The Family Nurse Partnership National Unit’s ADAPT project came to an end in October 2019.
The project harnessed the strength of research and the pragmatism of improvement approaches to adapt, test and learn about the FNP programme in England, working with Dartington Service Design Lab and FNP teams in 20 local authority areas.
As a result of this project, we have made a change to the service delivery model with further adaptations planned for 2020/21.
The delivery of the programme is more personalised to the needs of each client. This new approach provides greater freedom to tailor the programme for FNP clients based on assessed need, while continuing to utilise all the knowledge and skills of family nurses.
It involves the introduction of a new tool, the New Mum Star, which is completed collaboratively with clients to identify where the intervention should be focused and to inform the ongoing work with the client.
About the ADAPT project
The project used a rapid cycle adaptation and testing approach to innovate and test changes to the programme rapidly and responsively, to see what works and what doesn’t, and then act accordingly.
The project began with 10 FNP teams in 2016 and grew to involve FNP teams in 20 local authorities in a second phase of the project, which began in mid 2018. Other key collaborators in the project were Triangle, originators of the Outcomes Star, and the National Lottery Community Fund’s ‘A Better Start’ programme.
We tested two types of adaptation of the FNP programme:
1. Personalisation: focused on developing a more personalised and flexible approach to how the programme is delivered. This included flexing programme content, 'dialling' the frequency of visits up or down and early graduation, all based on a collaborative nurse-client assessment of need using the New Mum Star. We also explored the impact of greater flexibility in eligibility criteria to target the mums and families who can benefit most from FNP.
2. Clinical adaptations: focused on particular outcomes or areas of client need, including neglect and intimate partner violence. In earlier phases of the ADAPT project, we tested clinical adaptations on stopping smoking, breastfeeding, maternal mental health and attachment. Some of the materials and guidance developed during these early phases of testing have been rolled out to the wider FNP community.
What next?
At our ADAPT project close event in October 2019 we gained further insight and learning from the FNP nurses and supervisors who participated in the project. This feedback was used to inform the implementation of a more personalised FNP programme across all FNP teams in England in 2020.
Further reading
Read about this work in our report FNP ADAPT: Using evidence, pragmatism and collaboration to change the Family Nurse Partnership programme in England.
Our initial findings were published in the ADAPT Interim Report.
Hear from FNP supervisor Lorette and family nurses Norma and Megan about their involvement in FNP ADAPT.