Hertfordshire FNP Team

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Hertfordshire FNP Team
The FNP is a preventive programme for young first
time mothers. It offers intensive and
structured home visiting, delivered by specially
trained Family Nurses from early pregnancy
until the child is two
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How is the FNP Different?

• Research based programme- RCT
• Focuses on strengths and goals, not problems
• Starts in early pregnancy until 2 years of age
• Structured programme
• Universal service (with criteria) rather than
  referral based

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How is the FNP Different?

• Regular supervision for the family nurses
• Psychology Sessions
• Therapeutic relationship
• Motivational interviewing techniques used to
• facilitate behaviour change
• Training programme

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Scaffolding

• Family nurse as a temporary scaffold to help
  clients become organised and self-regulated
• Programme enables clients to learn, identify
  their goals and develop plans for reaching them
• Clients in turn will become supporting frameworks
  for their children

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Improved outcomes-short term

• Reduced smoking and drug use during pregnancy
• Fewer subsequent pregnancies and greater
  intervals between births
• improved parenting practices and behaviour
• increased maternal employment and reduced welfare
  use
• Increased breast-feeding initiation

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Programme outcomes long term

• Improved early language development, school
  readiness and academic achievement
• Reduced child abuse and neglect, fewer childhood
  injuries
• Improved behavioural and emotional development
• Fewer arrests and convictions by age 15 and 19

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Our Results So Far

• The project is well accepted by teenage parents
  with very few clients dropping out
• An increase in the number of young mothers and
  fathers who stop smoking in pregnancy
• An increase in self-esteem of young parents in
  the programme
• A greater involvement from young fathers and
  other family members in the programme
• A willingness to develop a long term therapeutic
  relationship with their Family Nurse
• A willingness to learn about and try breast
  feeding
• A willingness to learn about the development of
  babies and health related issues.

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February 2013
Fidelity Measure Wave measure ( achieved) FNP Hertfordshire achieved Comments
At least 60 enrolled before 16 weeks gestation 61 73.3 GREEN
75 of eligible clients who are offered the programme are enrolled Figures not available 79 GREEN
8/9 clients are recruited each month to reach target of 100 over a year 130 on average 108 Clients Recruited 3 Moved Out of Area 3 Transferred to another FNP site 6 Inactive 1 Stillbirth 1 Miscarriage Letchworth 10 Stevenage 51 Hatfield 11 WGC 20 Baldock 2 GREEN
of clients receiving expected 80 visits in pregnancy of clients receiving expected 65 visits in infancy 65 66 74 85 GREEN National average 52 National average 54
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What difference does FNP make with 100 families?

• For a cost of 3000/yr/family the outcomes
  attributable to the FNP could bring us the
  following cost benefits
• Year One
• If we prevent 1 day in hospital for 10 pregnant
  women we save 10,000
• If we prevent one overnight stay in SCBU for 10
  babies we save 4,500
• If we prevent a 10 day stay in intensive neonatal
  care for just one baby we save 10,000
• Year One and Two
• If we prevent 5 emergency hospital admissions we
  save 3,750
• If we prevent 20 AE attendances we save 2,000
• If we prevent 5 children going into foster care
  it will save 135,000 a year
• If we prevent the need for 10 core assessments by
  children's social care we save 6,500
• Thereafter
• If we prevent 10 cases of serious conduct
  disorder we can save society 2.25m over their
  lifetime and 1.5m if we prevent 20 cases of
  moderate conduct disorder
• If we improve the outcomes of 50 children with
  multiple disadvantages we could help save local
  services over 5m by the time these children are
  16
• If we help 10 young women with no qualifications
  return to education and so gain employment we can
  save the state 70,000 in benefits alone

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How Families Have Responded
I want the best for me, my partner and the baby
My Family Nurse will help me to achieve this

• a

I feel part of the pregnancy, my family nurse
involves me and values me as a DAD
My Family Nurse doesnt tell me off
I feel happier, better about myself, not
depressed growing up
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Next Steps

• Positive end of first year Annual Review by the
  National Unit.
• Expansion of FNP in Hertfordshire
• Continue to use Information Data system and S1 to
  measure programme outcomes

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EVERYBODY NEEDS A FAMILY NURSE