A partnership for change – listening, guiding and working together with young mums

By Ailsa Swarbrick on 20 April 2018

For the past decade across the UK, family nurses have been working with young women (and their partners) from early pregnancy until their child is two; listening, guiding and acting as a positive role model for vulnerable, first-time parents.

Purposeful, trusting relationships – are at the heart of the Family Nurse Partnership (FNP) clinical model, and that ethos runs through our approach to implementation more generally. Local FNP teams work closely with a range of professionals, and in particular midwives, who most often notify them about clients eligible for the programme and who continue to provide their ante natal care. This working relationship is vital in ensuring that we make the very important first connections with women so that that they can benefit from FNP as early as possible. It also means the nurse and midwife are able to work together in pregnancy, ensuring the client has the best possible service.

As Director of the FNP National Unit, I’m proud to say we have worked with over 35,000 families and seen over 31,000 babies born through the programme. I’ve seen first-hand the impact that this unique, therapeutic relationship between nurse and client can have in both the short and long-term, and heard the overwhelmingly positive response to it from many clients and their families. By focussing on strengths, nurses help young mums to make good choices and to have a healthy pregnancy, develop positive, attuned relationships with their baby and understand their needs, believe in themselves and their ability to succeed, and mirror the positive relationship they have with their family nurse with others.

How do we achieve this? Like any relationship, it’s important we start by building trust.  That means being respectful of the client’s expertise in their own life, recognising and building on their intrinsic motivation to do the best for their child, and also being honest.  Nurses then work towards creating and maintaining a therapeutic relationship. For many young parents on FNP, this will be the first time they have experienced such a degree of consistency over a long period with a positive role model in their lives (throughout the course of the programme, clients will receive up to 64 home visits). This helps young parents to build self-efficacy, which in turn can help them to make good choices about how they care for their babies, and also about their own future including education, employment or training.

FNP is underpinned by three theories: human ecology theory, attachment theory and self-efficacy theory. These provide the basis for the interventions nurses deliver and, over time, as nurses see clients start to fully engage with the programme, they benefit from and understand the materials that can help them to make positive changes for themselves and their baby. Nurses are able to use specific elements that best fit with the individual client needs – we call this agenda matching.

We know from clients that these approaches work for them, as do the theories that underpin the programme. Clients are the heart of FNP; their voices, opinions and feedback are woven into how we operate and have helped us to shape developments and changes to FNP. We believe strongly that young mothers and fathers, as experts in their own lives, should be partners in the design of their care.

Across the UK, local FNP teams work with a number of other services to ensure their clients are supported during their time on the programme and also have foundations in place to continue making positive choices after they graduate (usually when their child is 2 years old).

We’re proud to be working in such a strong and rich community, committed to achieving the best outcomes for young women. Midwives are often the critical link that connects clients with their family nurses; midwives unlock the opportunity for young mums to go on an FNP journey, and to have a healthy pregnancy and birth. By continuing to harness the power and impact from these relationships, both in an organisational context and between nurses and their clients we aim to provide the best possible early intervention services to those who need it most.

Ailsa Swarbrick
FNP National Unit Director 

For more information on the Family Nurse Partnership – http://fnp.nhs.uk

Twitter - @FNPNationalUnit