The Family Nurse Partnership National Unit’s ADAPT project aims to rapidly adapt, test and improve the Family Nurse Partnership programme in England, working in partnership Dartington Service Design Lab and Family Nurse Partnership teams in 20 local authority areas.
ADAPT harnesses the strength of research and the pragmatism of improvement approaches to adapt, test and learn about the FNP programme, while respecting its strong evidence base. It aims to identify adaptations that will enable FNP to better meet the needs of families and respond to ongoing change in the local and national context.
It has also enabled the development and documentation of a method for rapid cycle adaptation and testing - an approach to innovation that tests changes to the programme rapidly and responsively, to see what works and what doesn’t, and then act accordingly.
The project began with 10 FNP teams in 2016 and has grown to involve 20 FNP teams in a second phase of the project, which began in June 2018. Other key collaborators in this project are Triangle, originators of the Outcomes Star, and the Big Lottery Fund’s ‘A Better Start’ programme.
Read about our emerging findings from this project in the ADAPT Interim Report.
Alongside the Interim Report, we published a Key Documents booklet, which includes the six key documents created by the FNP sites which designed a clinical adaptation as part of the ADAPT project: an adaptation description; a logic model diagram; a logic model narrative; a dark logic model; a context map; and a clinical flow chart.
We are testing two types of adaptation of the FNP programme in ADAPT.
Personalisation: focusing on developing a more personalised and flexible approach to how the programme is delivered.
• Flexing the content - supporting family nurses to focus the content of visits on areas of help their client needs most.
• Dial down/dial up - supporting nurses to reduce or increase the number of visits according to a client's needs.
• Early graduation - supporting confident clients to leave FNP before their child's second birthday when they are ready to graduate to universal services.
• Eligibility – flexing the eligibility criteria for the programme so we can target the mums and families who could benefit most from FNP.
Clinical adaptations: focussing on particular outcomes or areas of client need.
• Perinatal Mental Health
In the first phase of ADAPT, we tested clinical adaptations on Smoking, Domestic Violence and Attachment. Materials and guidance developed during this phase of testing have been rolled out to the wider FNP community.