Wakefield General Practice Workforce Development Academy

Wakefield General Practice Workforce Development Academy

General Practice Healthcare Professional Preceptorship Framework

Produced by: Wakefield General Practice Workforce Development Academy

Date: 2.2.2018

Version: 1.0

Status: Live

Effective from: 2.2.2018

Date of review: 2.2.2020

Contents

1.0Introduction: The principles of preceptorship

It is recognised that the transition from student to registered practitioner and integration into a new practice setting is a challenging time. The literature supports that the transition in to professional practice can often lead to feelings of stress, inadequacy and uncertainty about their developing professional identity with the potential result of deleterious effects on patient care and staff retention (HEE 2017). In recognition of the latter Governing bodies which include the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC) strongly recommend that all new registrants have a period of preceptorship on commencement of their first post. The Department of Health (DH) Preceptorship Framework (2010) defines preceptorship as: ‘A period of structured transition for the newly registered practitioner (preceptee) 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 lifelong learning’.

Traditionally preceptorship has been used in the context of support for newly registered nurses and midwives. However the DH (2010) clearly identifies that the principles of preceptorship can and should be applied to all health professionals. Throughout the period of preceptorship the healthcare professional should be supported by an experienced practitioner – the preceptor, to develop their confidence as an autonomous professional, to refine their skills values and behaviours.

Additionally, the support and guidance offered through the process of preceptorship not only has a recognized and significant impact on the new registrant (the preceptee) but also the preceptor and the organisation such including:

• Improved recruitment and retention of staff
• Building of a resilient healthcare workforce
• Increased staff satisfaction
• Reduced staff sickness and absence levels
• Easy and early identification of individuals who may require further support
• Facilitation of the identification of future leaders
• Demonstration of the organisation’s commitment to supporting and developing their staff
• Facilitation if the revalidation process (for registered nurses and midwives)
• Development of coaching and supporting skills of team members
• Enhancement of the delivery of high quality care to patients and service users

(HEE 2017)

Preceptorship, what it’s not

• A replacement for a formalised induction or mandatory training

• About assessing another registrant’s competency, they have already been assessed as competent and any concerns regarding competency should be addressed through a different process within the organisation

• A ‘grace’ period whereby preceptor is accountable for the responsibilities and actions or omissions of the preceptee

• A substitute for appraisal processes of clinical supervision (HEE, 2017).

2.0Purpose of framework

The purpose of this framework is to facilitate and support a standardised, high quality approach to preceptorship across all general practices in the Wakefield area for all new registrants, practitioners’ new to role or those returning to practice.

The Wakefield General Practice Workforce Development Academy (WGPDWA) has devised a preceptorship portfolio (appendix 1) a professional development programme (appendix 3), to meet the HEE requirements, ‘Minimum Expectations to Support Preceptorship’ (HEE, 2015) (appendix 2).

• Entering practice for the first time, usually due to being newly qualified
• Entering a different field of practice by means of a second registration
• Entering practice within a different setting
• A practitioner returning to practice after a break in service of 5 years or more

• Will be a registered health care professional who has sufficient knowledge of the role of the preceptee
• Will have at least 1 year post registration experience in the role of Practice Nurse
• Undertake the relevant preparation/training to fulfil this role where required

• Sufficient knowledge regarding the role for which they are acting as preceptor, and relevant clinical skills and competencies
• They are able to identify the learning needs of the preceptee
• Are able to support the preceptee in applying knowledge to practice
• Understand how a new to post practitioner will integrate within a new setting and what problems this may create foe the individual and the team
• Understand that the preceptee is professionally accountable for their own actions, and that the preceptor is not accountable on their behalf
• The ability to support reflection in and on practice and offer supervision at a level required by the individual that facilitates optimum learning
• Ensure adequate time is allocated for preceptorship activities, with evaluations and reflection on the preceptee progress being undertaken at specific points in the programme
• Raise any concerns regarding the preceptee progress/professional development with the professional lead/manager in a timely manner so that any additional support or resources can be initiated

