National preceptorship framework for midwifery

Introduction and overview of preceptorship

This framework is for midwives and is a sister document to the National preceptorship framework for nursing, published October 2022.

What is preceptorship?

Preceptorship is a period of structured support for newly registered midwives. The main aim is to welcome and integrate the newly registered midwife into their new team and place of work.

Preceptorship helps professionals to translate and embed their knowledge into everyday practice, grow in confidence and have the best possible start to their careers.

The Nursing and Midwifery Council (NMC) principles of preceptorship (3.2 and 3.4) states: “Preceptorship is tailored to the individual nurse, midwife, and nursing associate preceptee’s new role and the health or care setting. It seeks to recognise and support the needs of the preceptee to promote their confidence in their professional healthcare role.”

The Royal College of Midwives (RCM) issued a position statement in August 2022 outlining: “While qualified midwives are competent at the point of registration, they need to consolidate their skills and knowledge and develop their confidence.”

Preceptorship should be a structured period of transition that develops the newly registered midwife, who possesses the knowledge, skills and behaviours required to join the professional register, to an accountable midwife who can convert this knowledge into everyday practice and work confidently to the NMC Code on a day-to-day basis.

Preceptorship is not designed to:

  • replace appraisals
  • be a substitute for a formal induction and mandatory training
  • be a way to re-test or repeat any knowledge and skills that a professional needs to qualify for the NMC register.

When does preceptorship happen?

All newly registered nurses, midwives and nursing associates should receive preceptorship in their first year after registration.

The RCM believes the preceptorship period should normally be not less than one year, and not more than two years.

What happens during preceptorship?

During the preceptorship period the newly registered midwife (preceptee) should have protected learning time and access to support from an experienced midwife (preceptor) to consolidate and develop their confidence, knowledge, skills, attitudes, values and behaviours as autonomous midwives and augment socialisation into the NHS, the trust, maternity service provider and maternity unit.

The RCM recommends that the preceptorship period should include:

  • a period of orientation to the trust and maternity service provider and its values, objectives, policies, and procedures
  • a formal, individualised learning agreement to allow the line manager, preceptor and preceptee to understand their roles and responsibilities in the process and provide an audit and evaluation of the preceptorship period
  • protected supernumerary time to allow orientation into all care settings in which midwives provide care
  • protected learning time to develop skills/competencies and become familiar with unit policies and procedures, including multidisciplinary skills and drills training relating to emergency/urgent and complex care situations
  • protected time with the preceptor to reflect on practice and receive constructive feedback on preceptorship programme requirements.

Preceptorship and retention

The main aim and anticipated impact of this is improved preceptee experience and support leading to higher retention rates for newly registered midwives.

As set out in the NHS Long Term Plan and NHS People Plan, improving the experience of our NHS people will help them to stay with us for longer.

The National Retention programme brings together national and local experience and expertise to offer information, tools and practical support for systems and organisations to help deliver the NHS People Promise.

There is no single or simple solution to improving retention. The programme takes a multi-dimensional approach and responds to where there may be challenges, including implementing a range of interventions at organisational level to improve the experience of our people.

Single interventions have limited efficacy, a bundle approach is most effective, and preceptorship is a key high impact intervention in the bundle.

The framework

The framework is intended for midwives and can be used as a core set of standards where multidisciplinary preceptorship programmes are in place. These core standards are the minimum requirements for midwifery preceptorship programmes.

Working with midwives from all regions, and accepting feedback, defining the standards to give more clarity, providing a narrative to underpin each standard, the core standards are considered achievable.

Mirroring the national preceptorship standards for nursing, the framework also includes a gold standard for those organisations who are excelling at the core standards, or who wish to further develop and enhance their midwifery preceptorship programmes.

We expect core standards to be achieved by September 2023 and organisations should be aiming for gold standard thereafter.

Models of preceptorship in midwifery

There are two models of midwifery preceptorship support recommended in this framework:

Model 1

The preceptorship lead is the named preceptor for all midwife preceptees in the organisation, supported by buddies (midwives), an education team and/or midwifery skills educators.

They work clinically alongside preceptees and undertake formal meetings every three months to track preceptees’ progress from band 5 to band 6. This ensures competencies are completed, confidence is grown, and pastoral support is provided until completion of the preceptorship period, which is a minimum of 12 months.

The preceptorship lead co-ordinates and monitors provision of preceptorship. Preceptees must also have a named midwife (buddy) in clinical practice who works alongside and is available to the preceptee for a proportion of clinical shifts.

Model 2

Preceptors (midwives) are clinically-based and support preceptees as part of their day-to-day clinical role.

They work clinically alongside preceptees and undertake formal meetings every three months to track the preceptees progress from band 5 to band 6.

