Family Nurse Partnership (FNP)
Renfrewshire, East Renfrewshire and
Inverclyde
Anne Burns FNP Supervisor
Alcohol & Drugs Workshop
19th November 2014
What is the FNP Programme?
• Preventive programme
through pregnancy until
child is aged 2 years
• Structured, intensive home
visiting programme
delivered by Family Nurses
• Based on theories of
human ecology, self
efficacy and attachment
• Underpinned by over 35
years research (3 large
scale RCTs)
Eligibility Criteria
• 19 and under (at LMP)
• Pregnant (<28 wks)
• First Baby
• Not planning to relinquish child
• Living in Renfrewshire, East Renfrewshire and
Inverclyde
Goals of FNP
Connecting with families to:
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Improve pregnancy outcomes
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Improve child health and
development and future
educational readiness and
achievement
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Improve parents’ economic
self-sufficiency
Why?...
Evidence
3 US trials over 35 years:
Improvements in women’s antenatal health
• Reductions in children’s injuries
• Fewer subsequent pregnancies
• Greater intervals between births
• Increased fathers’ involvement
• Increased employment
• Reductions in welfare dependency
• Reduced substance use initiation
• Improvements in educational readiness
• Review in Lancet 2009:
One of only 2 programmes shown to reduce child abuse and neglect
Formative Evaluation in England
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High quality Replication of programme
87% enrolment, fathers engaged and low rates of attrition
Early signs that clients have aspirations for the future and cope better with
pregnancy, labour and parenthood
Reduction in smoking during pregnancy
Breastfeeding initiation rate higher than national average for same age group
Significantly improved self esteem linked to positive behaviour change at the
end of programme compared to beginning
Clients returning to education and employment, making regular use of
contraception methods and spacing subsequent pregnancies
FNP children appear to be developing in line with population
Graduates very positive about parenting capability, report high levels of warm
parenting, low levels harsh discipline/ parenting stress compared to normal
population
RCT underway due to report later this year (Building Blocks Trial)
Key Elements of Programme
• Learning Phase
– Training for Supervisor and Family Nurses
– Cohort 25 clients per nurse
• Supervision of nurses
– Weekly
– Child Protection (triadic)
– Psychologist sessions
• Data collection
– Data Sheets completed for each visit
– Clinical Utility
• Replication of the programme with quality and fidelity
• Service User participation (Commendation at CHP
Awards)
What is the Programme made
up of?
• The client & their intrinsic motivation – plus the father/ partner/
mother/ family
• The nurse - qualities, understanding and skilfulness (supported by
supervision)
• The relationship – respectful, committed - the vehicle for change
• The approach/ method/ spirit – strength based, change focussed
• The content – visit by visit guidelines with facilitators and
educational materials
• The tools – FNP specific resources and tools PIPE, DANCE
• The context – team, organisation, system (Governance)
FNP Team
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FNP Sponsor
FNP Lead NHSGGC
Team B
• FNP Local Lead
• Family Nurse Supervisor
• Renfrewshire reps
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Psychologist
Child Protection Advisor
Data Manager
6 Family nurses
Board Nurse Director Mari Brannigan
Lorna Dunipace Head of Primary Care & CS
Liz Daniels CSM Children’s Services
Anne Burns
Social Work, Education, Maternity Services
Dr Clare Roberts Consultant ClinPsych
Carol Bews - CPU
Ellen Thomson
Kirsteen Begg, Lynsey Callaghan, Margaret
Lang, Anne McGowan, Jacqui Milligan and
Debbie Rankin
Progress to Date
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Full Team in post from 16 June 2014
Completed Pregnancy and Infancy Training –2 x 1 week residential
Advance Communication Skills Training
Stakeholder Analysis – Communication and Engagement Plan
Implementation
Pathway Development – Maternity and Generic
Went Live 1 August
Publicity Launch 25 August – Beacon Centre over140 attendees
56 Notifications received to date (17/11/14)
41 Enrolled – 7 engagement visits in progress
Transfer in - 1
Ineligible – 3
Refused programme – 4
Early shoots of success!
The Team
Contact Us
• Renfrew Health and Social Work Centre
– Anne.burns3@ggc.scot.nhs.uk
– 0141 207 7448
– Family.NursePartnership@ggc.scot.nhs.uk
Further Information
• http://www.nursefamilypartnership.org/
• http://fnp.nhs.uk/
• http://www.scotland.gov.uk/Topics/People/
Young-People/early-years/parenting-earlylearning/family-nurse-partnership
• m.youtube.com/watch?v=kX2R8lEOBZc
– (animation)
Thank you.
Any Questions?