Preceptorship

Framework
for Newly Registered
Nurses, Midwives and
Allied Health Professionals
 DH InformatIon reaDer BoX

Policy Estates
Hr/Workforce Commissioning
Management IM&T
Planning/Performance Finance
Clinical Social Care/Partnership Working
Document purpose Best practice guidance
Gateway reference 13889
title Preceptorship Framework for Newly Registered Nurses, Midwives
and Allied Health Professionals
author Department of Health, CNO Directorate
Publication date 17 Mar 2010
target audience irectors of Nursing, Directors of HR
D

Circulation list ommunications Leads, SHA Nursing, AHP, Workforce and Education
C
Leads, Trade Unions, Council of Deans of Health, NHS Employers,
Nursing and Midwifery Council, Health Professions Council,
Allied Health Professional Federation, Higher Education Institutions,
student organisations

Description his refreshed document provides guidance to NHS organisations
T
on establishing local arrangements for preceptorship. It builds
on feedback received on the draft ‘Preceptorship Framework for
Nursing’ published for comment in November 2009.

Cross reference A High Quality Workforce

Superseded documents Preceptorship Framework for Nursing (2009)

action required HS organisations should consider reviewing and developing local

N
preceptorship arrangements against the framework

timing N/A

Contact details hris Caldwell
C
Room 452C
Skipton House
80 London Road, London
SE1 6LH
020 7972 1447
chris.caldwell@dh.gsi.gov.uk
for recipient’s use
Contents

Foreword by Ann Keen, Parliamentary Under-Secretary of State for Health 3

Foreword by the Chief Nursing Officer and Chief Health Professions Officer 4

1 Introduction 6

2 Background 8

3 Defining preceptorship 10

4 What preceptorship is not 12

5 The elements of preceptorship 13

6 The benefits of preceptorship 14

7 A standard for preceptorship 16

8 Implementing preceptorship 18

Design of preceptorship 18

Content of preceptorship 19

Output of preceptorship 21

9 Equality, diversity and human rights 22

10 Realising the benefits of preceptorship: outcome measures 23

11 Delivering preceptorship through pledges 25

References 27

Acknowledgements 29

Contents 1
Foreword by Ann Keen,
Parliamentary Under Secretary
of State for Health
Dear colleagues, Through preceptorship we must strive to
nurture and develop our new registrants
In the foreword to the Preceptorship to develop life long careers in nursing. I
Framework for Nursing that I launched last hope you will continue to work with us in
November I made the point that what the future so that the framework, so clearly
happens to our nurses at the beginning of set out here, can be fully realised for every
their careers in this country’s health service newly registered nurse, midwife and allied
is pivotal. I also said that I hoped that the health professional.
principles set out in the framework could
be extended to encompass other clinical
professionals.

I am delighted that discussions with a

wide range of stakeholders have allowed
the framework to be refreshed so it
encompasses newly registered midwives
and allied health professionals too. The
framework will help ensure that our
newly qualified health professionals have
protected time and expert support to help
them apply academic knowledge and their
practice placement experiences in real life
situations as accountable professionals.
Ann Keen MP
This will help give our health professionals
Parliamentary Under Secretary of State
the best start possible start and reflects our
for Health
commitment in the NHS Constitution to
support our staff to succeed. November 2009

Foreword by Ann Keen, Parliamentary Under Secretary of State for Health 3

 Foreword by the Chief Nursing
Officer and the Chief Health
Professions Officer
The period of time following registration The value of preceptorship has been
as a health care professional, whether on recognised in policy documents such
completion of an education programme or as Modernising Nursing Careers1 and
following a break from practice, can be a Framing the Contribution of Allied Health
challenging time. We all know that good Professionals.2 Further, in High Quality
support and guidance during this period Care for All: NHS Next Stage Review3 we
is essential. Newly registered practitioners committed funds specifically to support
who manage the transition successfully are preceptorship. This framework also
able to provide effective care more quickly, contributes to the delivery of pledges
feel better about their role and are more to patients and staff set out in the NHS
likely to remain within the profession. Constitution.7
This means they make a greater
contribution to patient care, but also We have developed this framework in co
ensures the benefits from the investment production with strategic health authorities
in their education is maximised. (SHAs) and other key stakeholders. NHS
West Midlands have led the work and
Last November Ann Keen, Parliamentary worked closely with the Department of
Under Secretary of State for Health, Health. The framework, which is based on
launched the Preceptorship Framework for evidence from national and international
Nurses. Following interest from other staff sources, establishes clear principles of good
groups we said that we would consider preceptorship. It indicates what needs to
whether the framework could be extended be undertaken to ensure that local systems
to include midwives and allied health for preceptorship succeed and will further
professionals (AHPs). enable a smooth transition for newly
registered practitioners as they progress
We are delighted to say that following their professional careers and continue their
feedback from nurses, midwives, specialist journey of life-long learning.
community public health nurses and AHPs
we have developed the framework so The framework is intended primarily
that it applies to all those professional as a resource for those of you in NHS
groups. The feedback we received not only organisations with responsibility for
provided strong support for the framework establishing organisational systems for the
as it applied to newly registered nurses but management and development of the non
that it was also relevant to new registrants medical workforce – for example Nurse,
in these other professions. Midwife, AHP managers and HR Directors.

