FNP: Next Steps is an ambitious and exciting programme of work, led by the FNP National Unit, to ensure the Family Nurse Partnership (FNP) in England achieves the best possible outcomes for young families. 

The aim of FNP: Next Steps

FNP: Next Steps aims to improve and adapt the FNP programme in England. FNP will continue to offer a strong evidence-base and seek to deliver positive outcomes in relation to parenting, child development and maternal self-efficacy. This work will involve everyone in the FNP community – family nurses, teams, commissioners, providers and clients, as well as other experts and academics and will build on the excellent practice and good outcomes achieved already by the programme.

Overall, our goal is for FNP: Next Steps is to: 

  • Achieve greater outcomes for vulnerable families, with clear evidence of cost effectiveness.
  • Be more flexible, to allow the FNP programme to be more personalised to individual families and responsive to local contexts.
  • Support the exchange of good practice between services to improve outcomes for all families.

FNP: Next Steps will run initially for the next 18 months, and will encompass four main streams of work. The FNP National Unit will:

  • 1. Offer a range of universal improvements to all FNP teams to allow them to make changes to the FNP programme in their area. 
  • 2. Work with a small number of ADAPT (Accelerated Design and Programme Testing) to co-design and rapidly test some further complex innovations for FNP.
  • 3. Work to evidence FNP’s impact further by reviewing our current data and new research.
  • 4. Support knowledge exchange, sharing good practice from FNP with other services and also gathering learning from others to help improve outcomes more widely. 
Universal programme improvements

We will be releasing some significant changes to all FNP sites across England over the next 18 months.  Our goal is to support a step change in outcomes through more focused quality improvement and greater flexibilities for FNP to respond to local needs and circumstances.  For example, we have recently developed guidance to help sites change their FNP eligibility criteria. Sites can now recruit clients up to the age of 24, enabling them to target a narrower group of clients according to vulnerability.

In the coming weeks and months, we will also be sharing with FNP teams, a tool to help demonstrate impact in each local area around child development and safeguarding outcomes. Data dashboards are already available at a local authority level, and we will be working closely with teams to test different approaches to delivering better outcomes. This will include the release of refreshed diet and nutrition guidance, new e-learning packages (coproduced with experts in the field), and further support to help clients stop smoking during pregnancy. 

All FNP areas will have access to this work, and there are lots of opportunities for people to work with us on this. We will release information on further universal improvements and positive outcomes in our news and blog sections of the website. 

ADAPT (Accelerated Design and Programme Testing)

Many elements of the FNP programme are complex and lend themselves to a more intensive approach  design, testing and scaling.

We are working with 11 FNP sites from around the country, along with our partners at the Dartington Social Research Unit, to co-design  and rapidly test a number of more complex innovations over the next 18 months through our ADAPT project.

We hope that promising innovations will be identified quickly, so we can release these to the wider FNP community as fast as possible.

Participating sites have now pinpointed their areas of focus for their clinical adaptations of FNP and are working to finalise their adaptation designs over the summer of 2016.

  • Smoking cessation: Cheshire East, Dudley
  • Breastfeeding: Blackpool
  • Domestic violence: Lewisham, Lambeth
  • Promoting healthy relationships (through group work): Southend
  • Perinatal mental health: Nottingham
  • Attachment: Bradford
  • Safeguarding/child protection: Portsmouth

At this early stage, there are already some clear cross-cutting themes emerging in sites’ thinking about the nature of adaptions, such as:

  • Developing new materials – including in different formats and/or delivering them at different times – to help support some of the clinical adaptations

  • Working with the wider family (and beyond) to support achieving outcomes such as smoking cessation

  • Strengthening links and pathways within the wider system

  • More or different training for nurses to build skills and capacity to deliver particular adaptations.

In addition, all 11 ADAPT sites (including Derby) are now working to design  the detail of the adaptations they will test around personalisation of FNP based on four themes:

  • Early graduation
  • Flexing the content of FNP
  • Adjusting the number of visits
  • Targeting FNP well, using adapted eligibility criteria

We will share further updates about progress as this project develops.  For further information, please contact NextSteps@fnp.nhs.uk.