Clare McKenzie, Senior Public Health Commissioner – Children, London Borough of Hounslow
In times of austerity there are tough decisions to be made in public services. It is more important than ever that every pound is spent wisely, delivering good quality services and positive outcomes for families.
When we re-commissioned our Public Health Children’s services in 2017/18, we were very clear that FNP needed to be a core part of our offer. Now in 2020 whilst teenage pregnancy rates decline, in line with the rest of the country, I was asked is there still a need? The answer is YES. The young families we support are complex and often vulnerable, benefitting greatly from the unique way FNP works.
Furthermore, going forward, as we embed a more personalised FNP programme, we will extend the programme to other first time, vulnerable mums up to 24 years.
The intensive support given is instrumental in building trust between mum and family nurse, enabling them to disclose information about their personal circumstances and learn to grow as a parent, considering their own future. As a commissioner it is also important to consider the impact on the wider system, the costs saved by keeping families together, intervening early, supporting good early attachment, mums’ wellbeing and parenting skills.
In Hounslow, developing partnerships between FNP and other services has been prioritised. The complexity of FNP families means their needs cannot be met or supported by FNP alone. Housing, mental health, domestic abuse, employment and many more issues require partnership approaches. FNP Boards, the Knowledge and Skills Exchange programme and regular meetings with social care enable the programme locally to support joint working across the system and at a practitioner level.
But it is the stories of adversity overcome, the hope of the mothers for their own and their child’s future that inspires. Mums attend Board meetings with professionals and talk confidently and honestly about their experiences, both good and bad. They talk with affection about their family nurse, how they have supported them, helped them to access other services and be the best parent they can.
For families it’s important to consider what happens after they graduate. The relationship with universal health visiting and children's centres continues to be developed, through young mum’s groups, hand over visits with health visiting and mums coming back to FNP advisory board meetings to share their post FNP experiences.
It is for these reasons, Hounslow continues to review our services and ensure they meet the needs of the population we serve, with FNP an integral part of our offer.