4 Foreword by the Chief Nursing Officer and the Chief Health Professions Officer
It will also be of interest to newly registered
practitioners and those directly responsible
for preceptorship.

To further support preceptorship we

have adapted and are testing the Scottish
‘Flying Start NHS’ web-based, electronic
preceptorship programme in a range of NHS
organisations in England and with a higher
education institution. This multiprofessional
preceptorship programme, designed by
NHS Education Scotland (NES), has been
in use in Scotland since 2006 and has been Dame Christine Beasley, DBE
well received. Our testing, against a range Chief Nursing Officer (England)
of existing preceptorship models, started in
autumn 2009 for a six-month period, with
a view to establishing the programme as an
optional model for employers.

It is anticipated that this framework will

also contribute to the consideration of
the introduction of a mandatory period
of preceptorship planned by the Nursing
and Midwifery Council ‘to guide and
support all newly qualified nurses to make
the transition from student to develop
their practice further’. The NMC has
commissioned a research partner to explore
how policy will be developed and we Karen Middleton

expect to hear more from them about this Chief Health Professions Officer (England)

in late-2010.
London, March 2010

Foreword by the Chief Nursing Officer and the Chief Health Professions Officer 5
 1. Introduction

This framework is a guide and resource newly registered practitioners (see below).
for those in NHS organisations who have It will also be of interest to employers in
responsibility for systems for managing the independent and voluntary sectors as
and developing the workforce, for a guide to good practice in supporting
preceptors (registered practitioners) and nurses, midwives and AHPs who are newly

Preceptor:
In this document ‘preceptor’ refers to a registered
practitioner who has been given a formal responsibility
to support a newly registered practitioner through
preceptorship.

Newly Registered Practitioner:

In this document ‘newly registered practitioner’
refers to a nurse, midwife or AHP who is entering
employment in England for the first time following
professional registration with the NMC or HPC. It
includes those who are recently graduated students,
those returning to practice, those entering a new part
of the register e.g. community public health specialists
and overseas-prepared practitioners who have satisfied
the requirements of, and are registered with, their
regulatory body. While engaged in preceptorship
newly registered health professionals are sometimes
referred to as a ‘preceptee’.
6 Introduction
registered with the Nursing and Midwifery newly registered practitioners’ needs,
Council (NMC) and the Health Professions demonstrates value for money and
Council (HPC). underpins the delivery of high-quality care.

In preparing this framework, we Links are established between the aims

commissioned a review of the literature, of preceptorship and other broader
undertook extensive stakeholder developments such as Agenda for Change
engagement4 and considered the NMC’s (AfC)5, the Knowledge and Skills Framework
and HPC’s views on preceptorship and (KSF)6, the NHS Constitution7, Confidence
existing policy. We reviewed models and in caring: a framework for best practice8
approaches adopted in other countries and and the requirements of regulatory bodies
professional groups, including a specific such as the NMC, HPC and Care Quality
focus on Scotland’s multi-professional Commission (CQC).
preceptorship programme, ‘Flying Start
NHS’.
“I believe that I do have the
This document aims to provide a
knowledge and skills to undertake
framework that is practical and relevant
for employers to ensure equity of access to the role, but you can’t learn
high-quality preceptorship support for all everything in three years, there
newly registered practitioners in England. are bound to be skills that you
need to develop. My training has
Underpinning this work has been the
recognition that we will require a more taught me to be open and honest
independent, autonomous and innovative when you don’t know or haven’t
practitioner to meet the changing experienced a situation before.”
requirement of future healthcare provision.
Student in last week of
All this suggests that a different kind of
preceptorship is needed to consolidate final practice placement
these qualities and enable newly registered
practitioners to take responsibility for their
own professional and career development.

