Leading change

The Practice, Education and Preceptorship Lead Nurse at North Staffordshire Combined Healthcare NHS Trust led on the development and implementation of a programme to improve mentorship within the organisation. This programme has shown a variety of improvements including enhanced patient care and experience, more confident students, nurses & Allied Health Partners (AHPs) and increased staff satisfaction and morale.

Where to look

North Staffordshire Combined Healthcare NHS Trust is a provider of mental health, social care and learning disability services in the West Midlands. The Practice Education Team facilitates, develops and supports clinical placements for non-medical students within the Trust and provides professional development support for Trust staff. The team work across the organisation, with other NHS Trusts and with local universities to support the development of the future workforce for the local health economy and to promote the sharing of best practice.

The Practice, Education and Preceptorship lead nurse identified through existing Mentors and Practice Educators that they received little feedback or support for the mentorship they provided which was introducing unwarranted variation in the mentoring offered and on display. To address this unwarranted variation in practice, a programme of work was developed to better inform and support mentors and practice educators of guidance, improve feedback on the provision of practice-based learning and support visible recognition of their role.

Students on Nursing and Midwifery Council (NMC) approved pre-registration nursing education programmes must be supported and assessed by mentors. Mentors are responsible and accountable for:

• Organising and co-ordinating student learning activities in practice;
• Supervising students in learning situations and providing them with constructive feedback on their achievements;
• Setting and monitoring achievement of realistic learning objectives;
• Assessing total performance – including skills, attitudes and behaviours;
• Liaising with others (e.g. mentors, sign-off mentors, practice facilitators, practice teachers, personal tutors, programme leaders) to provide feedback, identify any concerns about performance and agree action as appropriate;
• Providing evidence for, or acting as, sign-off mentors – making decisions about achievement of proficiency at the end of a programme.

In order to do this, mentors need to ensure environments in which practice-based learning takes place is safe and supportive for learners as well as service users, so feedback and support is crucial (Health & Care Professions Council Education Standards, 2017).

What to change

The nurse lead in the Practice Education Team collated feedback from mentors and practice educators. A programme of work was developed and agreed with senior nursing and AHP managers within the Trust and this included a new programme of education and training for staff, additional resources for support and supportive forums, events and networks to ensure mentors feel valued. The programme aimed to:

• Increase support available to the mentors;
• Increase visibility in clinical areas of leads;
• Be the central point of contact for mentors & students;
• Improve communication;
• Address unwarranted variation in practice;
• Develop strengths and celebrate them;
• Increase the number of AHP students the Trust was mentoring.

How to change

The mentorship improvement programme is committed to ensuring staff have the right education, training and development to enhance their skills, knowledge and understanding. A refreshed education programme was devised and delivered for mentors, to offer peer support, identify and address specific areas for development across the Trust. The mentorship training is delivered, reviewed and evaluated for ongoing improvement by the nursing leads. Mentor workshops have also been developed and a revised and condensed Mentor and Student handbook was developed and rolled out based on clinician feedback. These resources were moved onto a digital platform to improve ease of access for mentors as well as ensuring that resources could be kept up-to-date.

A student mentoring recording form was created on the Trust’s intranet to support mentors to provide evidence for their portfolios and a ‘Mentor of the Year’ award was developed at the Trust’s annual Nursing Conference. A programme of regular student interest groups has also been established and training sessions rolled out at the local university and at the Trust’s induction to support students and mentors to manage their expectations and available use services to support them in their roles.

Adding value

Better outcomes – A qualitative evaluation of mentor training as well as evaluation reports from local supporting universities have been captured to identify how the variation has been addressed and to routinely support staff to deliver quality mentorship and clinical placements. Results have shown a variety of benefits for the individual and employer, such as:

• Enhanced patient care and experience
• Improved recruitment and retention
• Reduced sickness absence
• More confident students, nurses & AHPs
• Increased staff satisfaction and morale
• Increased revenue

Better experience – Staff and student responses to the programme have been positive with examples including:

I would like to nominate my mentor as she has supported me to evolve as a student nurse. She has supported my personal and professional development and enhanced my leadership skills which are required post qualification. She has remained positive and enthusiastic throughout my placement and has always facilitated my learning. She has helped to build my confidence and supported me with self-doubt; She is a wonderful role model and an asset to the trust.

I really enjoyed my community placement; this was my first placement for my first year. My mentor made me feel comfortable and part of the team straight away. His vast experience of mental health has helped me be aware of the environment that is completely new to me. Being aware of lone working was important. His positive attitude towards mental health and the individuals on his case load has helped to inspire myself. His personality and his nurturing attitude towards myself as a student and him being a mentor was outstanding.

A good session, excellently facilitated by team. Opportunity for group work and discussion.

Better use of resources – Since October 2016, the Trust has employed 35 newly registered clinicians that were students at the Trust. Thirty-four clinicians continue to work at the Trust. The Practice Education Team have associated this to the ‘home grown’ quality and focus of the mentoring programme. In 2018, the Trust has offered jobs to a further 29 individuals that are qualifying this year, all of whom have been students within the Trust and have experienced the new programme and the support it offers.

Challenges and lessons learnt for implementation

Successful mentorship training supports students to feel better equipped to face the transition from student to registered clinician.

Having high quality placements and delivering effective support to students, mentors and practice educators encourages Trust-wide sign up, which results in better staff engagement.

Ensuring all those involved understand the need to work differently and believe in the programme and its ideas allows the nurse leads to continue to drive this forward.

It is important to accept and support change, it happens with or without us, but being part of it can make change happen for the best.

Due to the success of the programme, the team are now planning how to implement the new NMC Education Standards as well as reaching out to more local universities to increase capacity and support.

Find out more

For more information contact:

• Rachel Bloor, Practice Education and Preceptorship Lead, North Staffordshire Combined Healthcare NHS Trust, Rachel.bloor@combined.nhs.uk