• Will practice in accordance with their professions’ Code of Professional Conduct (where applicable)
• Understand and take ownership of the preceptorship programme
• Agree to undertake a period of supported practice and to identify their key learning objectives for the duration of the preceptorship programme
• Take responsibility for, and be proactive in their own learning, actively seeking out appropriate learning opportunities
• Identify specific learning and skill development needs and develop actions plans for addressing these needs with their preceptor
• Agree upon fixed learning times, including pre planned study days
• Compile and keep an up to date learning development log/portfolio and actively participate in reflective practice
• Seek regular feedback from preceptor on progress and learning needs/skills development
• Provide preceptor with constructive feedback
• Raise any concerns/difficulties with the preceptorship process in a timely fashion with the programme leader/manager or other relevant person

• Commitment to support all new to post and/or newly qualified nurses/AHPs undergoing transition from student to independent practitioner/those moving into a new area of practice.
• Ensure policies and procedures and aligned with standards of preceptorship are in place to facilitate the delivery and support of an effective preceptorship programme in general practice and that all members of the practice team are aware of the preceptorship process
• Provide the new member of staff with a suitable prepared preceptor
• Ensure that preceptees receive induction training including the relevant mandatory/statutory training.
• Ensure that preceptorship is adequately resourced within the practice in terms of time, support and access to training and development for both preceptees and preceptors
• Ensure that systems are in place for appraisal of the preceptees progress through the preceptorship programme and any under performance is managed in accordance with practice policy and procedure.
• Ensure evaluation and audit of the process and outcomes of preceptorship in general practice to inform future practice

• The Practice has the responsibility to ensure that all new members of the staff receive a full and comprehensive induction to the Practice, including statutory and mandatory training which comply with health and safety requirements. This induction should be undertaken in a timely manner and the induction checklist should be used as part of the initial meeting between the preceptee and preceptor

• Will insure appropriate provision of preceptor and preceptee training to support the implementation of the policy and framework
• Oversee the maintenance of a database of preceptors who have completed the preceptor training, and provide reports in relation to this to Professional Forum/Professional Leads
• Will participate in the preparation of identified registrants to become preceptors
• Will lead on the quality assurance process and ensure a mechanism for ongoing review and guarantee continual improvements and development of the programme.
• Will ensure participation in the training and preparation of prospective preceptors and preceptees through acting as a Preceptorship Champion for the Wakefield area

• For other allied health practitioners (AHPs), whilst it is recognised by the Academy that AHP’ groups may not have the same requirements to complete preceptorship programmes in the same manner to that expected by nurses by the NMC, it is agreed that for those all new registrants and/or new to general practice clinical staff require preceptorship

5.0 The Preceptorship Programme

The preceptorship programme will include:

• Agreement to a 12 month personalised and flexible programme which will be built around the preceptees unique identified needs and evidenced in the form a portfolio.

• Provision of named preceptor from day one.

• The provision of a minimum of two weeks supernumerary practice in the clinical environment on starting employment. It is recognised that this may vary depending upon hours worked by the preceptee and the clinical area.

• Protected time to spend working towards their competencies.

• Orientation to all key areas of the Practice.

• Opportunity to shadow all members of the multidisciplinary team.

• Opportunity to meet with their preceptor on a regular basis.

• The development of a learning agreement based on ‘needs analysis’ completed by the preceptee, preceptor at the initial interview and agreed with the designated lead (AHP/Nurse Manager/GP Practice Manager). The preceptee must be at the centre of developing their own preceptorship programme, tailored to their individual level of need. Preceptorship must not be seen as a training course.

• To facilitate the above access to/opportunity to be involved in a range of learning methods and assessment processes will be required including:

• Self-directed leaning

• Experiential learning methods

• One to one support through observed and supported practice

• Shadowing/role modelling

• Formalised study as provided by the Academy/ HEI’s/online resources/accredited trainers

• The preceptee does not need to work under direct supervision, but should be well supported with direct access to the designated preceptor. The support that the preceptee will require is aimed at easing them through their transition into their new role and it is recognised that this will vary from individual to individual and situation to situation.

