Rapid cycle innovation within an established evidence-based programme operating at scale
  • Seminar Room 4, John Bull Building, Plymouth Science Park

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Family Nurse Partnership (FNP) is an evidence-based home visiting programme for young mothers. 

In 2015 a major RCT in the UK found no impact on primary outcomes and some encouraging findings for a subset of secondary outcomes. Since then, the FNP National Unit and the Dartington Social Research Unit have sought to respond constructively to these findings by adapting the programme and testing those adaptations. 

The adaptations take two forms. Clinical adaptations involve changing programme material and approaches to delivery in the areas of attachment, breastfeeding, intimate partner violence, maternal mental health, neglect and smoking cessation. System adaptations involve helping nurses to personalise the programme by changing the eligibility criteria, flexing the content, adjusting delivery intensity and graduating some clients early. A bespoke assessment tool has been developed to support nurse decision-making as part of these changes. Adaptations have been co-produced by nurses, commissioners, subject experts and clients. 

In this way the approach seeks to incorporates user experience, practice knowledge and insights from the science of child development and evidence on ‘what works’. Qualitative and quantitative data are collected regularly on both the clinical and system adaptations and inform further adaptations as part of an iterative process. The paper outlines the co-production method and resulting adaptations, and considers the challenges of changing a well-established programme with a strong professional culture, exacerbated by the external climate of austerity and commissioning threat. It also reflect briefly on the strengths and weaknesses of the approach and lessons for others seeking to do similar work.  

This informal seminar is presented by Nick Axford, PenCLAHRC Associate Professor (Reader) in Health Services and is open to Plymouth University staff, postgraduate students and researchers. Contact laura.gill@plymouth.ac.uk for any queries.

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