Best Practice Guidance for Preceptorship

Best Practice Guidance for Preceptorship

Health Education England (HEE) in Yorkshire and the Humber

Adapted and developed across Yorkshire and the Humber in partnership with the Preceptorship Leads from the HEE in West Midlands Guidelines

Contact for Further Information: Jean Hayles (Nursing Workforce Development Lead, Health Education Yorkshire and the Humber, [email protected])

Final version July 2017

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Context Within the NHS, demand for high quality services continues to increase, while we are also facing shortages in qualified practitioners in many professions. Service provider organisations are increasingly looking to develop recruitment and retention strategies in an attempt to ensure that they can not only retain their staff, but also ensure that they are fully supported within their roles to enable then to deliver the highest quality care to their populations. The Yorkshire and the Humber area covers a large geographical area and incorporates 3 STP (Sustainability and Transformation Plan) areas, with 3 corresponding Local Workforce Action Boards. Retention of staff remains a high priority for all LWABs. There is also a growing awareness of the different needs of new registrants from a different generation from those currently in the workforce (‘Mind the Gap’, Birmingham and Solihull Local Education and Training Council (2015) and the need to therefore ensure that support in the form of preceptorship addresses the needs of this new generation of professionals. Stakeholders from across the Yorkshire and the Humber region were invited to join a Task and Finish Preceptorship group to:      

Scope the preceptorship provision across the region against HEE’s Preceptorship Standards Identify gaps in provision Action plan to address those gaps Share good practice around Preceptorship Develop regional preceptorship guidelines Explore how organisations can be measured against the standards

Purpose of Document The purpose of this document is twofold: 1. To outline the minimum expectations for any Preceptorship Programme offered by employers of newly qualified, registered healthcare practitioners in Yorkshire and the Humber 2. To offer guidance and recommendations to support the implementation of the national HEE standards This guidance focuses on Preceptorship for newly qualified, registered healthcare practitioners, but can be adapted and used as a baseline of preceptorship and support for other staff groups requiring preceptorship, including:     

Return to Practice healthcare practitioners ‘Back to the floor’ healthcare practitioners International recruits entering the NMC register Those entering a new field of practice New and emerging roles including Nursing Associates and Physicians Associates


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Definitions Preceptorship is defined by the DH (2010) as: ‘A period of structured transition for the newly registered practitioner during which he or she will be supported by a preceptor, to develop their confidence as an autonomous professional, refine skills, values and behaviours and to continue on their journey of life-long learning’ Preceptorship is not: • • • • • • • • •

intended to replace mandatory training programmes; intended to be a substitute for performance management processes; intended to replace regulatory body processes to deal with performance; an additional period in which another registrant takes responsibility and accountability for the newly registered practitioner’s responsibilities and actions (ie it is not a further period of training); formal coaching (although coaching skills may be used by the preceptor to facilitate the learning of the newly registered practitioner); mentorship; statutory or clinical supervision; intended to replace induction to employment; or a distance or e-learning package for a newly registered practitioner to complete in isolation.

(Department of Health, 2010, Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals, London) A Preceptor is a registered practitioner who has been given a formal responsibility to support a newly registered practitioner through preceptorship (DH, 2010). A preceptor offers information, guidance and support to an identified preceptee. A Preceptee is a registered practitioner who is either • entering practice for the first time, usually due to being newly qualified • entering a different field of practice by means of a second registerable qualification • entering practice within a different setting (for example, acute, community, primary care, care home or a UK setting having qualified abroad) • a practitioner returning to practice after a break in service of more than 5 years


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Minimum Expectations for Preceptorship Health Education England (HEE), in consultation with the CNOs and AHPs at a local, regional and national level, developed a list of standards of the minimum requirements for effective preceptorship for newly registrants. These standards (see Figure 1) were published in 2015. The standards are not exhaustive and the expectation is that they will be exceeded in many organisations; however they form a baseline of best practice of support for newly qualified healthcare professionals Figure 1: Minimum Expectations to Support Preceptorship (HEE, 2015) 1 2 3