• The completion of a preceptorship portfolio to evidence progression will be completed. Evidence of achievement should include:

• Direct observation

• Written evidence in the form of personalised reflection, testimonies from patients and colleagues and practice educators, clinical case studies

• Progress should be monitored at designated intervals throughout the preceptorship period. Three and six monthly reviews will be undertaken by the preceptor with the final assessment of competence being carried out by the suitable qualified health professional

On Completion of the Preceptorship Programme it is expected that the preceptee will be able to:

•Demonstrate a professional attitude to health care in accordance with the appropriate Professional Codes of conduction

•Demonstrate understanding and awareness of their role, responsibilities and accountabilities and those of others within the practice, including associated ethical, legal and professional issues.

•Work effectively as part of a multidisciplinary team within general practice and the wider inter professional Primary Care Team. Recognising the importance of good, effective, working relationships at all levels.

•Be able to identify areas for further personal and professional development

•Demonstrate consolidation and further developmental skills such as communications, clinical skills, personal management and leadership skills.

•Demonstrate development of new understanding and skills and their practical application, specific to their level of practice.

•Demonstrate evidenced based holistic approach to the care of service users and their carers in Primary Care.

•Demonstrate their development of competency and capability to practice safely as a reflective independent accountable practitioner within general practice.

•Demonstrate and understanding of the importance of continuing professional development, clinical supervision and appraisal, in relation to their commitment as an autonomous practitioner to lifelong learning and the delivery of high quality patient care in general practice.

•Outcomes achieved with form the basis of the preceptee’s professional portfolio with any outstanding skills development at the end of the preceptorship period being built into the preceptee’s ongoing personal development plan.

•If an extension programme is required for preceptees requiring further development this will be discussed with the preceptee, preceptor and preceptor lead for the Practice.

6.0 Portfolio of evidence

It is the responsibility of the preceptee to keep a portfolio of evidence throughout the preceptorship period where a portfolio is defined as:

‘A personal and private collection of evidence which demonstrates the continuing acquisition of skills, knowledge and attitudes, understanding and achievement. It is both retrospective and prospective as well as reflecting the current stage of development and activity of the individual’ (Cable, 2012).

How the preceptee present the information is a personal decision, there is no right or wrong however the information must be relevant, to the point and their own work.

Recommendations for the portfolio include:

• Record of discussions and meeting including primary, intermediate and final interview
• Plan for individual training needs
• Training dates of the attended programme – this should include mandatory and statutory training including Practice induction
• Training dates attended with relation to the role
• Reflective accounts –- these should include reflection on an event, experience, critical incident and training that the preceptee has attended.
• Critical incidents/significant events
• Certificates, specialist practice or packages available in your area

See appendix 1 for an example portfolio.

7.0 Revalidation

For registered nurses revalidation takes place every three years. The requirements include:

• 450 practice hours, or 900 if renewing as both nurse and midwife
• 35 hours of CPD including 20 hours of participatory learning
• Five pieces of practice related feedback
• Five written reflective accounts
• Reflective discussion
• Health and character declaration
• Professional indemnity arrangement confirmation. (NMC, 2015)

The portfolio therefore will aid in commencement of the revalidation process the aim then being that following preceptorship the preceptee can continue to use the format autonomously as they develop their career providing a place to keep all important information safe and provide a record to meet future revalidation requirements (HEE, 2017).

8.0 References

Cole (2004) Support system. The Nursing Times Guide 2003/4 Emap, Healthcare London

Department of Health (2009) Preceptorship Framework for Newly Registered

Nurses, Midwives and Allied Health Professionals. London. Department of

Health: [Online] Available at: http://webarchive.nationalarchives.gov.uk/20130105024308/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@abous/documents/digitalasset/dh_114116.pdf

Accessed: 1st October 2017.

.

HEE (2015) Preceptorship: Mapping Against the Standards in Yorkshire and the Humber. HEE. Yorkshire and the Humber.

HEE (2017) Preceptorship Best Practice Guidance: Supported Practice for New Registrant Nurses in General Practice. HEE. Yorkshire and the Humber.

NMC (2006) Preceptorship Guidelines. [Online]. Available at: Accessed: 1st October 2017.

NMC (2015) Revalidation [Online]. Available at: Accessed: 1st October 2017.

Appendix 1

FLOW CHART OF PRECEPTORSHIP PROGRAMME

• Agree support network and mechanisms
• Identify activities and evidence of learning to be produced and develop learning contract
• Set date for intermediate interview
• Include induction information from the Practice

• Review progress to date
• Document learning as appropriate