This ensures competencies are completed, confidence is grown, and pastoral support is provided until completion of the preceptorship period, which is a minimum of 12 months.

Core elements of a programme

The core elements of a programme include a preceptorship policy that defines:

  • the roles and the preceptorship lead
  • the supernumerary period
  • protected time.

The policy also includes:

  • a formal structured programme of learning
  • standardised documentation
  • monitoring and evaluation
  • development of preceptors’ training
  • gold standards for organisations wanting to further develop their preceptorship programmes.

At gold standard, a senior responsible officer (SRO) for preceptorship should be in place at board level to mandate preceptorship across the organisation, confirm supernumerary and protected time for preceptees and preceptors, meeting templates and standard documentation.

There should be consideration of audit trails to demonstrate compliance, evaluation, and feedback with a measure of impact on recruitment and retention.

Intended recipients

There are other groups of midwives who will benefit from preceptorship:

Internationally recruited and return-to-practice midwives

In the case of internationally recruited educated midwives (registered from other European Economic Area [EEA] states and nation states) and return-to-practice midwives, the principles of an individualised development and support package remains.

For some experienced internationally recruited educated midwives, to repeat a preceptorship year in its entirety may not be appropriate.

However, in some cases, part or all of a preceptorship programme may be accessed, along with orientation and familiarisation of working in England, dependent upon each midwife’s individualised development plan.

Length of programme

As noted above, the RCM believes the preceptorship period should normally be not less than one year, and not more than two years, in line with the Agenda for Change handbook. Research has identified that most midwifery preceptorship programmes are 12 months with some extending this to two years.

The framework recommends a minimum of 12 months’ preceptorship period with the option for sign-off at nine months (the exception), and to extend the programme to those requiring it, up to 18 months to complete.

Gold standard would include a continuation of post-preceptorship year support, over 12 months and up to three years. For internationally recruited educated midwives, this would include an accelerated bespoke preceptorship programme at gold standard.

Supernumerary period

On commencement of the preceptorship period, all newly registered preceptees will have supernumerary status for a minimum of four weeks (150 hours) over a 12-month preceptorship period: usually two weeks at the start of each rotation or at the start of each new clinical area.

The preceptee will be allocated a midwife to work with, will not be personally allocated a caseload or patient, and will not be counted in the staffing numbers.

Protected time

In addition to supernumerary time described above, at core standard it is recommended that preceptors have at least eight hours’ protected time per year to enable them to carry out their preceptorship role successfully, undertake progress meetings and peer support needs.

At gold standard it is recommended at least 12 hours’ protected time for the preceptor to ensure time for personal development and this should be included within the preceptorship policy.

Meeting requirements

The core standard recommends a named preceptor being allocated to each preceptee within one week of starting in post, and the preceptee is notified, with an initial meeting taking place within the first two weeks of joining the organisation.

Gold standard would include a named preceptor being allocated prior to preceptee starting in post. This would take place when they have received their unique registration code called a PIN and the preceptee is notified, followed with the initial meeting taking place within one week of joining the organisation.

The initial meeting will result in an individualised, personalised development plan being jointly agreed by preceptee and preceptor, both core and gold standard.

Over the preceptorship year (12 months), four progress meetings should take place as a minimum, at approximately three, six, nine and 12 months between preceptee and preceptor. Meetings should last about an hour and should include protected time for both preceptee and preceptor. Meeting templates can be used as part of the framework and can be found in Appendix 1.

The preceptee will maintain a portfolio or a record of progress that provides reflective accounts and captures evidence that demonstrates working towards, or meeting, the required standards, competencies, or outcomes of their role alongside regular practice feedback.

At each meeting, a formal review of progress is completed, and expectations of the next three months’ competencies are agreed. Any planned support to help the midwife achieve their competencies should be documented. This should be regularly discussed and reviewed with outcomes recorded by the preceptee and preceptor at least every three months throughout the first 12 months.

A final sign off meeting should take place at either nine months (exceptional circumstances) or 12 months, or longer at the end of the preceptorship period. For midwives this is a formal process which includes progression from a band 5 to band 6.

The period of preceptorship ends after the preceptee has successfully acquired all necessary clinical skills, competencies, and performance requirements of their position. There is a formal documented process for sign off for both:

  • completion of the preceptorship year
  • progression from band 5 to band 6.

If the preceptee has not provided sufficient evidence that they have successfully met the requirements of their position, the process outlined in trusts managing performance and capability policy may be followed.

Gold standard would be a more frequent schedule of meetings between preceptor and preceptee than three, six, nine and 12 months.

Organisations are recommended to have a formal sign-off process which may include the preceptee, preceptor, preceptorship lead, HR and line manager, and professional midwifery advocate to ensure the preceptee’s progress has been satisfactory throughout, all competencies are achieved, the preceptee has gained sufficient confidence and autonomous skills competence to fulfil a band 6 role.


