HERTFORDSHIRE HEALTHY SCHOOLS PROGRAMME Lin O’Brien Head of Hertfordshire Catering.
Hertfordshire FNP Team
description
Transcript of Hertfordshire FNP Team
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
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
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
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
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
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
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.
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 Area3 Transferred to another FNP site6 Inactive1 Stillbirth1 Miscarriage
Letchworth 10Stevenage 51Hatfield 11 WGC 20Baldock 2
GREEN
% of clients receiving expected 80% visits in pregnancy
%of clients receiving expected 65% visits in infancy
65%
66%
74%
85%
GREENNational average 52%
National average 54%
February 2013
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 A&E 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 If we contribute to improved literacy and numeracy in 80 children we could help save society up to
£5m over a lifetime
8
How Families Have Responded
a“I want the best forme, my partner and
the baby” “My Family
Nurse will help me to
achieve this”
“My Family Nursedoesn’t tell me off”
“I feel happier,better about myself,
not depressedgrowing up”
“I feel part of thepregnancy, my
familynurse involves meand values me as
a DAD”
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
EVERYBODY NEEDS A FAMILY NURSE