Mandatory two-year preceptorship for community and prison nurses
The Oxleas nursing preceptorship programme has gone through great change over the last two years, as we have moved from providing nursing care in London and Kent, to also providing healthcare in prisons in the south-west of England. We also started our second year ‘Beyond’ preceptorship programme, and moved our competency completion from a paper booklet to an online platform that is also used as a resource hub.
Using our BAFO framework (Building a Fairer Oxleas) and focusing on equity of provision has been a key focus whilst bringing our nursing preceptorship and Beyond program to colleagues across the trust. For staff in London and Kent we host classroom sessions in a central venue. For staff in the South West of England we deliver the programme via Microsoft Teams. We have recently trialed classroom sessions in the South West, hosted by colleagues who are based there, but the delivery of Beyond remains on Teams.
Organisational Details
Oxleas NHS Foundation Trust is a south London based trust that has grown out of the original Bexley hospital for psychiatric patients located on the Bexley/Dartford borders. Over the year Oxleas has expanded and now provides both inpatient and community mental heath, community learning disability, community adult and child physical health and CAMHS services across the London boroughs of Bexley, Bromley and Greenwich, Primary care and mental health services for prisons in Kent and south London, and since 2022 Primary care and mental health services in prisons in the southwest of England, making us the largest provider of offender healthcare in the UK. Over a year on average we put between 80-100 staff through preceptorship over three cohorts. At the end of this year (2025) we will have enrolled 91 staff on Beyond/year 2.
Description
Oxleas nursing preceptorship has been running since the 2000’s, and has expanded over the years, as Oxleas has also, to support nursing staff from mental health, adult, child and learning disability, and more recently nursing associates, as they start their nursing careers. It has seen some major changes over the last few years as having been a south London and Kent based trust, we took on healthcare provision for prisons in the Southwest of England. This and the introduction of year 2 of preceptorship (Beyond) has caused us to look at how we are delivering the programmes.
Following a trial of in-person London sessions web streamed to southwest colleagues for year 1(preceptorship), we have moved to face to face teaching for all year 1 preceptees, with southwest sessions led by senior southwest colleagues. The first cohort of in person southwest sessions for Year 1 has recently completed, and we are gathering feedback from both Preceptees and facilitators. Year 2 (Beyond) remains being taught in person in the southeast, and online for the southwest.
The Executive Sponsor of the Oxleas Nursing Preceptorship is our Chief Nurse. Delivery is facilitated by the nursing preceptorship lead in the southeast and teaching provided by the nurse education team and nursing, AHP and social work colleagues from within the Trust. Guest speakers include senior leaders and service users. Southwest sessions are organized and facilitated by the Head of Nursing for southwest prisons and the Practice Development Nurses. Southwest sessions are based on the teaching sessions from London, though some are tailored more towards prison nursing.
Preceptees are supported in their own workplace by a Preceptor, a senior colleague who is a minimum of 12 months into their career. The preceptor offers support and advice and is also responsible for signing off the preceptee on each of their competencies. Overall responsibility for the planning and implementation of the preceptorship programme lies with the Preceptorship Lead, a band 7 registered nurse and member of the Oxleas Nurse Education Team.
Year 1 consists of 7 study days, followed by 6 months of action learning sessions (one day a month) with a range of competencies to complete.
Year 2 is a bi-monthly programme of 10 months, with 6 study days to attend. There is optional work that runs in parallel with the Year 2 programme relating to leadership, education and quality improvement.
What makes it stand out?
Oxleas is one of the first trusts in the country to introduce a mandatory 2-year preceptorship to all newly qualified nursing staff with the aim of developing experienced band 5’s and preparing band 6’s for their careers within the Trust. We have mental health, adult, learning disability and child nurses and nursing associates within the Trust, and our preceptorship has to support all of them in the early stages of their career. We also have a wide geographical area of newly qualified nursing staff to provide support to, with three south east London boroughs (Bromley, Bexley and Greenwich), and prison healthcare services in Kent, across to Bristol and down into the southwest in Devon and Dorset.