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

The organisation has a preceptorship policy, which has been formally approved by the appropriate Education Governance structures. There is an organisational wide lead for preceptorship There is a structured preceptorship programme that has been agreed by the Executive Nurse and other professional leads, given preceptorship should be available for all new registered practitioners. The organisation facilitates protected time for preceptorship activities There is a clearly defined purpose of preceptorship that is mutually understood by preceptors and preceptees Preceptorship aligns with the organisational appraisal framework Preceptors have undertaken training and education that is distinct from mentorship preparation There is a central register of preceptors Systems are in place to identify all staff requiring preceptorship Systems are in place to monitor and track newly registered practitioners from their appointment through completion of the preceptorship period Every newly qualified nurse/midwife/allied health professional has a named preceptor allocated from the first day of employment Preceptorship is tailored to meet the need of the individual preceptee The preceptee undertakes a transitional [training] learning needs analysis Preceptorship is monitored and evaluated on a scheduled basis A range of relevant skills training and assessments are available to meet the needs of preceptees Action learning, group reflection or discussion are included in the preceptorship process Preceptees contribute to the development of preceptorship programmes The preceptorship programme includes the following elements: 1. Accountability 2. Career Development 3. Communication 4. Dealing with conflict / managing difficult conversations 5. Delivering safe care 6. Emotional intelligence 7. Leadership 8. Quality Improvement 9. Resilience 10. Reflection 11. Safe staffing / raising concerns 12. Team working 13. Medicines management (where relevant) 14. Inter-professional Learning


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This document offers further guidance to support the implementation of these standards to help organisations to develop their core preceptorship offer for newly qualified and other healthcare practitioners within the context of their organisation. Whilst it is acknowledged that many organisations will have an existing offer, this is an opportunity to map that offer against those standards and further develop as appropriate. The below are intended only as a guideline for best practice and were developed with input from the Yorkshire and the Humber Preceptorship Group (see list of organisations / individuals involved in the development at the end of this document)

1. The organisation has a preceptorship policy, which has been formally approved by the appropriate Education Governance structures Recommendations: 1.1 That every employer of registered practitioners has a Preceptorship Policy in place that:  Has been approved by Trust Board or equivalent  Is reviewed in line with organisational policy to reflect changing national policy and local need  Is multidisciplinary 1.2 That the Preceptorship Policy contains the following:  Trust vision and values  Roles and responsibilities of Preceptee, Preceptor, Line Manager, Operational Preceptorship Lead, and Strategic Preceptorship Lead (see 2.1 for further detail)  Overview of Preceptorship Core offer (length of programme, number of taught study dates, core competencies for any taught sessions, links to appraisals / pay increments / career development framework / revalidation as appropriate)  Reference to standard templates for the organisation – reflective template, action plan, competencies, record of meetings, declaration of completion of preceptorship (regional templates under development)  Reference to the HEE national standards  Identification of the need for Preceptees not to be moved from their usual area of work wherever possible within the first 6 months in post to ensure consistency of support and transition into their new role

2. There is an organisational wide lead for preceptorship Recommendations: 2.1 That each organisation identifies a Strategic Preceptorship Lead at director level (for example DoN or HRD) 2.2 That each organisation identifies an Operational Preceptorship Lead who is responsible for the implementation and coordination of the Preceptorship Programme and support for Preceptees and Preceptors


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3. There is a structured preceptorship programme that has been agreed by the DoN and other professional leads, given preceptorship should be available for all new registered practitioners Recommendations: 3.1 That the Preceptorship period lasts for a minimum period of 12 months (although the form of the support offered may change during that period). 3.2 That all newly qualified staff from registered professions are mandated to participate in Preceptorship.

