Family Nurse Partnership

The Family Nurse Partnership (FNP) is a licensed programme, originally developed in the USA, in which specially trained nurses work with first-time young mothers to develop their parenting capacity and support them to make positive choices for themselves and their children. It also seeks to support these families to achieve their short and long terms goals and aspirations.

Implementing FNP in Scotland

Bringing a licensed programme to a new country allows us to consider how to best contextualise it to both fit with existing support and achieve shared outcomes with other service providers. The key areas we have developed since 2010 are to ensure the programme:

  • focuses on outcomes of the greatest importance to Scotland
  • is better integrated with local services
  • reaches all eligible 19 and under first time mothers, where possible

Family nurses in Scotland also deliver the Universal Health Visiting Pathway to the families they serve, alongside the FNP home visiting schedule.  

Mothers aged 19 and under across Scotland and young mothers under 25 in some areas are offered the FNP programme. The programme has been scaled up over time, since 2010. We are successfully delivery the service in the following NHS Board/Local Authority areas:

  • Lothian
  • Tayside
  • Fife
  • Greater Glasgow and Clyde
  • Ayrshire and Arran
  • Forth Valley
  • Highland (Inverness area)
  • Lanarkshire
  • Borders
  • Grampian
  • Dumfries and Galloway 

We will begin working with Island Boards this year to identify how FNP might be delivered in their area.  

We are also working closely with the team delivering on outcomes for a wider population of young parents, through the Pregnancy and Parenthood in Young People strategy to share our learning of what works and what is important for young parents. 

Wider learning has been shared with other nursing and midwifery services, including offering student health visitor alternative placements, and development of supervisory models. These insights have been well received and work to strengthen core universal service provision, in the earliest years of a child’s life.

How FNP works

The FNP programme is delivered in the homes, by a specially trained nurse on a one-to-one basis for first-time young mothers from early pregnancy (before 28 weeks) until their child is two years old. 

During these visits, the nurse builds a relationship with the mother and uses materials and activities designed to support health behaviour change, improve understanding of positive relationships, improve postive, consistent care-giving, and increase opportunities to access both community, education and employment opportunities. 

Midwives continue to deliver maternity care during the antenatal period. Once the child is born, the family nurse continues to visit the family until r the child reaches the age of twoat which point they become supported by the local health visiting service

The family nurse also takes on the named person role, as agreed by their organisation. 

The Family Nurse Partnership programme has  three main aims which are to improve:

  • pregnancy and birth outcomes
  • child health and development
  • parents' economic self-sufficiency

The methods used are based on theories of human ecology, self-efficacy and attachment, with a focus on building a strong, therapeutic relationship between the family nurse and the client.

View 'Becoming the Mum I Want to Be', a video produced by NHS Scotland about one woman's experiences and her involvement with the FNP.

Background on FNP

FNP was developed at the University of Colorado, 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

An international review by The Lancet in 2008 named the NFP/FNP as one of only two programmes shown to prevent child maltreatment.

FNP evaluation in Scotland

It is almost 10 years since the programme 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, we published an evaluability assessment, carried out by NHS Health Scotland, to identify the possible approaches to assessing current impact of the programme in Scotland.

As a result, in 2016, we commissioned a data linkage study, through Cardiff University, to retrospectively compare some health, education and social care outcomes for mothers and children who received the FNP programme and those who would have been eligible.  

In June 2019 we published a qualitative study, 'Revaluation of FNP 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. 

Since 2010, more than 3,000 families have graduated from the FNP programme in Scotland, and following the expansion of the programme we are now able to reach over 3,500 families at any one time.  Over 7,000 families have ever benefited from the programme.

If you want to know more please email the FNP team: familynursepartnership@gov.scot

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