This document provides a definition

of preceptorship, describes the key
elements of good preceptorship, and
suggests outcome measures to ensure
that preceptorship meets individual
Introduction 7
 2. Background

Many health practitioners across a wide Preceptorship is also within the spirit
range of organisations already benefit from of the staff pledges made in the NHS
well-established preceptorship schemes. Constitution, and the value and importance
Preceptorship was introduced following of preceptorship was recognised in A
the implementation of Project 2000, the High Quality Workforce: NHS Next Stage
outcome of a previous review of nurse Review10 where it is stated:
education. Preceptorship is now embedded
in a range of existing professional regulatory ‘A foundation period of preceptorship
and employment guidelines for example: for practitioners at the start of their
careers will help them begin the
• NMC guidance9 covers areas such as journey from novice to expert. This
the role of the newly registered nurse, will enable them to apply knowledge,
midwife and preceptor, the duration skills and competences acquired as
of preceptorship and preparation of students, into their area of practice,
preceptorship. In the longer term, the laying a solid foundation for life-long
NMC is considering the introduction of learning.’
a period of mandatory preceptorship.
Specifically regarding Allied Health
• The College of Occupational Therapists Professionals, A High Quality Workforce
has provided guidance and support14 said that:
for implementing preceptorship
for managers and newly registered ‘We will consider the benefits of
occupational therapists. preceptorship for newly qualified staff.’

• Agenda for Change (AfC) describes In 2008/09 the Department of Health

the process of preceptorship whereby made funding available, via strategic
new entrants to Band 5 (ie most health authorities (SHAs), to invest in
newly registered practitioners) achieve preceptorship. SHAs are required to report
accelerated progression through the on a quarterly basis to the Department on
first two pay points, provided they meet progress in investing these funds.
relevant standards of practice.

8 Background
The aim of preceptorship is to enhance supported, thereby enabling them to
the competence and confidence of newly deliver care and treatment to service
registered practitioners as autonomous users safely and to an appropriate
professionals. Preceptorship will support standard (including appropriate training,
the policy drive to place ‘quality at the professional development, supervision
heart of everything we do in healthcare’3, and appraisal).
while maximising NHS productivity through
harnessing and spreading innovation. It can • AfC terms and conditions.
also support strategies that impact directly
• Improvements in relevant scores of the
on patient and service-user experience.
staff and patient surveys.
For example, the principles outlined in
Confidence in caring: a framework for best NHS organisations that contract with
practice identify that: third parties who employ newly registered
practitioners are to give consideration to
‘At the individual level, confidence
encouraging such organisations to establish
can be created when patients see that
preceptorship arrangements.
individuals have the skills to do the
job and the will to provide the level In addition to publishing this framework,
of care the patient wants.’ the development of strong, local
preceptorship arrangements can be
Finally, effective preceptorship
underpinned through:
arrangements can be used by employers as
part of the processes in place or evidence • Multi-Professional Education and
that is submitted against regulatory and Training (MPET) budget service level
other standards, eg: agreements that requires quarterly
feedback from SHAs; and
• Care Quality Commission registration
requirements for providers require that • Learning and development agreements
providers take all reasonable steps to (LDAs) – SHAs, in discussion with NHS
ensure that workers are appropriately organisations, should include specific
requirements in relation to preceptorship
in the local LDA.

Background 9
 3. Defining preceptorship

What is preceptorship? The NMC9 defines it as:

From the moment they are registered, ‘A period [of preceptorship] to guide
practitioners are autonomous and and support all newly qualified
accountable. practitioners to make the transition
from student to develop their
Preceptorship should, therefore, be
practice further.’
considered as a transition phase for newly
registered practitioners when continuing Whilst the HPC does not formally
their professional development, building define preceptorship, members of the
their confidence and further developing Modernising Allied Health Professional
competence to practice, and not as a way Careers Steering Group agreed with the
to meet any shortfall in pre-registration Council of Deans of Health conclusion,
education. A High Quality Workforce: reached in 2009 at a national workshop on
NHS Next Stage Review10 describes preceptorship13, that:
preceptorship as:
‘Preceptorship should be seen as
‘A foundation period [of a model of enhancement, which
preceptorship] for practitioners at the acknowledges new graduates/
start of their careers which will help registrants as safe, competent but
them begin the journey from novice novice practitioners who will continue
to expert.’ to develop their competence as
part of their career development/
continuing professional development,
not as individuals who need to
address a deficit in terms of education
and training.’

