The beginning of a newly qualified practitioner's career or a colleague changing role or organisation can be a challenging time and their initial experiences can shape how they develop in their career. A quality preceptorship programme can ensure the best possible start for newly qualified nurses, nursing associates, midwives and allied health professionals (AHPs).
A preceptorship is a period of structured transition to guide and support newly qualified practitioners from students to autonomous professionals. This is to develop their practice, not to compensate for any shortfall in pre-registration education.
Preceptorship programmes can be used for nurses, nursing associates, midwives or AHPs when they start employment in the NHS. As well for those new to role in a new organisation, a preceptorship can support international recruits and those returning to practice. During this time, preceptees should be supported by an experienced practitioner, and a preceptor, to develop confidence as an independent professional and to refine their skills, values and behaviours. Expert support and dedicated learning time provides a foundation for effective patient-centred care confidently.
In June 2023, the NHS Long Term Workforce Plan set out ambitions to address inconsistencies in the delivery of preceptorship programmes for newly qualified staff across the country.
To ensure consistent delivery and a high-quality preceptorship experience for all early career healthcare professionals, the NHS will support trusts to adopt the national preceptorship framework and principles. Having a strong preceptorship programme in place will be vital to achieving these aims.
Oxford University Hospitals NHS Foundation Trust (OUH) has engaged in recruitment from across the globe to help meet staffing needs. Due to challenges centred around the nurses struggling to adjust, OUH introduced a preceptorship programme to support international nurses in their first year. This has led to positive feedback and improved retention.
As part of the programme, the team also provides the nurses with information about what support is on offer to them, for example Freedom to Speak Up, the LGBTQ+, BAME, disability networks, and trade unions. Read the full case study for more information.
Benefits of a preceptorship
It is recognised that where a preceptorship is well embedded as part of the organisational culture, there are significant benefits to newly qualified staff, teams, patients and the organisation itself in terms of retention, recruitment and staff engagement. Investing in a preceptorship programme can deliver a variety of benefits for the preceptee and employer, such as:
- enhanced patient care and experience
- becoming an employer of choice due to enhanced preceptorship offer
- improved retention
- reduced sickness absence
- more confident and skilled staff
- increased staff satisfaction and morale.
Employers are encouraged to track, measure and evaluate the success of their preceptorship programmes to be able to demonstrate value and make improvements where necessary.
The trust identified that their maternity support worker staff did not feel comfortable moving between wards. This was due to limitations in the induction process and training that prevented them from providing flexible support in different specialities. The trust responded through improving their preceptorship programme, ensuring that their induction process and training enhanced the confidence of staff and enabled deployment into areas where they are most needed. Read the full case study to find out more.
Support to enhance preceptorship offers
Knowing where to start when providing preceptorships can be challenging. But there are several simple steps employers can put in place to help make them a success:
- Collaborate with the preceptee to understand their learning needs. Agree on an action plan and use a coaching approach for support. Review the plan regularly in person to track progress.
- Undertake a comprehensive induction and discuss preceptorship on a one-to-one basis.
- Identify a named person for support from day one, with whom the preceptee can discuss any problems or concerns. Ensure there is a stand-in to account for leave and other times when they may not be available.
- Consider providing paid protected time, possibly a day a month, for preceptees to have time for reflection, study and peer networking.
- Support preceptees to have time with senior clinical leaders for mentoring and guidance so they can consider development opportunities.
- Provide information on other support available within the trust such as occupational health, counselling and trade union support. Also highlight external forms of support including peer support forums and groups and accounts on social media.
At University Hospitals of Derby and Burton NHS Foundation Trust, there is an embedded preceptorship programme. The programme is led by dedicated colleagues for staff including nurses, nursing associates, AHP’s and healthcare scientists. Preceptorship is mandatory and made up of:
- Regular meetings with a to support with development of the new starter's confidence.
- A green lanyard to wear so that newly registered staff are easily identifiable on the wards across.
- Seven themed preceptorship workshops, based on soft skills including resilience and wellbeing, communication and personal development.
- Additional pastoral support provided by the preceptorship leads.
The trust has implemented a preceptorship structure that can be used for any profession and has an online portal for electronic record keeping. They also employ trained bank nurses (bank preceptors) to provide additional support for newly qualified nurses who work 1:1 supernumerary on shifts, offer pre-preceptorship sessions for final year students, provide one-day induction for all newly registered AHPs and a two-week induction for newly qualified nurse’s and newly qualified nursing associate’s.
Learning from the pandemic
Following the pandemic, NHS organisations continue to experience high levels of pressure. However, they want to ensure newly qualified professionals have the best introduction to their new working environment, ensuring they stay in health and social care.
The pandemic affected education and training and it led to increased online learning and less placement and work experience opportunities. This brought a risk of students experiencing worse anxiety, stress and potentially burnout in their new roles. While all individuals who have qualified are undoubtedly competent, there are some scenarios they may not have encountered during their disrupted learning. This is where preceptorship programmes play an important role now more than ever.
The trust has understood the importance of preceptorships and delivered these virtually throughout the pandemic. As part of this approach, they have tailored virtual workshops and study days ensuring the NHS England standards are fulfilled. The trust was keen to explore preceptees views and ensure individual learning styles were met, mixing information sharing, storytelling, videos, and lots of time for peer to peer discussion in breakout rooms online.
