Family Nurse Partnership (FNP) ADAPT

Family Nurse Partnership (FNP) is a voluntary intensive home visiting programme for first time young mums. FNP ADAPT is part of an initiative by the FNP National Unit to improve the FNP programme in England. A Better Start Southend is one of a number of trial areas and we are trialling a range of adaptations to the FNP programme with the aim of improving outcomes.

FNP aims to enable young mums to:

  • Improve pregnancy health, behaviours and outcomes
  • Improve child health and development by developing parenting knowledge and skills
  • Improve economic self-sufficiency (of both parents), by helping them to achieve their aspirations (such as employment or returning to education

The programme is for first-time mothers, young mothers (aged 19 years or under) and their babies, from pregnancy until their child turns 2. Fathers and other family members are also invited to take part with the mothers’ permission. Women are enrolled onto the programme by the 16th week of pregnancy and no later than the 28th week.

Structured home visits are delivered by highly trained nurses. These are weekly during pregnancy and the six weeks after birth, then fortnightly until three months before the child’s second birthday, when visits become monthly in preparation for the programme ending. As far as possible, the mothers will see the same family nurse throughout the programme.

Here at A Better Start Southend, we have altered the client eligibility criteria to include mothers who present late for booking (up to 32+6 weeks gestation). In addition, mothers who have concealed their pregnancy can be enrolled at any time point in their pregnancy and immediately post birth.

The programme delivery has been adapted by utilising the New Mum’s Star (an assessment tool to assess and review the mum’s progress in particular areas) to personalise the programme delivery. The use of Dial Up and Dial Down visiting (more or less frequency of visits) and Early Graduation has also been implemented. Dialling Up is usually for a set time frame, Dialling Down can be throughout the programme or again for a specific time frame. Early Graduation (when the programme is completed prior to the child turning two years old) allows the family nurses to graduate mothers from the programme any time after their baby has turned one year old.

‘ADAPT’ refers to – Accelerated Design and Programme Testing. This methodology used for this project is a rapid cycle innovation process designed to allow for testing and effective refining of adaptations to FNP.

The primary aim of the ADAPT methodology is to gain an understanding of the deliverability of adaptations and early signals of the impact on outcomes. This learning is then fed into the rapid cycle process prior to further testing ultimately leading to some of adaptations being developed and evaluated on a wider scale.