10 Defining preceptorship
A further definition taken from a review These definitions and statements
of the literature by Bains12 includes all support the assertion that on
reference to the role of preceptorship in commencement of preceptorship newly
professional socialisation: registered practitioners are safe and
competent. They are however novice
‘Within nursing, midwifery practitioners who will continue to develop
and health visiting in the UK, and further enhance their competence
preceptorship refers to an and confidence as part of their continuing
individualised period of support under professional development.
guidance of an experienced clinical
practitioner which attempts to ease Taking into account the definitions
transition into professional practice or reviewed, we conclude that the following
socialisation into a new role.’ definition best encapsulates preceptorship
for newly registered practitioners.

Preceptorship:
‘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.’

Defining preceptorship 11
 4. What preceptorship is not

The newly registered practitioner and • mentorship;

the employer should have a clear
understanding of where the boundaries of • statutory or clinical supervision;
preceptorship lie. In addition, both parties
• intended to replace induction
should be aware that other processes and
to employment; or
systems are in place to manage ability and
performance in relation to the competency • a distance or e-learning package for
of the newly registered practitioner. a newly registered practitioner to
complete in isolation.
Preceptorship is not therefore:

• 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;
“It’s not that I don’t feel that I
• an additional period in which another
have the knowledge and skills
registrant takes responsibility and
accountability for the newly registered
to be a registered practitioner,
practitioner’s responsibilities and actions I’m just nervous about being
(ie it is not a further period of training); a student one day and a fully
accountable nurse the next day.”
• formal coaching (although coaching
skills may be used by the preceptor
Student due to qualify
to facilitate the learning of the newly in three weeks’ time
registered practitioner);

12 What preceptorship is not

5. The elements of preceptorship

The elements of preceptorship from the perspectives of the newly registered practitioner,
the preceptor and the employer are summarised below:

Newly registered Preceptor: Employer:

practitioner: • Responsibility to develop • It is a process to be
others professionally to quality assured.
• Opportunity to apply achieve potential.
and develop the knowledge, • It embeds the KSF at
skills and values already • Conduit to formalise and the start of employment
learned. demonstrate continued (where this is used).
professional development.
• Develop specific competences • It promotes and encourages
that relate to the preceptee’s • Responsibility to discuss an open, honest and
role. individual practice and transparent culture
provide feedback. among staff.
• Access support in embedding
the values and expectations • Responsibility to share • It supports the delivery
of the profession. individual knowledge of high-quality efficient
and experience. healthcare.
• Personalised programme
of development that includes • Have insight and • It demonstrates the
post-registration learning, eg empathy with the newly employer’s delivery of the
leadership, management and registered practitioner NHS Constitution and other
effectively working within a during the transition phase. key policies.
multi-disciplinary team.
• Act as an exemplary • It indicates the
• Opportunity to reflect role model. organisation’s commitment
on practice and receive to learning.
constructive feedback. • Receive preparation for
the role.
• Take responsibility for
individual learning and • Enables the embracement
development by learning of the principles of the
how to ‘manage self’. NHS Constitution.

• Continuation of life-long
learning.

• Enables the embracement

of the principles of the
NHS Constitution.

Source: Stakeholders
The elements of preceptorship 13
 6. The benefits of preceptorship

There are a number of benefits of implementing preceptorship for stakeholders that

contribute to the overall patient experience. The benefits of implementing preceptorship
from the perspective of the different key stakeholders are set out in the following diagram.

Patients/clients/service users
receive safe care and treatment

Newly
registered practitioner: Employer:
• Develops confidence. • Enhanced quality of patient care.
• Professional socialisation into working • Enhanced recruitment and retention.
environment.
• Reduced sickness and absence.
• Increased job satisfaction leading to improved
patient/client/service user satisfaction. • Enhanced service user experience.

• Feels valued and respected by their • Enhanced staff satisfaction.

employing organisation. • Opportunity to identify those staff that
• Feels invested in and enhances future career require additional support or a change
aspirations. of role.

