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BMC Nurs. 2019 Apr 2;18:13. doi: 10.1186/s12912-019-0338-y. eCollection 2019.

Implementation of the Family Nurse Partnership programme in England: experiences of key health professionals explored through trial parallel process evaluation.

Author information

Clinical Nursing and Midwifery, School of Healthcare Sciences, Room 1.7, Ty Dewi Sant,Heath Park, Cardiff, CF14 4XN UK.
2Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS UK.
3Division of Population Medicine, Cardiff University, Cardiff, CF14 4YS UK.
Department of Psychology, Clinical Psychology, Bath, Somerset BA2 7AY UK.



The Family Nurse Partnership (FNP) programme was introduced to support young first-time mothers. A randomised trial found FNP added little short-term benefit compared to usual care. The study included a comprehensive parallel process evaluation, including focus groups, conducted to aid understanding of the introduction of the programme into a new service and social context. The aim of the focus groups was to investigate views of key health professionals towards the integration and delivery of FNP programme in England.


Focus groups were conducted separately with Family Nurses, Health Visitors and Midwives at trial sites during 2011-2012. Transcripts from audio-recordings were analysed thematically.


A total of 122 professionals participated in one of 19 focus groups. Family Nurses were confident in the effectiveness of FNP, although they experienced practical difficulties meeting programme fidelity targets and considered that programme goals did not sufficiently reflect client or community priorities. Health Visitors and Midwives regarded FNP as well-resourced and beneficial to clients, describing their own services as undervalued and struggling. They wished to work closely with Family Nurses, but felt excluded from doing so by practical barriers and programme protection.


FNP was described as well-resourced and delivered by highly motivated and well supported Family Nurses. FNP eligibility, content and outcomes conflicted with individual client and community priorities. These factors may have restricted the potential effectiveness of a programme developed and previously tested in a different social milieu. Building Blocks ISRCTN23019866 Registered 20/04/2009.


Complex intervention; Early years; Family nurse partnership; Home visiting; Pregnancy; Process evaluation; Public health nursing; Qualitative focus groups; Teenage

Conflict of interest statement

The trial was approved by the NHS Research Ethics Committee for Wales, reference (09/MRE09/08). We contacted professional leads who invited their team members and circulated information sheets and consent forms before the meetings. At the start of each focus group participants re-read the information sheet, and provided written consent to participate including audio-recording and use of anonymised data including direct quotes.Not applicablePrior to working on the Building Blocks trial, Sue Channon facilitated two workshops on Motivational Interviewing for supervisors within the FNP. The authors declare no other competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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