Support and Learning for Preceptees
Preceptorship attendance and learning time is mandated by the Trust board, attendance of all 7 training days in Year 1 is required with a minimum attendance of 80%. If this is not met then the preceptee is required to move to the next preceptorship cohort to attend any missed sessions. Staff teaching on the course include mental health, adult and learning disability nurses, social workers, AHP’s and senior colleagues from within the Trust. Sessions taught over these 7 days are:
- Transition to an Accountable Practitioner
- Professional Values,
- Staff Wellbeing,
- Equality and Human Rights,
- Team Working and Leadership,
- AHP Awareness,
- Human Factors,
- Duty of Candour,
- Documentation,
- Quality: How do we know we are being effective?
- Change Management,
- Mental Capacity Act/DOLS,
- Mental Health Act (MH & LD nurses),
- Tissue Viability/Long term conditions and Heart failure (Adult & Child nurses),
- Whats in the bag? (emergency/red bag training),
- Managing the Deteriorating Patient & Simulation,
- Medication Administration & Errors,
- Learning Disability awareness with Lived Experience practitioner,
- Think Family (child safeguarding)
- A brief introduction to Domestic Abuse,
- Clinical Supervision – An Introduction,
- Patient Experience, PALS and Complaints,
- Practice Supervisor training,
Throughout year 1 staff are supported by their preceptors and the nursing preceptorship lead, with managers also involved in their preceptorship when required. In Year 2 staff continue to be supported by the preceptorship lead and are encouraged to support each other on the course. One of the Year 2 study days is heavily focused on what leadership is and what it means to the attendees, but also focusses on leaderships within (and outside of) the NHS. There is training available within the Trust, and all attendees are required to sign up to, and complete, the Edward Jenner leadership program during their Year 2 of preceptorship. We have an education day where staff complete their practice assessor training (NMC SSSA,2018) and a quality improvement day where they complete Trust QI training.
Throughout the two years of preceptorship staff are encouraged to look at and consider their careers, with the initial few months spent talking with their supervisor, developmental action plans being written throughout, career conversations with PNA’s at the end of year one and the whole of the second year being designed to help them contemplate where they would aim to be in their professional careers.
Support and Learning for Preceptors
Preceptor training is required, and is incorporated into our Practice Assessor training and updates. Preceptors are required to have completed their own preceptorship, and have a minimum of 12 months’ post qualification experience. Staff who attend Beyond preceptorship receive Practice Assessor training in their second session of the course (15 months since commencing preceptorship) and this covers what the NMC Code requires of Practice Assessors, Future Nurse and SSSA requirements, roles and responsibilities of the PA in comparison to the Practice Supervisor, Failure to Fail (not passing failing students), Coaching styles and giving feedback to students. Those outside of Beyond attend a 2 day course with the University of Greenwich, and PA’s are required to attend an Oxleas run PA update every 2 years.
The nurse education team maintains a list of those who are trained to be preceptors. Contact is maintained with those providing support to preceptees by the Preceptorship team to make sure they are aware that help and support is there if needed in their role as preceptor. When staff have acted as preceptor for a newly qualified nurse, this is acknowledged and thanked by the Education lead.
Oxleas has a strong network of Professional Nurse Advocates within the trust that all Preceptors have access to if required. There are various other networks, whilst not Preceptor specific, that would be able to offer support.
Inclusion and Equity
All internationally recruited nurses are enrolled onto the first nursing preceptorship that starts after they have joined the trust and obtained their NMC pin number, and so are offered the same support as any other preceptee. The preceptorship lead has historically taken a lead role in welcoming them to Oxleas and helping them settle into the area. Our programme design and online/website aspect of the course were designed and evaluated by colleagues including those with neurodiversity, and regular feedback is sought from all preceptees to see how we can improve their experience of the preceptorship programme,
During the first day of  Year 1 of preceptorship there is a session on staff wellbeing, and encourage preceptees to sign up to any Trust networks that may be relevant to them, with the Oxleas Disability Network offering support to those who are neurodiverse. We encourage colleagues with extra support needs to come forward and make the team aware so we can adapt for them.
