We recognise that early childhood policy is concerned not only with providing learning, development and care to young children but that it is also linked with issues of women's employment and equality of opportunity; child development; child and family poverty issues; Welsh language development for children and transmission of Welsh language across the wider community; labour market supply; health; social welfare; and, later, education. Key policy areas aiming to deliver this ambition include Flying Start and Foundation Phase. While these policies are based on the best international evidence of what works and produces the best possible start for children, we recognise that early intervention, universal and specialist services are not delivered in isolation. International research now provides us with a blueprint for the kind of structures that result in the best outcomes for children based on a holistic pedagogical approach to early childhood that is supported by integrated structures at all levels, joint working principles and partnership working with parents. The current challenge is recognising and building on the value of a whole system approach (policy, workforce and regulation) and the task of drawing together the strength of policy and best practice from across the children's sector to achieve consistent, needs-led delivery for children in Wales. This review has provided the opportunity to take a radical look at the existing structures to determine whether they are truly fit to efficiently and effectively support high quality early childhood care and education. Our recommendations have been developed based on the growing international evidence of what best supports children's development but set in the real-world context of limited resources and budgetary pressures. Nonetheless, we also believe that given its importance in meeting so many of Welsh Government's policy objectives, Early Childhood Education and Care would benefit from short term increased resourcing focussed on bringing about a simplified systemic change. (author abstract)