The following role descriptors are recommended, they can be tailored to each organisation, as required. These can be found in Appendix 2.

  • Preceptorship lead
  • Preceptor
  • Buddy
  • Professional midwifery advocate

Preceptorship lead

To meet the core standard, it is recommended that each organisation has a named preceptorship lead who is a band 7 midwife or midwifery manager. They are responsible for overseeing the preceptorship programme. The role may be combined with another role depending on the organisation and the number of newly registered midwives.

The role of the preceptorship lead is to act as the central point of contact and co-ordination for all preceptorship matters within the organisation. They are responsible for the co-ordination, monitoring and evaluation of preceptorship programmes, and development and review of both programme and policy.

To meet the gold standard the preceptorship lead would oversee the preceptorship programme and ensure there is a development programme to prepare preceptors for their role. The preceptorship lead would support the preceptors as and when required, maintain a register of preceptors and preceptees, promote the value of preceptorship within their organisation.

The role of preceptorship leads is critical to delivering a successful programme. The amount of time allocated to the role should be in proportion to the number of preceptees within their organisation. The preceptorship lead reports into the SRO, director of midwifery or head of midwifery.

Preceptor-to-preceptee ratios

  • Where the preceptorship lead is the named preceptor, and where buddies are in place for every preceptee:
    • there is no recommended ratio of preceptor to preceptee.
  • Where preceptors are clinical ward-based or community-based midwives who are working alongside the preceptee and completing progress meetings:
    • the ratio of preceptor-to-preceptee remains at 1:2.


A preceptor provides guidance to the preceptee by facilitating their transition from student to registered midwife. This is done by gaining experience and applying learning in a clinical setting during the preceptorship period.

The midwifery preceptor should be a registered midwife at band 6 or above with a minimum of 12 months’ experience post-registration. They should have experience of working in the same setting as the preceptee. They should attend initial training, development, and preparation for the role of preceptor. Preceptors should be provided with protected time as set out in the preceptorship policy.

In areas where there is a multi-professional preceptorship programme offered, midwifery preceptees should have access to a preceptor who is a clinical midwife. Each preceptor should have no more than two preceptees.

Gold standard includes a minimum of 12 months’ experience in the setting or work area, access to ongoing support and training and evidence of protected time for preceptor.

The preceptor should also participate in preceptorship forums and support networks to maintain up-to-date knowledge.


A midwife would be considered a preceptee if they are:

  • a newly registered midwife entering practice for the first time
  • a midwife going onto a new part of the register.

Midwives may access part or all of a preceptorship programme if they are:

  • a midwife returning to practice after re-joining the register
  • a registered midwife coming to work in the UK from within or outside the EEA/EU who receives preceptor support and guidance as part of their individualised support and development package.


A buddy is a registered midwife at band 6 or above with a minimum of 12 months’ experience as a midwife. They must have completed their own period of preceptorship and possess the necessary skills to:

  • observe practice
  • support, teach and assess skills
  • appraise competence
  • facilitate reflection
  • act as an exemplary role model at all times.

Buddies are a critical friend, a named person for whom the preceptee can go to for advice and guidance in the absence of the preceptor. Buddies may be allocated per shift or per rotation by the preceptorship lead or chosen by the preceptee. Buddies should work clinically alongside the preceptee for a proportion of their shifts.

The aim of this role is to ensure there is always a named person that a preceptee midwife can go to for support, in addition to the preceptorship lead. All buddies will communicate regularly with the preceptorship lead or preceptor on progress of the preceptee.

Professional midwifery advocate

Professional midwifery advocates (PMAs) were introduced in 2017 to replace the role of supervisor of midwives. Selection of PMAs is employer-led, being the responsibility of the director and or head of midwifery.

To become a PMA, a midwife must successfully complete a PMA preparation programme provided by a higher education institute.

PMAs provide support to preceptee and preceptor throughout the preceptorship programme using the advocating and education for quality improvement (A-EQUIP) model. This is made up of four functions:

  1. Restorative
  2. Normative
  3. Personal action for quality improvement
  4. Education and development to support the preceptee.

The A-EQUIP model aims to contribute to the provision of high-quality care via:

  • facilitating continuous improvement
  • valuing the midwife
  • enhancing health and wellbeing
  • building personal resilience.

A PMA can also offer restorative supervision: an evidence-based tool that enables midwives to feel valued, recognises their strengths and challenges, and identifies ways for them to progress, change and develop.

This can be undertaken individually or in a group setting with the remit to help staff understand and process thoughts. This will enable them to contemplate different perspectives and inform decision making.