Next Steps and Vision
The two main focuses for the nursing preceptorship in the near future involve our second year ‘Beyond’ program. We want to have it recognized, acknowledged and valued within the trust to the same standard as year one, so all staff are aware that it is the organizations route and support of newly qualified nurses when they join the trust.
Another priority for year two is ensuring the programme is received as positively in the South West as it has been in London and the South East. We want colleagues in the South West to feel fully included and equally engaged in the process, regardless of location. At present, the hybrid delivery model appears to favour the face-to-face experience, which can leave those accessing sessions remotely feeling less connected. We are hopeful that feedback from the upcoming in-person sessions in the South West will demonstrate a stronger sense of inclusion. This insight can then be used to refine the approach further and ensure greater equity of experience across all regions in year two
Evidence of impact
Our research showed that of those starting each of our preceptorships, one year later 1/3 were still in their starting roles they had been in when commencing, 1/3 were now working in Band 6 roles, and 1/3 had left the Trust – this may be for a number of reasons as exit interviews did not capture this information. Our hope with our Beyond (year two program) is that it will encourage any potential leavers to stay, support those who have moved up the bands to be the best new band six they can be, and support all attendees to think about their career and where they want to head with it – as we are yet to complete our first cohort we do not have any final representative feedback, though so far we have had positive comments from attendees, and have not seen 1/3 of attendees leave throughout the course.
At the end of every cohort of preceptorship year 1, attendees are invited to complete an anonymised feedback form via the preceptorship website. Overall, we receive very positive feedback from preceptees regarding the quality of teaching, the support provided by the nursing education team, and the guidance offered by their preceptors in practice. In the South West, feedback highlights the strength of relationships with the nurse education team and course facilitators, which is rated just as highly as in the South East. Where differences do emerge, they relate primarily to the learning experience itself, which has until recently relied more heavily on online delivery. This suggests that technology and mode of delivery may present barriers to learning and inclusion, rather than to the quality of support and relationship-building.
Feedback quotes
‘It is a very good learning opportunity, this allowed me to get more understanding and uplifted my confidence in some areas especially my communications skills and reminding me about my accountability, my responsibilities and the expectations.’
‘I strongly believe that Preceptorship program can help the Trust to attract and retain talented professionals, positioning itself as a preferred employer.’
‘My involvement in the preceptorship has been a pivotal step in enhancing my comprehension and competence; it has facilitated the translation of my knowledge and latent talents into practical application, fostered my confidence, and clarified the implementation of the NMC Code in my daily activities and task.
‘I particularly appreciate the Action learning and how it has help me in reflective practice’
Challenges and Lessons learned
The main challenge with Beyond has been with raising awareness of this ‘second’ year, and the understanding of the process and attendance.
Initial thoughts on the program from the Preceptorship lead were greeted positively by the Nursing Education Team, and the further developed plans more so. The plan was taken to the Oxleas board in 2024 where it was also greeted enthusiastically, and agreed to its implementation as part of the preceptorship program, taking it from a one year to two year mandatory course, despite the additional costings involved.
Communicating the structure of the preceptorship programme to new preceptees and the wider nursing workforce has been an important area of learning. On the first day, when preceptees are introduced to the full two-year pathway, some initially feel apprehensive — understandably, given they have just completed three years of training to qualify as registered nurses. We have found that reassurance at this point is key. Encouraging them to focus first on the initial seven teaching days of year one helps make the programme feel more manageable and achievable. Providing clarity on how the programme supports career development has also been valuable. For example, some staff, particularly district nurses, had thought they were unable to apply for other roles until completing their preceptorship. Explaining that year one marks the completion of core learning, competencies, and reflection — while year two is designed to further support progression into senior roles — has been effective in reassuring and motivating them.
Other issues around Beyond have been related to the structure, and these will be dealt with as the course becomes more known around the Trust, with people believing they choose one day to attend from a choice of six, or optionally choose which of the session they attend depending on their interest. As stated, the more known the course is, the more people will be aware.
Region/Nation: England
Setting: Community care, Mental Health, Prisons
Professional Groups Involved: Nursing, Nursing Associates
Part of a recognised framework: Yes.
Is this mandated in your organisation? Yes
Executive Sponsor for Preceptorship: Chief Nurse
