Gail Trotter

National Implementation Lead (FNP)

Family Nurse Partnership programme

(FNP)

FNP Goals

1. Improve pregnancy outcomes

2. Improve child health and development and future school readiness and achievement

3. Improve parents’ economic self-sufficiency

Criterion for FNP… who is entitled to FNP?

First time pregnant teenagers aged 19 and under at LMP

• Residing in the area for 2 years

• Not planning to relinquish the baby

• “Opt in” programme

Scotland's teenage parents

• Under 20’s first time parents nine times more likely to live in deprived areas

• 66% (2,300 women) from the most deprived quintiles

• Just 16% in the least 2 deprived quintiles• Obstetric immaturity• Young mothers higher increase of lbw babies• More likely to be smoking at booking and less

likely to engage in Ante Natal care support• Less likely to breastfeed• LAC teenagers 25 % pregnant leaving care.

Evidence Base

3 USA RCT trials3 USA RCT trials

Improvements in women’s antenatal health Reductions in children’s injuries Fewer subsequent pregnancies Greater intervals between births Increases in fathers’ involvement Increases in employment Reductions in welfare dependency Reduced substance use initiation Improvements in school readiness

The cost savings grow over timeBased on Elmira High-Risk Families

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

0 2 5 10 15 20 25 30 35 40 45 50 55 60 65

SOCIAL

RETURN

Cumulative dollars

perchild

Age of child (years)

Cumulative savings

Cumulative Costs

Unit Costs Comparisons

Family Information Direct –£33.86 per family via telephone helpline£1.95 per family via digital services

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Severity of need

Cost

Family Intervention Projects –£8-20,000 per family per year

Family Nurse Partnerships –£3,000 per family per year

Child looked after in children’s home – £125,000 per year

Child looked after in foster care – £25,000 per year

Schools - £5,000 per pupil

Children’s Centres - £300 for each 0-5 year old

Costs increase as children get older

Multi-dimensional Treatment Foster Care - £70,000 per year

Child looked after in secure accommodation –£134,000 per year

Parenting programme –£900-1,000 per family

Unit costs at different levels of need

‘Families have a right to expect evidence based interventions’.

• Evidence what we do.

• Be confident to stop doing what does not make a difference

• Involve clients in the feedback loop

• Learn and share from what we are doing well