News Insight: Health - Family nurses to reach more areas

The soon-to-be published child health strategy will unveil an expansion of family nurse partnerships - the innovative US scheme that targets young, vulnerable parents.

The scheme is already being piloted in 30 primary care trust (PCT) areas. It has proved its value and is set to be rolled out further. Last week's white paper on social mobility hailed family nurse partnerships as a successful way to target vulnerable families. So why is the government so keen on them?

Research from both sides of the Atlantic has shown they lead to improvements in children's language skills and health, and a reduction in incidents of neglect and abuse. Other benefits include greater involvement of fathers and better job prospects for mothers.

The scheme involves health professionals - often health visitors - working intensively with a small caseload of 25 families. They are given training in employment and education support and work with organisations such as Connexions.

Real benefits

Chris Tully, family nurse partnership lead at NHS Derby City, which is piloting the scheme, says: "We are already seeing real benefits, with eight out of 10 fathers involved, and there have been improvements in terms of smoking cessation."

Further results will be revealed in April, when Derby takes part in an evaluation involving 2,400 families across 18 of the pilot sites.

Health union Unite/CPHVA is broadly supportive of the partnerships, but hopes they won't replace universal health visiting, which has seen an erosion in funding and posts in recent years. Dr Cheryll Adams, lead professional officer at the union, says exhaustion is another worry: "It is very intense work and there is a fear that these nurses may face burnout 10 years down the line."

Rosemary Cook, director of Queen's Nursing Institute, also welcomes the scheme but says government promotion needs to do more to counter concerns. "There has been resistance. Some professionals see it as a threat to universal provision or believe it is not needed," she says.

Janet Rich, children's services development officer at the National Care Association, warns of the dangers of setting targets for hard- to-reach groups: "We know that if a person is difficult and not going to help meet a target then professionals are more inclined to move on to the next one. That is counterproductive and fails to help those most in need."

FAMILY NURSE PARTNERSHIPS

• £30m was allocated to pilot family nurse partnerships as part of last year's Comprehensive Spending Review
• The partnerships target mothers who are under 20 and those between 20 and 23 who are either on low incomes, unemployed, single parents or have little or no qualifications
• Evaluation of the UK pilots showed a 17 per cent reduction in those who smoked during pregnancy and more than half of fathers attending visits.