• Feels proud and committed to the • Reduced risk of complaints.

organisation’s corporate strategy • Opportunity to ‘talent spot’ to meet the
and objectives. leadership agenda.
• Develops understanding of the commitment • Progression through pay-band gateways for
to working within the profession and those organisations who implement AfC.
regulatory body requirements.
• Registered practitioners who understand the
• Personal responsibility for maintaining regulatory impact of the care they deliver
up-to-date knowledge. and develop an outcome/evidenced-based
approach.

• Identify staff that require further/extra

support.

Source: Stakeholders – see References

14 The benefits of preceptorship

 Patients/clients/service users
receive safe care and treatment

Preceptor: Benefits to the

• Develops appraisal, supervision, mentorship
professions:
and supportive skills.
Embracing professional responsibilities
• Enhances ability to progress through AfC including:
gateways.
• Providing a high standard of practice
• Engenders a feeling of value to the and care at all times.
organisation, newly registered practitioners
and patients. • Making care the priority, treating service
users as individuals and respecting
• Identifies commitment to their profession their dignity.
and the regulatory requirements.
• Working with others to protect and promote
• Supports their own lifelong learning. the health and well-being of those in their
care, their families and carers and the
• Enhances future career aspirations. wider community.

• Being open and honest, acting with

integrity and upholding the reputation
of the profession.

• Enhancing the image of health

care professionals.

The benefits of preceptorship 15

 7. A standard for preceptorship

The evidence and experiences of other can be most effectively delivered for all
professions and the feedback we have newly registered practitioners, regardless
gathered suggest that it is important to of their work environment or the design of
adopt a clear standard for preceptorship. preceptorship arrangements.
This will ensure that the benefits identified

The standard contains the following elements:

• 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 to completion of the preceptorship period.
• Preceptors are identified from the workforce within clinical areas and demonstrate
the attributes outlined in the box (see right).
• Organisations have sufficient numbers of preceptors in place to support the number
of newly registered practitioners employed.
• Organisations demonstrate that preceptors are appropriately prepared and
supported to undertake the role and that the effectiveness of the preceptor is
monitored through appraisal.
• Organisations ensure that their preceptorship arrangements meet and satisfy
professional regulatory body and the KSF requirements.
• Organisations ensure that newly registered practitioners understand the concept of
preceptorship and engage fully.
• An evaluative framework is in place that demonstrates benefits and value for money.
• Organisations publish their preceptorship framework facilitating transparency of
goals and expectations.
• Organisations ensure that evidence produced during preceptorship is available for
audit and submission for potential verification by the NMC/HPC.
• Preceptorship operates within a governance framework.

16 A standard for preceptorship

The attributes of an effective preceptor
The attributes required of a registered practitioner who supports the newly
registered practitioner through preceptorship may take up to two years to
develop from registration and include:

• giving constructive feedback;

• setting goals and assessing competency;
• facilitating problem-solving;
• active listening skills;
• understanding, demonstrating and evidencing reflective-practice ability in
the working environment;

• demonstrating good time-management and leadership skills;

• prioritising care;
• demonstrating appropriate clinical decision-making and evidence-based
practice;

• recognising their own limitations and those of others;

• knowing what resources are available and how to refer a newly registered
practitioner appropriately if additional support is required, for example,
pastoral support or occupational health services;

• being an effective and inspirational role model and demonstrating professional

values, attitude and behaviours;

• demonstrating a clear understanding of the regulatory impact of the care that

they deliver and the ability to pass on this knowledge;

• providing a high standard of practice at all times.

A standard for preceptorship 17

 8. Implementing preceptorship

Design of preceptorship • web-based/blended learning

programmes, eg ‘Flying Start NHS’; and
A variety of learning methods should
be integrated into preceptorship so that • attitudinal and behavioural based
programmes can be personalised to learning, eg through role modelling.
meet the needs of each newly registered
practitioner to build their confidence as a Effective preceptorship is likely to see the
practising professional. newly registered practitioner engage in a
range of activities for varying amounts of
Learning can be achieved through: time over the first six to twelve months
of their first post-registration role. Careful
• organisationally based preceptorship, eg:
consideration needs to be given to ensuring
– action learning sets; cost-effective investment of the time and
resources devoted to preceptorship to
– self-directed learning; allow a good balance between effective
preceptorship and wider provision.
– clinical practice focus days,
e.g. dignity and the service user; There are no hard and fast indicators
of what constitutes the best approach.
– reflective practice;
Preceptorship needs to reflect the
– shadowing; and requirements of the newly registered
practitioner. Our work with stakeholders
– one-to-one support (in person or indicates that two core components will
remotely/electronically); be theoretical learning (e.g. classroom
based reading or distance/e-learning) and
• preceptorship facilitated in partnership supervision/guided reflection on practice
with higher education institutions that (one to one or in a small group, face to
is delivered through an academically face or remotely). An optimal mix of
accredited programme; these core components should consist of
around 4–6 days in total for theoretical
• work-based learning, eg portfolio
learning and around 18 hours in total for
building;

