NHS preceptorship for newly qualified staff

Preceptorship is a structured period of support for someone newly registered as a nurse, midwife, nursing associate or allied health professional. In England, NHS England says all newly registered nurses, nursing associates and midwives should receive preceptorship in their first year after registration. It is set out in national frameworks that employers are expected to follow, not in the Agenda for Change contract, so what you get depends on your trust.

What it is for

The nursing framework describes preceptorship as a structured start for newly qualified practitioners. The aim is to welcome them into their team, help them turn what they learned into everyday practice and build confidence. It is not meant to replace appraisals, induction or mandatory training. Newly registered nurses become accountable for their practice the moment they are registered with the Nursing and Midwifery Council, which is why the move from student to registrant is treated as a hard one.

Content varies by trust. NHS England says programmes may include classroom teaching, role-specific competencies, online support, clinical supervision and coaching, but the most important element is individual support from the preceptor in practice.

Nursing

The national preceptorship framework for nursing was published in October 2022. Its core standards are a minimum, with a higher “gold standard” for organisations that want to go further. For nursing it recommends:

• A programme of at least six months at core standard, and at least 12 months at gold standard.
• A supernumerary period of at least two weeks, which it equates to 75 hours, on top of induction.
• A first meeting with your preceptor within two weeks of joining or receiving your registration number.
• At least two further meetings: one halfway and a final sign-off meeting near the end, each around an hour.
• A preceptor who is a registered professional of equivalent or senior level in the same discipline, with at least 12 months’ experience after registration.

Supernumerary means you are not counted in the staffing numbers. The framework also recommends eight hours a year of protected time for each preceptor, and 12 at gold standard, and expects trusts to have a written policy and a named preceptorship lead.

Midwifery

The midwifery framework was published in March 2023 and is firmer on length. It recommends at least 12 months, with sign-off at nine months only in exceptional circumstances and extension up to 18 months for anyone who needs it. Supernumerary time is at least four weeks (150 hours) across the 12 months, usually two weeks at the start of each rotation or new clinical area.

There should be at least four progress meetings, at about three, six, nine and 12 months, each around an hour. The preceptor should be a band 6 or above midwife with at least 12 months’ post-registration experience. For midwives, the final sign-off is a formal process that includes progression from band 5 to band 6. See the band 5 pay guide for pay at entry.

Allied health professionals

The AHP preceptorship standards and framework suggests a 12-month programme. Preceptor and preceptee meetings should take place at least monthly, for at least an hour each, with the first meeting in the first week of transition. It recommends preceptees get at least one hour a month of protected time for preceptorship tasks, with a total of 12 to 36 hours a year, and says preceptors do not have to come from the same profession.

The HCPC points out that arrangements differ by nation. England has the NHS England implementation framework for AHPs. Scotland has the Flying Start NHS programme for newly qualified AHPs, nurses and midwives, designed to be completed in the first year of practice. Wales has no multi-professional programme for HCPC registrants, only local or profession-specific schemes. If you are registering with the HCPC, the HCPC registration guide covers the basics.

Who else benefits

The nursing framework says other groups benefit too, including international registrants and returners to practice. It also asks trusts to keep standard documents: a policy, a charter, meeting templates, a development needs analysis, an individual learning plan, a reflection record and an escalation process. If your meetings are not being scheduled, ask whether your trust has that escalation process written down.

Preceptorship sits alongside other early-career support, such as the mentoring and induction guide describes. Nurses and midwives will also need to revalidate with the NMC every few years, and the NMC revalidation guide explains what is required.

What to check

• Whether your offer letter or job advert mentions a preceptorship programme and its length.
• When your first meeting with your preceptor is booked, and who your preceptor is.
• Whether you have supernumerary time and how it is recorded on the rota.
• Whether protected time for meetings is in your working week.
• Who the preceptorship lead is, so you know where to go if something slips.