30 / 03 / 2009
This case study sets out how South West London and St. Georges Mental Health NHS Trust, working with other London mental health trusts, designed, implemented and evaluated a preceptorship programme for newly qualified therapists which dovetailed with the KSF.
How we did it
The results and next steps
Further information and contact details
South West London and St. Georges Mental Health NHS Trust (SWLSTG) employs 2700 staff and provides local and national mental health services to a population of about one million across five London boroughs.
What we did and why
SWLSTG was an early implementer site for Agenda for Change, and piloted the Knowledge and Skills Framework (KSF) within occupational therapy and physiotherapy from 2004.
The trust looked at how to introduce preceptorship which was a new requirement for therapists. The KSF handbook sets out how the KSF should be used during the preceptorship year but there was no guidance on the process.
Preceptorship programmes have been in place in nursing for several decades to support the transition of newly registered nurses into practice. The therapy service saw the formal introduction of preceptorship as an opportunity to ease the transitional period for newly qualfied occupational therapists.
Spring 2005 - The director of therapies at SWLSTG presented a proposal for the London mental health trusts to work in partnership to design, implement and evaluate a preceptorship programme for newly qualified occupational therapists. This approach was adopted because the therapy services across the trusts had already worked together on a set of KSF outlines for all bands of staff. This would ensure that the preceptorship process dovetailed with the KSF.
The project was approved and a planning group was set up. The programme was set to roll out in Autumn 2005 across the London mental health trusts and their partner organisations with shared rotation schemes, so needed to work in a wide range of care settings, including social services. The draft programme was presented to the London Unison occupational therapy stewards as well as to the professional leads group.
The project group met frequently and as preceptorship is new in occupational therapy, looked at:
best practice in nursing
literature relating to the experience of newly qualified occupational therapists
the findings of an action research study conducted by occupational therapists working in the South West London Mental Health Trust (OT News, February 2006).
From these, they developed a preceptorship process that complies with Agenda for Change and draws on evidence of best practice that could be piloted.
Summer 2005 - the planning group circulated briefings and also a readiness audit tool to assess the extent to which therapy services had infrastructure in place. This highlighted a need for:
a template preceptorship policy
pre-preceptorship preparation checklist for managers to discuss with KSF leads, staff etc in the organisations
a KSF awareness training pack for all therapists.
These were circulated in July 2005.
The planning group launched the model at workshops to encourage discussion and skills development. The group developed two sets of workshop programmes and training materials to target the learning needs of the two target groups: heads and supervisors and newly qualified occupational therapists. Participants also received a copy of a preceptorship handbook (Morley, COT 2006).
September 2005 - November 2006 - The pilot phase ran from September 2005 - November 2006. There were seven workshops for 211 heads and supervisors and four workshops for 69 newly qualified occupational therapists.
There was no allocated budget for the project in the pilot year. The workshop materials and handbooks were produced in local services. Each occupational therapist manager with staff participating in the pilot year provided either a workshop venue and catering or a co-trainer for the workshops.
In most cases, there was strong support from the professional lead occupational therapists and this facilitated implementation and local buy-in. The design of the programme also required that one agreed KSF outline and preceptorship policy were used in organisations with shared rotational schemes so that participants were not confused. The evaluation highlighted that this was not always achieved.
The pilot year of the programme was evaluated in a number of ways. The workshop evaluation focused on the ‘before and after’ levels of knowledge and understanding of the participants and feedback on how each session was received. The formal learning outcomes planned were achieved and many participants gave positive feedback.
The use of the workshops was an effective way of raising awareness of preceptorship, structuring Continuing Professional Development (CPD) and also identifying future training needs, a summary of which was sent to lead occupational therapists OTs.
A doctoral evaluation research study was also conducted in order to build a theory of preceptorship (Morley 2007). Data was collected by questionnaire, interview and observation across seventeen organisations. The findings showed that preceptorship was effective at improving the transitional challenges facing newly qualified occupational therapists and facilitating the development of professional identity and competence, although success was tempered by personal and contextual factors, including the changing demands of the workplace, lone-working and inter-professional practice.
Since the pilot year, a series of workshops have been provided each year, not only in London but in other areas at the request of local managers. The lessons learned during the initial roll-out of the preceptorship programme have been incorporated into a preceptorship handbook and training manual published by the College of Occupational Therapists. The therapy service at SWLSTG has also been commissioned to write an allied health professional training manual.
Details of the programme and its evaluation have been presented to New Ways of Working at Department of Health and published in allied health professional and occupational therapy bulletins and journals.
Dr. Mary Morley, Director of Therapies at South West London and St George's Mental Health NHS Trust 0208 682 6000 ext 6360 or email Mary.Morley@swlstg-tr.nhs.uk