Preceptorship: Nurses gaining protected time a ‘thorny issue’

The standards, which cover England and were launched in October 2022, require that preceptors receive at least eight hours’ protected time a year for the role.

This eight hour period includes time for training on being a preceptor and also meetings with their preceptee.

The gold standard is for preceptors to have 12 hours’ protected time. Achieving the gold standards mean organisations can gain a quality mark.

However, an event held in London on Monday about the national preceptorship project in England heard how protected time for preceptors had been a “thorny issue”.

Desiree Cox, who is the manager for the national preceptorship project and also the CapitalNurse preceptorship programme in London, said time for preceptors had been one of the “biggest challenges”.

However, she said ensuring preceptors received this dedicated time was “really important”.

“If we put preceptorship at the top of our agenda, and we value our new registrants, we’ve got to invest time in our preceptors to support them,” she told delegates at the event.

“We can’t expect our preceptors to stay on after a 12-and-half-hour shift, or come in early before starting a night shift, to meet with their preceptees.

“Nor should we expect them to undertake preceptorship without being given proper training and development,” she said.

Preceptors are professionals who volunteer to provide support and mentorship to NRNs in their organisation.

Under the standards, preceptors must be registered within the same discipline as the preceptee, for example, nurse or nursing associate.

They should have a minimum of 12 months’ experience post registration, including experience working in the area their preceptee is based, and should attend initial training on how to be a preceptor.

The issue of protected time was also brought up during a panel session at the event with Dr Cox and other leaders of the programme who were asked: “How do we manage protected time for preceptors?”

Responding, Ms Cox said: “It’s about recognising the value of preceptorship, it’s about getting the executive support, working with colleagues across the [integrated care systems], demonstrating the value of preceptorship in terms of retention and the financial return that gives to an organisation.

“What you find is, when people realise the financial benefits, suddenly things become more important,” she said.

Clinical lead for the national preceptorship programme, Dr Jane Wray, said: “The protected time is something we fought long and hard for to include [in the preceptorship standards] and we know it’s a challenge for organisations.”

The pair also highlighted this issue during an interview with Nursing Times in November 2022 – one month after the launch of the standards – when they said that providing preceptors with protected time for the role was emerging as the “biggest challenge” for organisations.

The aim is for all health and care organisations that employ newly registered nurses (NRNs) to have achieved the minimum standards, also known as the “core” standards, by September 2023.

As well as protected time for preceptors, the core standards state that all preceptorship programmes for NRNs should be at least six months in duration.

In addition, the preceptees must have two weeks’ supernumerary time where they are not counted in staffing numbers, as they find their feet after starting.

Three meetings should take place between the preceptee and preceptor during the course of the preceptorship, with the first happening within two weeks of the NRN starting or gaining their PIN.

In terms of preceptorship programme content, the standards state that this should be decided based on individual needs, but that “facilitated learning” and “study days” should be provided.

Programmes should also include wellbeing initiatives as well as time for reflection, clinical supervision and pastoral care, according to the standards.

Despite challenges, the event heard how 10 organisations had managed to achieve the gold standards, which go above and beyond the core ones, and, therefore, had been awarded the “interim quality mark”.

Speaking with Nursing Times after the event, Ms Cox explained that the quality mark was “interim” at present while NHS England considered introducing “a process of credentialing”.

The event, titled Preceptorship Matters – Celebrating Preceptorship, was attended by professionals with an interest in preceptorship including organisation-level preceptorship leads.

The regional preceptorship leads, who have been established via the national programme, also gave presentations at the event.

Asked what she had taken away from the event, Ms Cox said: “I think it’s just the passion and energy and enthusiasm.

“There’s so many people out there who really want to support our new registrants and I think they want support in doing that, particularly from executive mangers.”

Answering the same question, Dr Wray said: “It’s almost that collective voice thing.

Jane Wray

“The work that we’ve been doing, and there’s lots of other work [happening] around preceptorship… it feels like it’s all come together at a point in time.

“It finally feels like there’s one voice saying, ‘this is important and we keep pushing’. And that voice feels to me like it’s getting louder.”

NHS England funding for the national and regional lead roles is due to come to an end in September, although there are hopes for an extension into next year.

In the longer-term, the aim is for the regional leads to remain in place and for funding for them to be taken over locally, potentially by the integrated care systems.

Nursing Times has worked alongside the union Unison and nursing charity the Florence Nightingale Foundation to campaign for improvements to preceptorship across the UK.

A survey we carried out at the start of 2022 found too many nurses were lacking good support as they started their careers and that the situation had worsened during the Covid-19 pandemic.