Family Nurse Partnership
Family Nurse Partnership Programme
The Family Nurse Partnership is a person-centred, preventative intervention programme offered to young first time parents aged 19 or under, and eligible 20 to 24 year olds in some areas, and their children. It is an evidence based change programme that is delivered in the parents’ own homes. It is designed to cover the first 1001 days of life, from early pregnancy until the child reaches the age of 2 years old.
The Family Nurse Partnership programme is tailored to meet the specific needs of young parents. Family nurses are experienced, qualified nurses and midwives who undergo extensive additional training at Masters level. This enables them to deliver this structured programme to support young parents to build the confidence and skills they need to provide the right support for their baby and give them the best start in life.
Family Nurse Partnership in Scotland
The Family Nurse Partnership programme is viewed as a long term investment in the early years by the Scottish Government, to promote positive outcomes.
In 2008 we committed to testing one of the strongest evidence based programmes available at the time. This was the Family Nurse Partnership programme, which provides support to families to break intergenerational cycles of poor outcomes. This was because we recognised the importance of the earliest years of life, including pre-birth, the role of the family and the wider environment to shape children’s lives, as well as the need to respond to increasing inequalities
This programme continues to make a difference in the earliest years of life, including pre-birth. The population the programme targets, first time young mothers, can face a number of challenges. The programme is person-centred, aligned to Getting It Right For Every Child (GIRFEC). It has a core aim around tackling child poverty, and a significant number of the first time young mothers receiving the programme were either care experienced or under child protection themselves (1 in 5).
The Family Nurse Partnership has been expanded over the last 10 years and is now delivered in all mainland health boards in Scotland. Over 10,000 families have received the programme, and 6,000 have graduated from the programme. The Family Nurse Partnership reaches over 3,000 families at any one time.
We are successfully delivering the service in the following NHS board/ local authority areas:
- NHS Ayrshire and Arran
- NHS Borders
- NHS Dumfries and Galloway
- NHS Fife
- NHS Forth Valley
- NHS Grampian
- NHS Greater Glasgow and Clyde
- Highland (Inverness/Caithness area)
- NHS Lanarkshire
- NHS Lothian
- NHS Tayside
We are continuing to explore how this programme could be delivered in more remote and rural areas, including island boards.
Background
The Family Nurse Partnership was developed at the University of Colorado, Denver, USA, where it is known as the Nurse-Family Partnership (NFP). Over 40 years of research, the programme has been shown to produce many benefits, including:
- improvements in antenatal health
- improved early language development and academic achievement
- reductions in children's injuries, neglect and abuse
- improved parenting practices and behaviour
- fewer subsequent pregnancies and greater intervals between births
- increased maternal employment and reduced welfare use
- increased involvement from fathers
The programme is delivered internationally, including in England and Northern Ireland. Two major studies called Building Blocks 0-2 and Building Blocks 2-6 have been published about the Family Nurse Partnership programme in England. These studies demonstrate the programme’s positive effect for children, particularly in relation to educational attainment.
How Family Nurse Partnership works
The Family Nurse Partnership is an intensive home visiting programme for first time parents age 19 and under, and eligible 20 to 24 year olds in some areas, from early pregnancy until the child reaches two, delivered by specially trained nurses and midwives.
The three main aims of the Family Nurse Partnership programme are to:
- improve pregnancy and birth outcomes
- improve child health and development outcomes
- improve the economic stability of the family
The evidence-based licensed programme is underpinned by three theories:
- human ecology theory
- attachment theory
- self-efficacy theory
The support provided by family nurses is both holistic in nature and aims to address young parents’ immediate health and wellbeing needs. Family nurses also help build pathways into community support and resources to address social and economic factors, such as welfare, education, employment and money advice.
The Family Nurse Partnership recognises the specific needs and challenges of young parents, and family nurses develop a therapeutic relationship with the family, identifying their strengths to achieve their goals and aspirations for themselves and their children.
Midwives continue to deliver maternity care during the antenatal period. Once the child is born, the family nurse continues to visit the family until the child reaches the age of two, at which point they become supported by the local health visiting service.
Evaluation
It has been over 10 years since the Family Nurse Partnership was first delivered in Scotland and over that time a number of evaluative methods have been used to access both acceptability of the programme by the clients, and the potential impact.
In 2014, we published a summary of key learning from the formative evaluation of the programme in NHS Lothian, carried out over the previous four years.
In September 2015 an evaluability assessment was carried out by NHS Health Scotland, to identify the possible approaches to assessing the current impact of the programme in Scotland.
In June 2019 we published a qualitative study, 'Revaluation of Family Nurse Partnership in Scotland', which provides insight to the value of the programme as perceived by clients, nurses and wider stakeholders. This approach used client and nurse stories to inform the report.
In March 2021 we published the Family Nurse Partnership - a family nurse perspective: 10 year anniversary. This is a reflection on the first 10 years of the programme in Scotland, which is a collection of testimonials from family nurses.
In August 2021 we commissioned the Coronavirus (COVID-19) Family Nurse Partnership insights: evaluation report which explores the experiences of the family nurses and clients in Scotland during the COVID-19 pandemic. This includes initial findings on service delivery, mode of delivery, dosage, materials and resources.
Following the evaluability assessment in 2015 we commissioned a comparative study on the Family Nurse Partnership, using routine administrative data sets across health, education and social work. In 2020 we published a paper on Family Nurse Partnership evaluation on the methods and process which will be used for this study.
In May 2022 we published the 10 Year Analysis of Family Nurse Partnership data. This study helps improve our understanding of the programme as a whole, understand who has received the programme, changes over the 10 years of operation, and to identify areas of success and for improvement. This video on the 10 year analysis highlights some of the main findings of the report.
If you want to know more please email the Family Nurse Partnership team: familynursepartnership@gov.scot