Family Nurse Partnership

BLACKPOOL

FAMILY NURSE PARTNERSHIP PROGRAMME

• 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 friends.

•Advances in neuroscience and our understanding of pregnancy show just how important early life is for the emotional and cognitive

development of children

The case for prevention and early intervention has never been stronger

•Pregnancy and early life is a sensitive period when adversities become biologically embedded – fetal

programming

•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

“It is....also a parent's willingness to nurture a child, that finally decides our fate”(Obama2009)

“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 included

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

Memphis TN

1987

N = 1,138

• Low income blacks

•Urban

Randomised Controlled Trials

Elmira NY

1977

N = 400

•Low income whites

•Semi – rural

Denver CO

1994

N = 735

•Large portion of Hispanics

•Nurse v para-professional

Consistent Outcomes

Improvements in women’s antenatal health

Reduction in children’s injury (NAI/accidental)

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 life

QUESTIONS??