18 Implementing preceptorship
supervision/guided reflection although the Content of preceptorship
exact mix will depend on the profession
Preceptorship should be planned in the
and the setting in which they work.
context of the individual’s professional
Preceptorship programmes need to responsibilities and the needs of
consider the following: their employer. There should not be
any duplication of effort in relation
• Theoretical knowledge can be facilitated to the learning undertaken and the
by a preceptor, self-directed or by documentation of such learning. Record
simulated learning. keeping for preceptorship should also
meet the requirements of the KSF appraisal
• Practical skills and knowledge can be process, current continuing professional
facilitated by learning from a more development requirements and potential
skilled practitioner, self-reflection and/or future revalidation requirements of the
online support. NMC and HPC.
• Simulated practice in skills laboratories
that is assessed and certified locally
should be incorporated.

• Attitudes and behaviours need to be

developed to facilitate an approach
that demonstrates and upholds
professional values and beliefs inline “It’s not that you want someone
with professional regulatory body to hold your hand, it’s support
requirements. and constructive feedback that
you need.”
Student in the last week
of final practice placement

Implementing preceptorship 19
 The indicative content of preceptorship is detailed in the following diagram. This diagram
was developed with reference to ‘Flying Start NHS’ with additional suggestions from
stakeholders.

Confidence in applying 
evidence­ Develop 
Decision  based practice confidence
making and 
self­awareness 
Team  Implement 
working the codes of 
professional values

Leadership and  Increase 
management  knowledge and clinical 
development  skills

Negotiation and 
conflict resolution
Preceptorship Integrate prior learning 
into practice

Equality 
Understand policies 
and 
and procedures
diversity

Manage risk  Reflection and 
and not being risk  receiving feedback 
averse Develop an
outcome­based 
Interpersonal 
approach to continuing 
skills
professional 
Advocacy
development

Source: Flying Start and Stakeholders

20 Implementing preceptorship
Output of preceptorship Benchmarking current
On successful completion of preceptorship it practice
is anticipated that the registered practitioner
A number of examples of current
will have become an effective, confident
approaches to delivering preceptorship have
and fully autonomous registered individual,
been gathered during the development of
who is able to deliver high quality care for
the framework. They provide an insight
patients, clients and service users.
into how preceptorship is currently being
The practitioner’s continuing journey will delivered across a variety of healthcare
then take them forward as an independent settings in England. In addition, we have
and innovative leader and role model outlined details of the Scottish ‘Flying
for future generations of health care Start NHS’ programme. A summary of
practitioners. this information can be found on our
website at http://www.dh.gov.uk/en/
Aboutus/Chiefprofessionalofficers/
Chiefnursingofficer/DH_108368

Implementing preceptorship 21
 9. Equality, diversity and

human rights

It is critical that all newly registered Preceptorship arrangements should give

practitioners have equitable access due regard to individual difference and
to preceptorship, as well as equitable respond accordingly, taking all reasonable
experiences and outcomes from the steps to ensure that adjustments are
process. made according to need and requirement.
Differentials should be considered and
Preceptorship should be barrier free; planned for in anticipation of need
it is important that the transition from against an equitable outcome standard.
student, or arrangements to support new The legal obligations to comply with the
registrants following other routes, supports duties around race, disability and gender
and promotes the individual’s equality of should be assured through equality
opportunity. Preceptorship seeks to build impact assessments of the individual sites’
confidence in the delivery of the role preceptorship programmes.
an individual has been employed to do
and should empower them to give safe, Successful preceptorship should enable
competent, high-quality care using the progress through the KSF foundation
human rights principles of fairness, dignity, gateway, where applicable, at the relevant
equality, respect and autonomy. time (ie six months).

