Evaluation of the Family Nurse Partnership Programme in NHS Lothian, Scotland: 3rd Report - Infancy

Footnotes

1. 'Stretch goals' are goals which the programme aspires to achieve. Based on the US research evidence, these are the optimum goals for ensuring the success of the programme. However, they may be difficult to achieve when first implementing the programme. See Annexes to Martin et al (2011) for a full list of the FNP Core Model Elements and Fidelity 'stretch' goals.

2. Three new Family Nurses started with the team in the first half of 2012. These new Nurses were recruited in part to enable one of the existing team to act up to Supervisor 2 days a week, and in part to prepare the team for offering the programme to all eligible clients on an ongoing basis in the future. The team's original Supervisor remains in place but, at the time of writing, was seconded one day a week to the Scottish Government as the National Lead Supervisor for Scotland. The local FNP Lead for Lothian left at the end of their contract in spring 2012. The team Administrator also left in early 2012 and was replaced after a four month gap. There are also now plans to recruit a second team of 8 Family Nurses in NHS Lothian.

3. Initially by the NHS Lothian Local FNP Lead, and from March 2012 by the newly appointed FNP Research and Information officer, based in NHS Education for Scotland (NES).

4. One dropped out after their first evaluation interview and another after their second interview.

5. Note that although the NHS Lothian, Edinburgh Family Nurse team has expanded since the second evaluation interviews (with three new Family Nurses recruited to allow for expansion and cover for existing members of the team who have taken on additional responsibilities), the evaluation interviews are with the original cohort of 6 Family Nurses and the Nurse Supervisor, since the purpose of the evaluation is to capture learning from the first test phase of FNP in Scotland and to explore any changes in Family Nurses' experiences and views over this period.

6. Of the 4 clients who left the programme during pregnancy, 1 rejoined during infancy. This client is therefore included in the bases for infancy attrition and explains why the cumulative total of clients leaving/inactive by the end of infancy is less than the sum of the individual attrition figures for pregnancy and infancy.

7. The figure in the second report was based on client status at the fixed point when all clients had reached the end of the pregnancy period (that is, the end of April 2011). It therefore erroneously included several clients who actually became inactive after their own babies were born (i.e. during the infancy period). The figures presented in Table 3.1 are based on the status of each individual client when they reach the end of the relevant stage of the programme (i.e. when their own baby was born (end of pregnancy) or turned one (end of infancy)).

8. 'Health for All Children', child health screening and surveillance requirements - see http://www.scotland.gov.ukf06bf29f-9ca2-4a29-9089-fa6250423259

9. Note that the form does not distinguish between these people.

10. 'Significant others' nominated by clients participating in the evaluation are being interviewed in the fourth round of interviews when clients' children are around 21-24 months old. Their views will therefore be included in the next (fourth) evaluation report.

11. Note: the Monitoring and Evaluation Framework originally asked 'Is the FNP structure useful/appropriate?'. However, as the evaluation is focusing on the process of implementing FNP in NHS Lothian, Edinburgh, it was felt that it was more appropriate to reframe this in terms of how the structure was experienced in that site.

12. NB of the 128 clients still in FNP at the end of the infancy phase, 3 were temporarily disengaged at the point their child turned 1, so this information was not collected at 12 months. Of those clients for whom information was recorded, 66% of records were based on the client's self-report that their child's immunisations were up to date and 34% were based on a written record of immunisations.

13. See http://www.hps.scot.nhs.uk/immvax/vaccineuptake.aspx

14. See also http://www.nursefamilypartnership.org/proven-results/Changes-in-mother-s-life-course for a summary of results. The increase in intervals between first and second babies for FNP clients compared with control groups was 3.7, 4.1 and 12.5 months across the 3 US trials.

15. http://clinicaltrials.gov/ct2/show/NCT00928538

16. 3 of the 128 clients still in FNP at the end of the infancy phase were temporarily disengaged at the point their child turned 1, so their demographic details were not updated at that point.