Cheshire West and Chester: spreading the skills of the Family Nurse Partnership team

Family nurses have been using their skills to train up the wider workforce in support of young parents and families. So far over 100 staff, including health visitors, school nurses and early years workers, have been supported. This case study is an example of the work that councils are doing to support young parents.

The challenge

Cheshire West and Chester’s Family Nurse Partnership – provided by Cheshire and Wirral Partnership NHS Trust – has been in operation for the past seven years, successfully supporting young parents.

But the service is unable to give places to all young parents, with help being offered to around half of the eligible cohort.

In 2018 a new integrated 0 to 19 years’ service was set up across area by the council. The model, called Starting Well, brought together the healthy child programme, children centres and the Family Nurse Partnership (FNP).

The creation of the integrated service was seen as an opportunity to re-consider the approach being taken.

The solution

The skills of the six-strong family nurse team were seen as crucial to improving outcomes for families because of their ability to communicate and engage hard-to-reach groups as well as providing support to vulnerable groups. The decision was taken to set up a training programme to allow the family nurses to equip the wider workforce with similar skills.

The training – based on packages developed by the FNP National Unit – has been offered across four-modules, covering: • communication skills:

  • the adolescent brain
  • attachment and bonding
  • engaging marginalised groups.

Among the techniques taught are asking open questions and importance and confidence rulers, where clients are asked to rate their willingness or confidence to do something from one to 10, which in turn opens up an avenue to engage them more proactively.

FNP Supervisor Claire Maidment said: “We know the FNP service cannot reach everyone, but the skills and knowledge we have developed can help to ensure we work with our colleagues to have a wider impact not just on young parents but all families. “Everyone from front of office staff to health visitors and early years workers have been trained in communication skills with an emphasis on ‘making every contact count’.

“For example, if a dad accompanies his partner for an appointment with a midwife the receptionist should feel confident to strike up a conversation with him about a behaviour change, such as smoking. He may not act on the information shared, but we are at least giving him an opportunity.”

The impact

Over 100 staff have undertaken the training so far. Those that have taken part are full of praise for the impact it has had on their practice.

One health visitor said: “I will now approach client contacts differently. I will be more confident in letting clients develop their own solutions through affirming their strengths.”

Meanwhile, another added: “The training exceeded expectations. The most useful training I have been on for a while. The FNP facilitators were so supportive, professional and inspirational.”

As part of the new Starting Well model, the FNP team has been spread across the area so each children’s centre has its own assigned family nurse.

Claire said: “The new integrated service has naturally brought us closer. It means we can provide a more seamless service which is good for the families we help, especially the more vulnerable ones like young parents.”

Lessons learned

The FNP team are in the process of introducing some ‘bite-size’ training courses to help staff who have completed the training. The communication workshop lasts a day, while the others are half-day courses.

Claire said: “As with any training, there is always a lot to take in. You can find yourself back in the day job forgetting some of the bits you have done or finding it difficult to put into practice. “We realise the importance of keeping momentum going. So we are now looking at doing one-hour bite size sessions on communication skills to act as a ‘top up’.”

How is the approach being sustained?

The training is constantly being offered to more and more staff. Recently those from outside the integrated 0 to19 Starting Well service have started taking part. This has included the council’s early help and prevention service and health visitor and school nurse students from a local university. The fourth module – engaging marginalised groups – has also not been run yet. That is due to start in the coming months.

But, off the back of the success of the programme, the FNP team has also been taking part in a wider piece of work. The experiences of the family nurses in motivational interviewing, trauma-informed practice and understanding of adverse childhood experiences are being used to inform a training programme for the health, social care, education and police workforce.

The programme – to be delivered by an outside provider – is going to be offered to 900 staff and is due to start in April.


Claire Maidment FNP Supervisor, Cheshire and Wirral Partnership NHS Trust