1. Family Nurse Partnership (FNP) Renfrewshire, East Renfrewshire and Inverclyde Anne Burns FNP Supervisor Alcohol & Drugs Workshop 19th November 2014

2. 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)

3. Eligibility Criteria 19 and under (at LMP) Pregnant (<28 wks)
First Baby
Not planning to relinquish child
Living in Renfrewshire, East Renfrewshire and Inverclyde

4. Goals of FNP Connecting with families to: Improve pregnancy outcomes
Improve child health and development and future educational readiness and achievement
Improve parents’ economic self-sufficiency

5. 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

6. Formative Evaluation in England
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)

7. 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)

8. 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)

9. FNP Team FNP Sponsor Board Nurse Director Mari Brannigan
FNP Lead NHSGGC Lorna Dunipace Head of Primary Care & CS
Team B
FNP Local Lead Liz Daniels CSM Children’s Services
Family Nurse Supervisor Anne Burns
Renfrewshire reps Social Work, Education, Maternity Services
Psychologist Dr Clare Roberts Consultant ClinPsych
Child Protection Advisor Carol Bews - CPU
Data Manager Ellen Thomson
6 Family nurses Kirsteen Begg, Lynsey Callaghan, Margaret Lang, Anne McGowan, Jacqui Milligan and Debbie Rankin

10. Progress to Date 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!

11. The Team

12. Contact Us Renfrew Health and Social Work Centre

13. Further Information http://www.nursefamilypartnership.org/
m.youtube.com/watch?v=kX2R8lEOBZc
(animation)

14. Thank you. Any Questions?