Now is the time to properly embed preceptorship as a core and essential offer for all newly registered nurses and midwives, researchers have said.
The Florence Nightingale Foundation (FNF) has urged the government and NHS England to use this “pivotal moment” to address the remaining gaps in support for early career nurses and midwives.
“There is a fundamental misunderstanding of the preceptor role”
Survey respondent
Its call comes as part of a new “pulse check” on preceptorship, published today and seen early by Nursing Times.
The nursing charity has surveyed 870 nursing and midwifery students, early career registrants, preceptors and preceptorship leads and champions, to find out current preceptorship experiences.
It is a follow-up to two previous surveys on the same topic carried out in collaboration between Nursing Times, FNF and the union Unison since 2021.
The latest survey reveals a “steady recovery and growing maturity of preceptorship practice following the disruption of the Covid-19 pandemic”, said FNF.
It found that 91% of early career respondents had been offered a preceptorship programme – up from 68% in the 2023-24 survey and just 61% in 2021-22.
The majority (59%) who received a preceptorship programme rated the quality as “good” or “excellent”, while 25% considered it “average” and 16% rated it “poor” or “very poor”.
“I received a high level of support and understanding from my preceptor, managers and wider team, which has helped me stay in the role during periods of self-doubt and low confidence,” said one early career nurse working in NHS mental health services.
The role of preceptorship in supporting retention was made clear in the results, which were mostly from respondents based in England’s NHS.
Almost three-quarters (74%) of early career respondents said the quality of the preceptorship offered impacted their intention to stay with or leave their organisation.
Meanwhile, 66% of student respondents said the presence of a preceptorship would influence their decision to accept a job offer – up from 53% in 2023-24 and 54% in 2021-22.
However, the research revealed a knowledge gap for some students in regards to preceptorship.
While 58% of students reported having a moderate level of knowledge about preceptorship, a third (34%) stated they knew “very little” or “nothing at all” about it.
Workshop discussions carried out alongside the survey found a “progressive awareness pattern”, with students knowing more about preceptorship the later they got into their studies.
For the 9% of early career respondents who were not offered a preceptorship programme, the top reasons provided included a lack of provision in their workplace and a shortage of available preceptors.
Meanwhile, the report warned of a “clear disparity” in access depending on whether the early career registrant was from the UK or abroad.
While 94% of UK-educated early career registrants received preceptorship, only 81% of internationally educated early career registrants did.
“This 13-percentage point gap indicates internationally educated colleagues were more than three times as likely to be denied preceptorship opportunities despite potentially facing additional challenges in their transition to practice,” stated the FNF report.
The new report included a focus on the experiences of preceptors and preceptorship leads and champions and uncovered issues around poor training and preparation for those supporting early career staff.
Only 3% of preceptors felt “extremely” prepared to undertake their role while 25% felt “very” prepared.
Conversely, 9% said they felt “not at all” prepared, 21% were “slightly” prepared and 42% felt “moderately” prepared.
The survey of preceptors further found that 17% had received no training at all for the role and 12% were unsure whether any training or criteria were even required.
One preceptor nurse working in an NHS acute hospital said: “There is a fundamental misunderstanding of the preceptor role, which has led to significant problems within our trust.
“Staff think they are acting in the role of preceptor but have not engaged with any formal training, nor do they understand what is involved – they feel simply being named as a preceptor as an ad-hoc point of contact for new starters is the entirety of the role.”
Preceptors also highlighted workload challenges, with 49% saying they struggled to balance their preceptor and clinical duties.
Despite the difficulties, 63% of preceptors described their experience of their role as “somewhat” or “very” positive.
Many appreciated the opportunity to support the development of others (85%), share their own expertise (81%) and witness the growth of their preceptees (74%).
They also reported benefits for their own development, with 68% saying they had built new skills and 64% saying it had enhanced their leadership.
However, feedback from preceptorship leads and champions suggested that too few nurses and midwives were still willing to take on the role.
Only 46% said there were enough staff in their organisations willing to become preceptors.
Among the top barriers identified as preventing people from taking on these roles were workplace pressures (89%) and lack of protected time to carry out the preceptor role (69%).
“This research highlights the remarkable progress made over the past five years”
Greta Westwood
The research as a whole identified concerns about the “administrative burden of preceptorship” with calls made for digital tools to support the documentation requirements of programmes.
FNF made a number of recommendations in its report and highlighted now as a “pivotal moment” for addressing the remaining issues affecting preceptorship.
It noted the government’s 10-year plan for the NHS that is due soon, and NHS England’s work on a national “quality mark” accreditation programme for preceptorship programmes.
Currently, an “interim quality mark”, which was launched following the publication of the national preceptorship framework for nursing by NHS England in October 2022, is in use across the health service.
Organisations that meet the gold standards set out in the preceptorship framework can earn the quality mark.
“As NHS England pilots the national preceptorship quality mark, we have a unique opportunity to embed high-quality, consistent support across organisations,” stated the FNF report.
“To do so, we must act on the evidence: preceptorship should not be an optional extra, but a foundational element of early career development.
“It must be resourced, standardised and embedded into the culture of practice.”
As part of its development and implementation of the quality mark, FNF asked NHS England to establish “clear national expectations” for preceptorship programmes.
The charity also called on NHS England to “standardise and strengthen” training for all preceptorship roles and support digital transformation of preceptorship systems.
Meanwhile, it urged the Department of Health and Social Care (DHSC) to “reaffirm commitment to preceptorship in national policy”.
Specifically, FNF wanted to see preceptorship embedded as a core component of workforce development and retention strategies in the 10-Year Health Plan.
The DHSC was also asked to provide ring-fenced national funding to support the delivery of preceptorship programmes for all groups that need them, including international recruits.
Greta Westwood
Commenting on the report, Professor Greta Westwood, chief executive of FNF, said: “This research highlights the remarkable progress made over the past five years – more newly registered nurses and midwives are receiving structured support, and the quality of preceptorship programmes is clearly improving.
“However, the findings also expose significant challenges, especially in how we prepare and support preceptors.”
She noted how this lack of training for preceptors had led FNF to partner with information analytics company Elsevier to create a new course for preceptors called Preceptor Plus.
An NHS England spokesperson said it would be taking note of the new findings in the FNF report.
They said: “We have made real progress in improving preceptorships for newly qualified nurses and midwives, and we will carefully examine the feedback from the Florence Nightingale Foundation and other stakeholders to continue to support newly qualified colleagues in their roles as best as possible.”
Meanwhile, a DHSC spokesperson said: “We are working closely with NHS England, employers and educators to improve transition into the workforce.
“We will publish a refreshed workforce plan later this year, to ensure the NHS has the right people in the right places with the right skills.”
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