Appendix 4(a)

Family Nurse
• A structured, intensive home visiting programme
•A preventative programme
•Benefits children and families who have the
poorest outcomes i.e. mothers with low
psychological resources, low educational
achievement, limited family support and poor
mental health
•Licensed programme with fidelity measures to
ensure replication of original research
•High degree of intensity, depth and skill required to
deliver the programme
Structure of the visits
From recruitment – weekly for 4 weeks
2 weekly until birth of the baby
Weekly for 6 weeks
2 weekly until baby is 21 months
Monthly until baby is 2 years
Domains covered –
Personal & environmental health, life course
development, maternal (paternal) role, family and
The case for prevention and early intervention has never been
•Advances in neuroscience and our understanding of pregnancy show
just how important early life is for the emotional and cognitive
development of children
•Pregnancy and early life is a sensitive period when
adversities become biologically embedded – fetal
“It is....also a parent's willingness to nurture a child, that finally
decides our fate”(Obama2009)
•Pregnancy and birth a key time – mothers have an
instinctive drive to protect their young and first time parents
in particular want their child to be healthy and happy and
do well in life
•Increasing evidence that effective health promotion and
disease prevention interventions in early life can produce
measurable benefits in health, later educational achievement,
economic productivity and responsible citizenship
“Like it or not,
the most important mental and behavioural patterns,
Once established,
Are difficult to change once children enter school”
Nobel Laureate, James Heckman (2005)
Target Group
• Young pregnant women, 19 years and under at LMP
• First pregnancy, although having a previous miscarriage or
stillbirth does not prevent recruitment
• Up to 28 weeks pregnant but before 16 weeks if possible
• Programme is completely voluntary
• Young Fathers and other family members are very much
Family Nurse Partnership’s Goals
1. Improve pregnancy outcomes
2. Improve child health and development and
future school readiness and achievement
3. Improve parents economic self-sufficiency
Randomised Controlled Trials
Elmira NY
Memphis TN
Denver CO
N = 400
N = 1,138
N = 735
•Low income
• Low income
•Large portion
of Hispanics
•Semi – rural
•Nurse v paraprofessional
Consistent Outcomes
Improvements in women’s antenatal health
Reduction in children’s injury
Increases fathers involvement
Increases in employment
Reduction in dependence on benefits
Fewer subsequent pregnancies
Greater intervals between births
Improved school readiness and greater IQ age 6
Nurses= sustained outcomes over many years
1. Be Healthy
2. Stay Safe
3. Enjoy and Achieve
4. Make a Positive Contribution
5. Achieve Economic Wellbeing
Cost savings
Unscheduled antenatal admission = £1,000 per night
To keep a child in residential care = £2,500 per week
Support a child in need = £400 per week
90% reduction of PINS = (approx)£40k a year
(Person In Need of Supervision- Equivalent to our ASBO)
Healthy Child Programme
Pregnancy and the first five years of