22 Equality, diversity and human rights

10. Realising the benefits of
preceptorship: outcome
measures
The benefits of preceptorship should
be demonstrated through objective
measurement. Outcome measures should
be negotiated locally, eg through learning
and development agreements.

Further work is required to identify the

most effective measures but the following
could be considered as a start.

Outcome measure Rationale

1 All newly registered practitioners Equity of access meets equality and
employed access preceptorship diversity agenda
2 Robust preceptorship is in place Equity of access meets equality and
diversity agenda
3 Retention rates for newly Successful retention will lead to cost reduction
registered practitioners associated with recruitment and temporary
replacement
4 Time taken to progress newly Monitor and ensure equity and non-
qualified practitioners through discriminatory practice and compliance
KSF gateways (where relevant) with national guidelines
or other indicators of
preceptorship completion

Realising the benefits of preceptorship: outcome measures 23

 Outcome measure Rationale
5 Sickness/absence levels of newly Expect a lower sickness/absence rate due to
registered practitioners improved staff satisfaction and confidence
during and following preceptorship
6 Number of clinical incidents Preceptorship should result in practitioners who
reported by newly registered are confident to report incidents
practitioners undertaking
preceptorship
7 Number of actual or near miss Practitioners who complete preceptorship make
incidents reported involving fewer errors and have fewer complaints made
newly registered practitioners against them
during preceptorship as a
percentage of their professional
group

“I have recently been a preceptor

and I really enjoyed sharing the
knowledge and experience that
I have gained.”
Registered practitioner, qualified
for four years

24 Realising the benefits of preceptorship: outcome measures

11. Delivering preceptorship
through pledges

The use of pledges is considered to be ‘The NHS commits to provide all staff
an effective approach to setting out and with personal development, access
delivering commitments to customers to appropriate training for their jobs
and employees, and this approach has and line management support to
recently been adopted through the NHS succeed.’
Constitution. The staff pledges of the
NHS Constitution include: ‘The NHS commits to provide support
and opportunities for staff to maintain
‘The NHS commits to provide all staff their health, well-being and safety.’
with clear roles and responsibilities
and rewarding jobs for teams and In the light of this we have defined our
individuals that make a difference to commitment to preceptorship for newly
patients, their families and carers and registered practitioners through a series of
communities.’ pledges. These pledges are presented in
the Figure overleaf.

Delivering preceptorship through pledges 25

 Preceptorship Pledge Preceptorship Pledge

Newly registered Preceptor:

practitioner: I commit to delivering my responsibilities
as a preceptor, including to:
I commit to assume my responsibilities
as a registered practitioner, including: • commit to the preceptorship role and
its responsibilities;
• adherence to codes of professional practice;
• personalise the newly registered
• ensuring that I understand the standards, practitioner’s learning and development
competences or objectives set by my needs and help him or her to identify key
employer that are required to be met; learning opportunities and resources; and
• committing time to preceptorship; • commit time and provide constructive
• working collaboratively with my preceptor to feedback to support the newly
identify, plan and achieve my learning needs; registered practitioner.

• taking responsibility for my own learning and

development; and

• providing feedback to enable preceptorship

to develop further.

Preceptorship Pledge

The strategic health authority:

Commits to:

• fair and equitable access to resources for all organisations;

• clear monitoring and evaluation processes between the SHA and organisations,
including higher education institutions, if relevant;

• sharing of best practice and innovation across the SHA and nationally; and
• ensuring value for money.

26 Delivering preceptorship through pledges

 Preceptorship Pledge

Employer:
Commits to delivering responsibilities
for preceptorship, including to:

• identify a Board Member who has

accountability for the delivery of the
preceptorship programme and assessing
its impact;

• ensure that all newly registered practitioners

have equitable access to preceptorship and,
as appropriate, access to an identified,
suitably prepared preceptor;

• ensure that preceptorship is adequately

resourced;

• ensure that a system is in place for appraising

the preceptee’s performance through the
Knowledge and Skills Framework7 process or
other structure to support appraisal; and

• evaluate the process and outcomes

of preceptorship.