Herefordshire and Worcestershire Health and Care are keen to meet the NMC requirements for a preceptorship to work closely with higher education institutes. As part of this, they organised a multi-collaborative pilot project with six other trusts in the region and other private sector organisations to support third year students and develop a transition module for them at university. These organisations deliver virtual events to give short sessions to share how each support newly qualified staff and the employment opportunities. This is an important session for students to understand whether each of the employers’ preceptorship programmes met their individual needs.
Good practice in the NHS
We have collated some examples of good practice from NHS organisations that have been delivering preceptorship programmes and initiatives.
University Hospitals Sussex have developed their own in house multi-disciplinary preceptorship model. It is supported by a virtual training programme accredited by the University of Surrey. At the end of that year preceptees do a reflective assignment and receive academic credits.
After the first year, preceptees can go into a year two module which looks at nursing in the acute care environment, an opportunity to enhance skills in their area. Then finally the third year looks at leadership which is mapped to the advanced clinical practice pillars. The three year preceptorship programme then leads them to revalidation at which point have experience to already be considering pathways to explore further or specialise.
The trust works to the Greater Manchester preceptorship standards that are aligned in the area for employers to work to. They allow a supernumerary period to enable the multi-professional preceptee to settle into their role and organisation. In the first year they also offer workshops on operational areas, leadership, health and wellbeing and transitional sessions. This approach has been advantageous to preceptees joining the trust and supports retention of staff.
Following feedback from previous preceptees, there was an identified need to change the preceptorship programme, to align with the current needs of post registration clinicians and to support the ongoing need to recruit and retain registered clinicians.
The research outlined the need for the trust to:
- have a preceptorship policy
- recruit an organisational wide lead for preceptorship
- be an organisation that facilitates protected time for preceptorship activities
- have a clearly defined purpose of preceptorship that is mutually understood by preceptors and preceptees
- to ensure preceptors have undertaken training and education that is distinct from mentorship preparation and a central register of preceptors
- have systems in place to monitor and track newly registered practitioners from their appointment through completion of the preceptorship period.
Through the development and implementation of a new preceptorship programme which has improved outcomes, experiences and use of resources locally.
Oxleas offer a six-month action learning programme as part of their preceptorship programme, which has supported newly qualified nurses’ transition to the workplace. The programme offers participants the opportunity to find solutions to real-life challenges through peer support.
Evaluation of the programme has demonstrated consistently positive outcomes for confidence and skills. In response to COVID-19, the programme successfully moved to online delivery in 2020 with no negative impact on outcomes.
National resourses to improve your preceptorship programme
The national preceptorship framework for nursing sets national standards for preceptorship for nurses and establishes a framework for good practice that can be adopted across all regions in England.
The national preceptorship framework for midwifery, builds on the national preceptorship framework for nursing. This framework, though intended for midwives, can be used as a core set of standards where multidisciplinary preceptorship programmes are in place.
NHS England’s AHP preceptorship standards and framework is to ensure clarity and offer best practice. The resources align with the Health and Care Professions Council (HCPC) principles for preceptorship, available on the HCPC website.
Standards to support learning and assessment in practice, outlines the requirements for supporting the learning and assessment of students in the practice learning environment.
Further advice is also available to students and line managers on the NMC website.
The NMC developed a set of principles for employers to help them deliver high-quality and effective preceptorships for newly qualified nurses, midwives and nursing associates.
- a best-practice approach to implementing preceptorships
- clear guidance for first year post-graduate students on managing their preceptorship
- standards for protected time for preceptorship
- charter setting out what is expected of preceptors and employers
- practical templates for preceptors to use14 required elements of a preceptorship.
e-learning preceptorship programme was designed to develop the knowledge and skills needed to act as a preceptor, includes case studies, videos and workbooks.
The Multi-Professional Preceptor e-Compendium developed by NHS England recognises the needs of preceptors and provides them with the guidance, support and practical tools.
NHS England has developed an online learning programme for second and third year nursing students supporting them as they transition into their first post as a registered nurse. The programme is freely available on the NHS England's Learning Hub, and includes topics such as what to expect as a nurse and how to make the most of your early years as a nurse.
They have also developed resources that support organisations to implement and employ legacy mentors. Legacy mentors are experienced nurses, or colleagues in other regulated professions.
- a practical framework to develop preceptorships
- a description of key elements of a good preceptorship
- suggestions of outcomes measures to evaluate if the preceptorship meets individual’s need, demonstrates value for money and underpins delivery of high-quality care.
The scottish government requires all Scottish government requires all newly qualified nurses, midwives and AHPs to undertake the Flying start development programme in the first year of practice.
Programme based around four pillars; clinical practice, leadership, facilitating learning and evidence.
All Wales Preceptorship Guidelines for newly appointed ward sisters/charge nurses which requires all newly-appointed ward sisters and charge nurses to have a period of preceptorship of no less than six months from appointment.
Position statement for newly qualified midwives from the Royal College of Midwives.
A multi-professional preceptorship programme developed for newly qualified primary care staff can be found on the Sussex Training Hub website.
This resource shares a toolkit on the high impact actions for retention including preceptorship.