Research involving almost 1,400 shoppers across four UK regions found that when using top-up vouchers, “habits shifted positively towards the Eatwell Guide” with “fewer discretionary purchases and a higher intake of fruit & vegetables”.

On average, baskets contained 13 more portions of fruit & veg and 12% more fresh fruit, with fewer composite dishes, discretionary products and less meat.

It also found 98% of vouchers were used to redeem the full £2 on fruit & vegetables as intended, while just 5% were used on frozen vegetables.

Moreover, a “small but significant change” in purchasing behaviour lasted for months after the trial ended.

Despite what it said were “well known” concerns over the stigma surrounding using the vouchers, during the trial period almost 38,000 top-ups were used by Sainsbury’s customers. This represented a much higher than typical redemption rate compared with other types of printed vouchers at the time, even though the paper vouchers could only be printed in supermarkets.

Sritharan tells The Grocer: “We have a long-standing commitment to helping families access healthy, affordable food, which is why we previously offered a £2 top-up for customers using the government’s Healthy Start scheme.

“We know how impactful that support was for those who needed it most, so we are actively working with the government to find solutions that would make a top-up scheme possible under the new digital system.”

A report published by the Food Foundation in October urged ministers to make the Healthy Start scheme a key part of its food strategy, arguing it should be extended to all families on Universal Credit, just as the government is doing with free school meals from September.

Among supermarkets, the will to step in and help make the vouchers go further is there. But until they and ministers between them can work out how to make that happen, struggling families will have to wait for extra help.