New Intensive Support Pathway for young and vulnerable families

Following the restructure of the Integrated Specialist Public Health Nursing (ISPHN) and Children Looked After (CLA) service in line with recommissioning in April 2022 a new approach to supporting young and vulnerable families was agreed to implement an Intensive Support Pathway (ISP) for young and vulnerable families.

The Intensive Support Pathway (ISP) is intended to provide high intensity and targeted support to young and vulnerable new mothers who require a higher level of intervention than the Healthy Child Programme Specialist level. The ISP shares the over-arching aims of the ISPHNS to reduce inequalities in outcomes and to ensure a strong focus on prevention, health promotion and early identification of needs.

Project Aims

• To improve the outcomes of pregnancy by helping young women improve their ante-natal health and the health of their unborn baby
• To improve children’s subsequent health and development by helping parents to provide more consistent competent care for their children
• To improve women’s life course by planning subsequent pregnancies, finishing their education and finding employment

The ISP will have a two-level approach:

ISP Level One: 3 WTE family nurses to deliver the Family Nurse Partnership (FNP) programme to young parents aged 19 years and under across the East Riding.

ISP Level Two: other young /vulnerable mothers requiring support more than UPP/Specialist level including those that decline the FNP programme.

Benefits for Children and Mothers

The new pathway will benefit children through:

• Increased birth weight
• Improved early language development, school readiness and improved academic achievement
• Reductions in children’s injuries, neglect and abuse
• Improved behavioural and emotional development
• Fewer mental health problems
• Reduced arrests, convictions and supervision order by age 15 and 19

The new Intensive Support Pathway will help mothers by delivering:

• Improvements in antenatal health
• Reduced smoking in pregnancy
• Reduced alcohol and/or drug use in pregnancy
• Increased initiation and maintenance of breastfeeding
• Increased take-up of long-acting reversible contraception
• Fewer subsequent pregnancies and greater intervals between births
• Improved parenting practices and behaviour
• Increased maternal employment and reduced welfare use
• Improvements in mothers’ social support, relationship quality (including increased father’s involvement) and self-efficacy

There will be a soft launch in April 2023 of the intensive support pathway for younger families with vulnerabilities with a hard launch in September 2023 that will include not only young families but all families with vulnerabilities.

More families will receive an increased number of visits that are client focused and therefore meet their individual needs. More vulnerable families will be seen by a professional who can assess their needs and signpost families to relevant services.

The FNP team in the East Riding will continue to offer an intensive home visiting programme for young mothers with vulnerabilities.

There will be an alternative pathway if the FNP programme is declined, or clients do not fit the eligibility criteria for FNP. Please see proposed split:

Next Steps

Presentations to stakeholders have taken place, with training for health visitors to take place in April 2023.

If you have any questions on the project, please contact Sarah Clapham, FNP Supervisor on sarah.clapham@nhs.net.