Southwark PCT Health Led Parenting Project Family Nurse Partnership

1
Southwark PCT Health Led Parenting
ProjectFamily Nurse Partnership

• Barbara Hills Project Lead
• Locality Director
• Rachel Bartlett - Supervisor
• Surjit Bhandal Interim Project Manager

2
Family Nurse Partnership (UK programme)

• Based on Nurse Family Partnership which has been
  rigorously tested in USA over 30 year period.
• 10 pilot sites in UK. London has 2 Tower
  Hamlets and Southwark.
• Supports families/young pregnant women who have a
  low income.
• First time parents
• Supported through pregnancy and first 2 years of
  life.

3
Social Exclusion Action Plan Reaching Out

• We have seen reductions in child poverty,
  unemployment and crime, we now need to help those
  families caught in a cycle of disadvantage and
  exclusion by
• Earlier and better identification of at risk
  families
• Earlier and more effective intervention and
  prevention
• Building on the strengths of existing universal
  health visiting and midwifery services
• Builds on policy successes for children and
  families (Every Child Matters and the National
  Service Framework for maternity and children)
• Multi-faceted risks need multi-faceted but
  integrated responses

4
Like it or not, the most important mental and
behavioural patterns, once established, are
difficult to change once children enter
schoolNobel Laureate James Heckman (2005)

• Pregnancy and the first 3 years are vital to
  child development, life chances and future
  achievement
• Pregnancy and birth of a child is a magic
  moment of opportunity when parents are uniquely
  receptive to support
• Universal midwifery and health visiting services
  are ideally placed to identify children and
  families at risk
• Embedding the principle of progressive
  universalism into maternal services should be a
  priority to ensure that additional support is
  provided to those children and families at
  greatest risk

5
Emerging knowledge on neurological development

• Brain development depends on both genes and
  experiences
• Rapid brain development takes place in the first
  year of life
• Early interactions directly affect the way the
  brain is wired use it or lose it
• Early relationships set the thermostat for later
  control of stress response
• (Shore R, Rethinking the Brain, 1997)

6
Why love matters

• Looks and smiles help the brain to grow
• Baby looks at mother sees dilated pupils
  (evidence that sympathetic nervous system aroused
  and happy) own nervous system is aroused - heart
  rate increases
• Lead to a biochemical response - pleasure
  neuropeptides (betaendorphin and dopamine)
  released into brain and helps neurons grow
• Negative looks trigger a different biochemical
  response (cortisol) stops these hormones and
  related growth
• 
  (Gerhardt, 2004)

7
Differences in brain development following
sensory neglect
8
Family Nurse Partnership Visiting Schedule

• Once every week for first month
• Every other week through Pregnancy
• Once every week for first 6 weeks after delivery
• Every other week until 21 months
• Once a month until child is 2 years old

9
Southwark PCTs Programme Scope

• Aim to recruit 120 families - Equates to 24
  families per home/health visitor
• CRITERIA
• All first time mothers under 20 years Between 16
  28 weeks of their pregnancy
• No marketable education qualification
• Lack of meaningful social support
• May have other major issues, ie, mental health
  illness

10
Whats different?

• Programme outcomes are dependent on faithful
  replication of the original research
• Fidelity to the research model - responsibility
  of Supervisor
• Content prescribed but delivery tailored
• network for publicity
• Client centred, strength based and solution
  focused

11
Content of visits covers 6 domains

• Personal health womens health practices and
  mental health
• Environmental health adequacy of home and
  neighbourhood
• Life course development womens future goals
• Maternal role skills and knowledge to promote
  health and development of their child
• Family and friends helping to deal with
  relationship issues and enhance social support
• Health and human services linking to other
  services

• other services

12
FAQs

• Can anyone refer to the team? YES
• How long will this service be available? THE
  PROGRAMME IS RECRUITING UNTIL SEPTEMBER 2007
  (TARGET OF 120 FAMILIES)
• What is the skill mix of the team? THEY ARE ALL
  EXPERIENCED HEALTH VISITORS (SOME ARE DUAL
  TRAINED) HAVE RECEIVED ADDITIONAL TRAINING TO
  DELIVER THIS SERVICE
• What is the difference between the Family Nurse
  Partnership (FNP) and Sure Start Plus? THE FNP
  IS A PRESCRIPTIVE PROGRAMME WHICH ALL 10 SITES
  HAVE TO IMPLEMENT IN AN IDENTICAL WAY

13

• There is no one model of Sure Start Plus. The
  implementation of Sure Start Plus has been left
  to local implementation and has become integrated
  /linked to the Teenage Pregnancy Strategy.
• Therefore it was difficult to evaluate and
  measure some of the objectives due to poor data
  recording/collection. (Example, repeat
  pregnancies, health targets no significant
  differences on the breastfeeding and smoking
  cessation)
• The Sure Start Plus National Evaluation
  highlights the need to develop health services
  specifically targeted at meeting young peoples
  needs. Through partnership work, the teenage
  pregnancy/parenthood support service should take
  a lead within the Childrens Trust to influence
  mainstream services, such as maternity, health
  visiting and housing services.

14
Family Nurse Partnership Team in Southwark

• Supervisor Rachel Bartlett ext
  7836
• FNP Team Bernie Chambers ext 7839
• Ann Cleary ext 7837
• Margaret Wilkins ext 7838
• Margaret Khumalo
• Dorothy Oseki
• Base Gaumont House
• (Peckham Camberwell Locality Offices),
• 95 Marmont Road,off Peckham High StreetPeckham,
  London, SE15 5SL
• Tel [phone] Fax [phone]