Delivering preceptorship through pledges 27

 References

1. Department of Health (2006). Modernising 9. Nursing and Midwifery Council (2006).

Nursing Careers: setting the direction. Preceptorship guidelines. NMC Circular
London: Department of Health. 21/2006, published 4 October 2006.
www.nmc-uk.org/aDisplayDocument.
2. Department of Health (2008). Framing the aspx?documentID=2088
contribution of allied health professionals:
Delivering high-quality healthcare. London: 10. Department of Health (2008). A High
Department of Health. Quality Workforce: NHS Next Stage Review.
London: Department of Health.
3. Darzi, Lord (2008). High Quality Care For
All: NHS Next Stage Review Final Report. 11. Nursing and Midwifery Council (2008).
London: Department of Health. Annex 1: Developing new standards for
nursing education in the UK. www.nmc-uk.
4. See ‘Acknowledgements’ (p.27) for details org/aFrameDisplay.aspx?DocumentID=4617
of the range of individual and stakeholder
groups engaged in this work. 12. Bain, L (1996). Preceptorship: a review of
the literature. Journal of Advanced Nursing,
5. NHS Employers (2005). Agenda for change: 24 (1):104–107.
NHS Terms and Conditions of Service
Handbook. Leeds: NHS Employers. 13. Council of Deans of Health (2009). Report
from the preceptorship workshops retreat.
6. Department of Health (2004). Knowledge Bristol, 27 May 2009 (unpublished).
and Skills Framework. London: Department
of Health. 14. College of Occupational Therapists (2006).
The preceptorship training manual: a resource
7. Department of Health (2009). for occupational therapists. London: COT.
The NHS Constitution for England. London:
Department of Health.
8. Department of Health (2008). Confidence
in caring: a framework for best practice.
London: Department of Health.

28 References
Acknowledgements

This framework has been developed in David Hutton

partnership with a wide range of stakeholders Professional Advisor Revalidation, Nursing
across the NHS and other organisations. and Midwifery Council
Thanks are extended to all contributors,
specifically the following: Betty Kershaw
Education Advisor, Royal College of Nursing

Members of the National Michelle Mello

Modernising Nursing Careers Lead,
Reference Group NHS West Midlands
Maggie Bayley (Co-Chair)
Project Lead/Assistant Director of Nursing, Jane Nicklin
NHS West Midlands Modernising Allied Health Professions
Careers Stakeholder Engagement Lead,
Lisa Bayliss-Pratt Department of Health
Operational Project Lead, NHS West
Midlands Caroline Waterfield
Deputy Head of Employment Services,
Gwendolen Bradshaw NHS Employers
Dean of the School of Health Studies,
University of Bradford and Chair, Education Gwyneth Wilson
and Career Progression workstream, Director of Nursing/Clinical Academic Fellow,
Midwifery 2020 representing the Council of Mid-Essex Hospital Services NHS Trust/Anglia
Deans of Health Ruskin University

Chris Caldwell (Co-Chair)

Programme Director, Modernising Nursing
Careers, Department of Health

Gareth Durling
Policy Manager, Department of Health

Acknowledgements 29
 SHA Stakeholder Group Audrey Kirby
NHS North East
Lynn Andrews
NHS East Midlands Rob McSherry
NHS North East
Liz Ballantyne
NHS South West Joe McCardle
NHS North West
Sally Bassett
NHS East of England Michelle Mello
NHS West Midlands
Maggie Bayley (Chair)
NHS West Midlands Suzanne Rankin
NHS South Central
Lisa Bayliss-Pratt
NHS West Midlands Chris Sutcliffe
NHS East Midlands
Jane Butler
NHS South East Coast Guy Young
NHS London
Tracey Carstairs
NHS East Midlands

Rosemary Chabble
NHS South Central

Elizabeth Foley
NHS Yorkshire and the Humber

Chris Humbles
NHS East of England

30 Acknowledgements
Student Stakeholder Group Luc Taperelle
Royal College of Nursing
Vicky Allen
University of Wolverhampton Alexis Taylor
Birmingham City University
James Anthony
UNISON Lindsey Walker
Royal College of Nursing
Iain Bell
Anglia Ruskin University Cherril Watts
University of Manchester
Balbir Bhatia
University of Wolverhampton Anthea Williams
University of Wolverhampton
Caroline Brooking
University of Hertfordshire Stuart Young
Royal College of Nursing
Kirsty Dando
University of Chester

Joanna Greenshill
Executive Student Board
All members of the Executive Student Board,
University of Wolverhampton
Royal College of Nursing
Donna Martin
University of Worcester

Nicky McBarnet
University of Worcester

Priscilla Peart
University of Northumbria

Priyavadita Slater
University of Manchester

Acknowledgements 31
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