A new model for speech and language therapist preceptorships

Lucy Mackechnie shares how Kent Community Health NHS Foundation Trust has transformed their preceptorship model to provide consistent, structured and supportive development for newly qualified speech and language therapists (NQPs).

In our experience, NQPs are dedicated, enthusiastic and keen to start their new role in our adult community setting at Kent Community Health NHS Foundation Trust (KCHFT). However, they can frequently struggle in the first year when they realise how much more there is to learn such as the complications of putting theory into practice with communication clients and developing dysphagia skills. More challenges arise where NQPs take new roles in busy and often resource-stretched teams. During discussions, NQPs have shared their concerns of feeling like a drain on SLTs because they are initially unable to have a significant impact on waiting lists and require support with the clients on their caseload. This leads to a lack of confidence which hinders the natural progression of learning and professional development.

Introducing a new model

Preceptorship: a period of structured transition for the newly registered practitioner 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 their journey of lifelong learning (Department of Health, 2010).

Preceptor: an individual providing one-to-one support to someone undertaking preceptorship (HCPC, 2023).

While there has previously been a service-wide preceptorship framework based on RCSLT guidance, the development experience of each NQP has varied across localities. NQP training has depended on the individual preceptor and their own approach to preceptorship resulting in inconsistencies in training quality, levels of support and speed of progression to independence in the first year post qualification.

To address these challenges, KCHFT aimed to create an innovative and consistent working model for preceptorships. We wanted to provide one-to-one and group supervision of clinical and core capability skills for all NQPs in the service, and support to line managers and preceptors.

We developed a Clinical Development Lead role to coordinate this new preceptorship model. A Band 7 SLT, with experience in working with NQPs and students, filled this position. They were assigned a maximum of four NQPs at any one time.

What did this change for NQPs?

A clear framework for both NQPs and preceptors and consistent and equitable preceptorship training across all localities.

We wrote an individual preceptorship framework for communication, dysphagia and caseload management. This outlined a gradual structuring of establishing competencies, giving timeframes and the anticipated support needed.

Evidence-based, structured training in dysphagia and communication.

We provided training through individual and group teaching sessions, clinical facilitation, and direct supervision. This was an incremental structure for expectations around caseload management, note keeping, report writing and administrative duties. We conducted one-to-one supervision in diverse settings initially working with less complex clients and gradually building in complexity.

A protected space and time to facilitate learning and a supportive, individual, positive experience of their preceptorship training.

NQPs stated that introducing the new preceptorship model and Clinical Development Lead role has had a positive impact: “As a new Band 5, choosing to work for a service that offered continuous support in the preceptorship year by a designated mentor has made the transition from student to NQP less daunting.”

Moving forward

From a service perspective, there is a high investment of time and resources involved in training each NQP. We are able to recruit to Band 5 posts but rarely draw external applicants to Band 6 posts, so for us NQPs are the ‘life blood’ of our service as we hope that they will stay and develop their career within our trust. In the future we plan to continue to develop this model and maintain a dynamic and innovative approach to preceptorship, extending the role potentially into developing Band 6 criteria and opportunities.

The RCSLT is currently reviewing the NQP goals process and developing new guidance for career transitions. With thanks to those who have been involved in working groups and consultations. We will share updates on this work later in the year.

Preceptorships

Newly-qualified practitioners (NQP)