The Norfolk Teenage Parent Pathway (TPP) was launched on the 4 September 2017. This was the culmination of a service redesign; to broaden the reach of support to all teenage parents within Norfolk, in addition to the extra resources focused on those teenage parents identified as most vulnerable.
The challenge
Norfolk had for many years a Family Nurse Partnership (FNP) service but it focused on young parents-to-be with very high levels of vulnerability, meaning only 20 per cent of the teenage parent population were able to access a service: it was recognised that there was a need to develop a high quality pathway of support for all teenage parents across Norfolk because they are all a vulnerable group.
The solution
Norfolk decided to offer a more intensive programme of support to all teenage parents in Norfolk, from the antenatal period through to the child’s second birthday. The most vulnerable receive the Family Nurse Partnership model and, by recruiting additional capacity to be teenage Parent Practitioners and upskilling the wider Healthy Child Programme (HCP) team, all the young people are offered a service which is strengths-based and rooted in evidence-based practice. There is supervision and support available to the Teenage Parent Practitioners from Family Nurses, and joint visits with Health Visitors at key points such as the five mandated checks. In the last year 195 families have received the core programme (for the most vulnerable) and currently there are an additional 161 families in Norfolk receiving the enhanced service offer of the Norfolk Teenage Parent Programme.
The impact
Despite the higher vulnerability of the young parents-to-be as a result of their own Adverse Childhood Experiences (ACEs), their risk of being NEET, and challenges around housing (compared to all parents-to-be), outcomes from the TPP continue to be positive; developmental progress of babies and infants are in line with the general population.
In the wider context, the evidence overwhelmingly suggests that ensuring the ‘best start in life’ (particularly amongst those families with risk factors for poorer health outcomes) pays dividends across the health economy and beyond. Sir Michael Marmot’s research, the Early Intervention Foundation and ‘1001 Critical Days’ show the rationale behind why targeted, preventative intervention gives such a significant return on investment over the medium to long term. Breaking the generational cycles of ACEs through programmes like the TPP will result in better physical and mental health outcomes: benefitting children, families and their communities.
How is the new approach being sustained?
The TPP is embedded within the Norfolk HCP – an integrated service for 0-19 year olds, focusing on prevention and early intervention. The HCP in Norfolk includes health visitors, school nurses, the NCMP and other linked provision for children, young people and their families. The TPP is funded by Norfolk County Council as part of the HCP contract as a whole and accessed via the single point of access for the entire service, Just One Number.
Lessons learned
Services for children and families work best if they are integrated within a wider system, with positive relationships between commissioner and provider - and a willingness to develop and flex service delivery to respond to the emerging needs of families and communities. This is as a result of consistent and dedicated hard work by Commissioners and the Provider.
Contact
Sarah Barnes, Public Health Commissioning Manager for Sexual Health and Children and Young People, Public Health
Norfolk County Council
Phone: 07776 313440
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