The Family Nurse Partnership (FNP) Programme Developing the Evaluation Framework

1. The Family Nurse Partnership (FNP) ProgrammeDeveloping the Evaluation Framework

2. FNP Programme • It is an intensive nurse-led home visiting programme that enables the family nurse to visit the same client from early pregnancy until the child is two • It is an intervention for young, first time mothers, who meet the broad eligibility criteria (19 and under at LMP, keeping their baby, living within geographical boundaries, <28 wks gestation at recruitment) • Programme aims: Improve pregnancy outcomes Improve child development Improve the economic self-sufficiency of the family

3. FNP in UK • England since April 2007. Implemented in 55 LA/ PCT areas. • FNP is now being tested in Scotland for the first time in NHS Lothian City of Edinburgh Community Health Partnership (Edinburgh CHP). First babies enrolled in March 2010. • 2 teams in NHS Tayside, covering Dundee, Angus and Perth and Kinross CHP’s. • England: Formative evaluation of the first ten sites reported 2011 • England: RCT in 18 sites which will report, initially, in 2013. The RCT will assess what the benefits and costs associated with FNP, looking closely at prenatal health behaviours, and early child health outcomes.

4. FNP Evaluation Evaluation Tem: Scottish Centre for Social Research The overall aim: evaluate the implementation of the programme in Scotland (Lothian) Specific questions: • Is the programme being implemented as intended? If not, why not? • How does the programme work in Scotland (Lothian)? • Wider implications for implementing the programme in Scotland. Evaluation implementation: Monitoring and Evaluation Framework: Internal (FNP data) and External (stakeholder interviews, qualitative panel and focus groups) relevant to outcomes of interest in Scotland

5. How we developed M+E framework • Series of focused meetings facilitated to achieve consensus on the what the programme was intending to achieve (outcomes) and how this was intended to operate (processes and assumptions) • Produced two logic models: a Google Earth view and an implementation model • These provided framework for the M+E

6. Preliminary logic model using EB and incorporating outcomes in service level agreement

7. FNP: High level strategic model

8. FNP: Implementation model

9. FNP: Embedded implementation model

10. From Having to Using…… We used the logic models to frame monitoring and evaluation of the programme by: • Prioritising key outcomes and assumptions of interest • Prioritise key questions addressing above • Agreeing who would collect and analyse which data, when and how • Decisions underpinned by considerations of feasibility, acceptability and data robustness (including how to improve these)

14. The M+E framework in action…

15. Application • Scottish context: ensures evaluation relevant to outcomes of interest in Scotland • Evaluation tools: Identifies data collection relevant to outcomes of interest • Wider work: informed NHS Lothian on wider maternity services work Ist report: intake and early pregnancy http://www.scotland.gov.uk/Publications/2011/07/28142203/0 Contact: Vikki Milne, victoria.milne@scotland.gsi.gov.uk