Since the 2018 implementation of the Standards for Student Supervision and Assessment, pre-registration nursing education placement providers require health and/or social care registrants to supervise and assess students on practice placements (Nursing and Midwifery Council (NMC), 2018). These regulatory changes are in line with recent moves to develop integrated care systems and place-based care: an approach that emphasises the need for fewer referrals into statutory health services. Private, independent and voluntary organisations (PIVOs) are a valuable source of these types of practice placements, but many have lain dormant since 2018 because they do not employ registrants, and thus struggle to meet regulatory requirements for assessing students in practice.
In response, the University of Chester's Faculty of Health and Social Care has developed an innovative long-arm practice supervision model, which supports the development of these types of practice placements as hubs and also funds the registrants to deliver it, ensuring optimum support for students and the practice area. This model expands and broadens in scope the University's placement capacity, and structures engagement with its PIVOs—for instance, charities and specialist schools. The long-arm approach was designed to mitigate issues of many PIVOs that were potential or former placement sites being unable to independently assess students on placement.
Since the model's implementation during the COVID-19 pandemic, the University now provides health and social care registrants to each of these new placements, satisfying NMC regulations. Within this remit, a dedicated team of visiting lecturer registrants who are experienced practice assessors is deployed on a flexible basis to meet the support and assessment needs of students and their increasingly diverse placement practice areas. By investing in this model, the University ensures that PIVOs are receiving the full Health Education England (HEE) education and training placement tariff payment via the standard PIVO HEE payment process (Department of Health and Social Care and HEE, 2021) establishing clear reputational and cooperative benefits for all parties. Furthermore, this long-arm model stimulates an upskilling feedback loop, via its investment in practitioners. HEE has begun to fund simulated placements within university simulation units as an emergency response to the pandemic. The University initially began by using visiting lecturers to offer objective practice assessment in these simulations, attracting HEE placement tariff funding, before recognising that the tariff could be used more broadly to support a long-arm supervision approach to PIVOs. By using the long-arm team to supervise and assess during simulated placements internally, all the model's outgoing costs are now covered. Externally, this ensures an ability to not only regrow social care placements to re-balance health and social care experience, but also to grow the circuit (Knight et al, 2021).
Implementation of the long-arm model has re-established students' opportunities to undertake innovative placements extending beyond the NHS, which promote vital alternative skillsets across diverse cultural and situational backgrounds. In short, this allows students a valuable opportunity to learn about the different approaches to supporting people, and to focus on self-care; building a picture of individual strengths and preferences while involving a wider social network that is asset based and not illness/deficit focused. This allows the students to develop the ability to communicate effectively with people across the lifespan, address challenging behaviours, communication and language difficulties, and support clients with mental health needs. This approach also opens doors to supporting new placements via PIVOs who had not previously worked with higher education institutions (HEIs), with unique student experiences.
Although other HEIs have proposed alternative models using current academics as assessors, such practices are disproportionately costly, and therefore cannot easily be scaled up. Our long-arm model is financially self-sufficient, and allows full coverage of PIVOs without the recruitment of additional academics. Through its flexibility, the University is leading the way by implementing a financially and morally sustainable model of supervision and assessment.
The University's long-arm team has recruited experienced practice assessors very easily; externally it offers an attractive opportunity for registered nurse assessors to supplement their regular contracts, and internally it proves an effective outreach method for recruiting highly motivated academic health and social care staff with proven expertise in practice assessment. Structured preparation for the role builds on practitioners' prior knowledge and skills in practice support, and the team are supported specifically to meet the NMC requirements.
By gaining valuable experience working within the University, the long-arm team not only help grow placement capacity in the short term, but also navigate a pathway into academia in the long term, with some already having been appointed to their first academic posts. It is widely recognised that this represents a singular and innovative way of expanding placement circuits and growing a sustainable academic nursing workforce, with other HEIs keen to learn from this model.