The PMA role does not include regulatory matters, investigating concerns, imposing interim orders, specifying monitoring local programmes or making referrals to the NMC.


It is recommended that organisation’s preceptorship programmes comply with the following:

  • National preceptorship framework for midwifery (2023)
  • NMC principles of preceptorship (2020)
  • RCM position statement on preceptorship (2022)
  • Ockendon Maternity Reviews (2022)
  • Immediate and essential actions (EIAs) relating specifically to midwifery preceptorship.


Each organisation will be responsible for evaluating their preceptorship programme, with evaluations falling within the remit of the preceptorship lead. At a core level this will include analysis of course feedback forms, retention statistics (12- and 24-months post-registration), and evaluation of preceptorship experience based on questionnaires from preceptees at the end of their programme together with feedback from preceptors.

The preceptorship programme should be evaluated on an annual basis and adjustments made which has taken the feedback into account.

At a gold standard level, feedback should be analysed after each workshop or training session and preceptees should provide feedback at mid-point and endpoint of their programme, together with feedback from preceptors and other stakeholders. Preceptees should be involved in the design and development of the programme.

Standardised documentation

All organisations should have standard documentation for use across their organisation. These should include:

  • Policy
  • Charter
  • Meeting templates

Development needs analysis (SLOT analysis: Strengths, Learning needs, Opportunities and Threats) The SLOT model can assist in developing an agreed programme of development between preceptee and preceptor.

  • Individual learning plan
  • Reflection
  • Escalation process

A set of standard documentation is provided for use by organisations and may be tailored according to their needs. Details of these documents are available in Appendix 3.

Appendix 1: Meeting templates

Appendix 2: Role descriptors

The following role descriptors are recommended; they can be tailored to each organisation as required.

Preceptorship lead

The responsibilities of the preceptorship lead are to ensure the learning environment meets the needs of the preceptee.

  1. Identify all newly registered midwives requiring preceptorship and allocate or delegate the responsibility for identifying preceptors in time for the preceptee’s start date. This may include involvement in the recruitment process.
  2. Co-ordinate the identification of preceptors, knowing who they are and providing appropriate level of preparation and support.
  3. Implement and or maintain a register of preceptees and preceptors.
  4. Ensure adequate protected time is happening in line with policy.
  5. Monitor and track completion rates for all preceptees.
  6. Perform regular checks that the preceptor/preceptee relationship is working satisfactorily.
  7. Identify any development/support needs of preceptors.
  8. Measure the effectiveness and impact of preceptorship programmes on retention and staff engagement. Evaluate programmes after each cohort, quality assure programme.
  9. Ensure there are sufficient trained preceptors.
  10. Support/prioritise staff retention.


The responsibilities of the preceptor are to:

  1. Possess a good understanding of the preceptorship framework requirements and communicate these to the preceptee clearly and concisely.
  2. Understand the scope and boundaries of the roles of the preceptee.
  3. Act as a professional friend, peer, and advocate, demonstrate insight and empathy with the preceptee.
  4. Act as a role model for professional practice and socialisation, living organisational values.
  5. Ensure all induction has been completed and check that the preceptee is fully aware of local ways of working and appropriate policies.
  6. Facilitate introductions for the newly registered midwife to colleagues, multidisciplinary team, peers, and others (internal and external to the organisation as appropriate). Promote networking and development of effective working relationships.
  7. Agree learning needs with preceptee, co-develop a learning plan with achievable goals with regular and confidential review with the newly registered midwife.
  8. Use coaching and mentoring skills to enable the newly registered midwife to develop both clinical and professionally and to develop confidence.
  9. Facilitate a supportive and inclusive learning environment by signposting resources and actively planning learning opportunities for clinical, professional and personal growth of the newly registered midwife.
  10. Give timely and appropriate feedback to the newly registered midwife on a regular basis.
  11. Liaise with the line manager to monitor progress and address areas of poor performance or areas requiring further development through objective setting and regular review.
  12. Participate in regular formal meetings with preceptee.
  13. Embrace principles of NMC Code.


A buddy is a registered midwife at band 6 or above with a minimum of 12 months’ experience as a midwife, who has completed their own period of preceptorship. A buddy will:

  1. Work clinically alongside preceptee.
  2. Act as a professional friend, peer, and advocate, demonstrate insight and empathy with the preceptee.
  3. Act as a role model for professional practice and socialization, living organisational values.
  4. Facilitate introductions for the newly registered midwife to colleagues, multi-disciplinary team, peers, and others (internal and external to the organisation as appropriate). Promote networking and development of effective working relationships.
  5. Give timely and appropriate feedback to newly registered midwife on a regular basis.
  6. Embrace principles of the NMC Code.

Appendix 3: Midwifery framework charter

Publication reference: PR2098_i