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How cost-effective is the Family Nurse Partnership?

A study to gauge whether the nurse-led home-visiting programme for first-time parents represents good value for money for the NHS

A study to gauge whether the nurse-led home-visiting programme for first-time parents represents good value for money for the NHS

Picture shows woman holding up baby to nurse. The additional costs of providing the Family Nurse Partnership (FNP) - an intensive, nurse-led home visiting programme for young, first time parents - is leading to questions on whether the investment is worthwhile
Picture: iStock

The additional costs of providing the Family Nurse Partnership (FNP) – an intensive, nurse-led home visiting programme for young, first time parents – is leading to questions on whether the investment is worthwhile.

Introduced from the US in 2006, the scheme is provided in around 125 English local authorities. The Building Blocks randomised control trial examined effectiveness and cost-effectiveness of delivery under a comprehensive NHS.  

The trial found no statistical differences in outcomes for smoking cessation, birth weight, second pregnancies within two years or child emergency care attendances and admissions to hospital between those receiving FNP services and those receiving usual care.  

Economic evaluation and conclusions

For the economic evaluation, 1,618 families were followed-up during pregnancy and for two years after birth.  A full range of costs, covering health and social measures, were collected through interviews and self-report questionnaires.  

Average health costs were found to be slightly lower for those receiving FNP than those receiving usual care. Resource use and average per person costs were higher for non-health related items.  

Some of the costly items were positive, such as attendance at a mainstream education programme and attendance at children’s centres.  

The study identified additional costs beyond the implementation costs of the intervention. Given no differences in outcomes within the two-year follow-up period, it is questionable whether the FNP is worth the substantial costs and commissioners may wish to consider other options for investment. 


Reference

Bell K, Corbacho B, Ronaldson S et al (2019) Costs and consequences of the Family Nurse Partnership (FNP) programme in England: evidence from the Building Blocks trial. F1000Res. 13, 8,1640. doi: 10.12688/f1000research.20149.1


Vari Drennan is professor of healthcare and policy research at Kingston University and St George’s, University of London

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