4. The organisation facilitates protected time for preceptorship activities Recommendations: 4.1 That all preceptees are provided with adequate protected time for meetings and other negotiated preceptorship activities, agreed and supported by their line manager 4.2 That priority is given to protecting time within the first 4 months in post 4.3 That all Preceptors are provided with adequate protected time in order to support Preceptees, agreed and supported by their line manager

5. There is a clearly defined purpose of preceptorship that is mutually understood by preceptors and preceptees Recommendations: 5.1 That every Preceptorship Policy and Programme adheres to the definition of Preceptorship, the Preceptee and the Preceptor role, as defined by the Department of Health, 2010 5.2 That each Preceptorship policy identifies a clear purpose and outcome for preceptorship

6. Preceptorship aligns with the organisational appraisal framework Recommendations: 6.1 That the Preceptorship progress is included as part of the appraisal process by line managers

7. Preceptors have undertaken training and education that is distinct from mentorship preparation Recommendations: 7.1 That a member of staff can only be identified as a Preceptor if he/she has been qualified and / or have been working within that clinical speciality / setting for a minimum period of12 months 7.2 That a Preceptor is working as a professional peer at the same or similar band as the Preceptee where appropriate and possible 7.3 That each identified Preceptor is provided with guidance and/or training for being a Preceptor (form of training / guidance to be decided locally and regional resource under development) 7.4 That each Preceptor should be supported with relevant continuing professional development and / or direct support from the Operational Preceptorship Lead


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8. There is a central register of preceptors Recommendations: 8.1 That line managers maintain an accurate, current record of preceptees and preceptors which the Operational Lead can access on request for quality assurance and audit purposes

9. Systems are in place to identify all staff requiring preceptorship Recommendations: 9.1 That each newly qualified member of staff is contacted by the Operational Preceptorship Lead within 2 weeks of starting employment 9.2 That each newly qualified member of staff is required to have a named Preceptor identified prior to starting employment 9.3 That all newly qualified staff are given a minimum of 2 weeks supernumerary practice in the clinical environment on receipt of PIN (where applicable). It is recognised that this may vary depending upon hours worked by the preceptee and the clinical area, where increased time may be required. 9.4 That consideration is given to the need for new registrants to also be offered a period of supernumerary practice on commencement of employment (in addition to on receipt of PIN) dependent upon area of work and previous experience / placements.

10.Systems are in place to monitor and track newly registered practitioners from their appointment through completion of the preceptorship period Recommendations: 10.1 That the Preceptor ensures appropriate goals and milestones are set, recorded and monitored for each Preceptee, in consultation with the Preceptee and Line Manager. 10.2 That progress through Preceptorship and final sign-off of completion of the Preceptorship Programme is reviewed by the Preceptor and the Preceptee’s Line Manager. 10.3 That the Operational Preceptorship Lead ensures members of staff who have successfully completed the Preceptorship Programme have a completion certificate and that completion is recorded on ESR (if appropriate). 10.4 That the Operational Preceptorship Lead monitors the progress of preceptees and actions any areas for concern, escalating to the Strategic Preceptorship Lead if appropriate.

11.Every newly qualified nurse/midwife/allied health professional has a named preceptor allocated from the first day of employment. Recommendations: Refer to point 9.2.

12.Preceptorship is tailored to meet the need of the individual preceptee Recommendations: 12.1 That the Preceptorship Policy includes the need to identify individual goals and milestones as well as those required by the organisation.


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12.2 That preceptors record discussions of meetings including identification of individual preceptee needs.

13.The preceptee undertakes a transitional [training] learning needs analysis Recommendations: 13.1 The preceptee develops a plan for their individual training needs (in addition to the core training) in conjunction with his/ her preceptor and line manager. 13.2 That this plan is included in the preceptorship meetings and reviewed after 6 months and again at 12 months.

14.Preceptorship is monitored and evaluated on a scheduled basis. Recommendations: 14.1 That the Preceptorship Policy identifies monitoring and evaluation processes, with feedback to the Strategic Preceptorship lead if appropriate. 14.2 That examples of best practice, including monitoring and evaluation continue to be shared across the region.

