Family Nurse Partnership programme

This report commissioned by the DCSF and Department for Health examined the first year effects of the pilot Family Nurse Partnership (FNP) programme found that the scheme can be successful but further development is needed.

The pilot is based on a model developed in the USA by Professor David Olds, it is an evidence-based nurse home-visiting programme designed to improve the health, well-being and self-sufficiency of young first-time parents and their children. It involves weekly or fortnightly structured home visits by a specially trained nurse from early pregnancy until children are 24 months old. The curriculum is well specified and detailed with a plan for the number, timing and content of visits. Supervision is ongoing and careful records of visits are maintained. The programme has strong theoretical underpinnings, with the formation of a strong therapeutic relationship between nurse and mother at its heart. The programme is designed for low-income mothers who have had no previous live births and starts in the second trimester of pregnancy.

Key points:
- The conditions of being a test site, learning the programme and demands of the tight set up timetable i.e. birth clustered around same time.
- There were wider demands on Family Nurses’ time from organisation and multi-agency working.
- There were challenges in providing this service within the UK context, with national health care, compared to the USA.
- There was a lack of integration between maternity and child health services.
- The FNP reached those who are likely to benefit most and the current eligibility criteria of all 19 years and under first time births should continue. Any further testing of the FNP with non-teenage mothers should focus on 20 to 22 year olds.
- The FNP is acceptable to first-time, young mothers but attrition during pregnancy exceeded the fidelity target in some sites. Further work is needed to understand why clients refuse or leave the programme.
- The FNP seems acceptable to fathers. The evaluation found that fathers:
• Participated in visits;
• Used programme activities;
• Valued the learning on prenatal development, diet and smoking, and preparation for labour and delivery; and
• FNs reported that many clients requested materials for fathers who could not be present, and conveyed questions that fathers had asked about the FNP programme.
- FNs recognised the benefits of using a structured programme, developing a different kind of relationship with clients, using new skills and reaching real need.