15.A range of relevant skills training and assessments are available to meet the needs of preceptees. Recommendations: 15.1 That a Preceptee must be supported to achieve a minimum safe standard against core competencies and any professional competencies within the Preceptorship Programme 15.2 That a Preceptee is released from work to attend any required training during their 12 month Preceptorship Programme including induction and statutory / mandatory training 15.3 That consideration is given to pooling resources across the region with regards to accessing specific skills training as appropriate.

16.Action learning, group reflection or discussion are included in the preceptorship process. Recommendations: 16.1 That a local forum for discussions, action learning and group reflections for Preceptees within organisations is considered. 16.2 That a local forum for discussions and sharing best practice for Preceptors within organisations is considered. 16.3 That opportunities for group learning, discussion and reflection are incorporated into and explicit within the Preceptorship Process.

17.Preceptees contribute to development of Preceptorship programmes. Recommendations: 17.1 That each Preceptee and Preceptor is asked to evaluate the Preceptorship process, including suggestions for improvements during the programme and following completion of the programme.


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17.2 That the Preceptorship Lead analyses the evaluations to ensure relevant actions are taken to improve the programme based on evaluation feedback. 17.3 That the regional evaluation form is used to collect feedback from Preceptees and Preceptors. 18.Preceptorship Programmes include particular core elements. Recommendations: 18.1 That any Preceptorship Programme contains the identified core elements as a minimum requirement, although it is acknowledged that some elements may be covered in other areas such as the induction programme, and that some may be covered less explicitly than others as they are embedded throughout the process, for example career development. 18.2 That other organisational / setting specific required elements are identified as appropriate and included in the Preceptorship Programme.

Yorkshire and the Humber Preceptorship Group members The below individuals were instrumental in and consulted with regarding the development of this document as well as the development of the Preceptorship resources available on the HEE (YH) website. Grateful thanks go to all those involved. Airedale NHS Foundation Trust Barnsley Hospital NHS Foundation Trust Bradford District Care NHS Foundation Trust Bradford Teaching Hospitals NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust Care Plus Group City Healthcare Partnership CIC Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust Harrogate and District NHS Foundation Trust Haxby Advanced Training Practice Health Education England Hull and East Yorkshire Hospitals NHS Trust Humber NHS Foundation Trust Leeds and York Partnership NHS Foundation Trust Leeds Community Healthcare NHS Trust Leeds Teaching Hospitals NHS Trust Locala Community Partnership CIC Mid Yorkshire Hospitals NHS Trust Navigo Health and Social Care CIC Northern Lincolnshire and Goole NHS Foundation Trust Primary Care Works Rotherham Doncaster and South Humber NHS Foundation Trust Sheffield Children’s NHS Foundation Trust Sheffield Health and Social Care NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust South West Yorkshire Partnership NHS Foundation Trust Spectrum Community Health CIC The Rotherham NHS Foundation Trust Vale of York Clinical Commissioning Group Wakefield Clinical Commissioning Group York Teaching Hospital NHS Foundation Trust


Jane McSharry Amy Marshall Debbie Cromack & Kerry Bennett Hille Halonen Yvonne Hardcastle Sarah Spooner Karen Petterson Aimi Dillon Mark Flowers Debra Smith Jean Hayles Nicola Buckle Allyson Kent, Melanie Barnard & Karen Petterson Adam Maher & Marie-Clare Trevett Zoe Dunphy Heather McClelland & Lyndsay Murden Emma Bartlett Fiona Timbs & Charlene Pressley Amanda Simpson Ellie Parker Alison Jackson Sue Sparks Alison Widdas Andy Algar Karen Percival & Michelle Freeman George Smith Karen Payne Mary Dougan Jo Smith Jo Pollard & Louise Hodgson Helen Hey

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References Department of Health (2010) ‘Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals’ Health Education England (2015) ‘Preceptorship Standards’ Birmingham and Solihull Local Education and Training Council (2015) ‘Mind the Gap; exploring the needs of early career nurses and midwives in the workplace’


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Best Practice Guidance for Preceptorship

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