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NMC considers compulsory preceptorship and longer courses for midwives

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The midwifery regulator is seeking views on whether preceptorship should be made mandatory for newly qualified midwives.

The Nursing and Midwifery Council is also exploring the idea of increasing the length of the midwifery degree, which is currently three years.

“A period of preceptorship is currently recommended yet it doesn’t happen in practice and there is considerable variability”

Carmel Lloyd

The changes are being considered as part of the NMC’s latest overhaul of its standards of proficiency for midwives and for pre-registration midwifery education courses.

A “recurring theme” that occurred during the wide-ranging engagement on the proposals was whether the current length of the midwifery course and the approach to preceptorship were sufficient to properly prepare students for the modern challenges of the job.

Dr Geraldine Walters, director of education standards at the NMC, told Nursing Times that some people believed newly qualified midwives were entering the world of work with “competence but not confidence” and they needed extra support. 

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Geraldine Walters

The regulator has now commissioned audit firm KPMG to gather evidence to help inform its decision.

Members of the public will also be asked for their views as part of the upcoming consultation of the new “future midwife” education and proficiency standards.

The NMC made clear that it may not make any changes to the length of the course or preceptorship if the evidence did not support it. 

Dr Walters said: “There’s a question here that we are bound to look into, but we don’t know what the answer is. So we have to try and get a consensus through consultation and we want to do some work to try and inform that better first.”

Mandating preceptorship would require new legislation, Dr Walters said.

She added that some may believe this option to be too “bureaucratic” and employers could implement good preceptorship programmes without being forced to by law.

Currently, organisations are advised to offer newly qualified practitioners a period of extra support to help them make the transition from student to professional and embed their practical skills.

“If it came to light that it was thought to be necessary for midwives then we would have to open the box”

Geraldine Walters

NHS Employers claims preceptorship can help enhance patient care and experience, improve recruitment and retention, reduce sickness absence and boost confidence and morale among staff.

However, the quality of programmes varies across the country and some organisations will not offer any preceptorship at all. 

Dr Walters said: “Most organisations… say there should be a period of preceptorship, but some organisations will do it much better than others, some organisations won’t do it at all.

“There’s lots of evidence that says if you do do it, you will have less turnover,” she said. “So, what some people think is that we need to put it in our legislation to make sure it happens, where others are saying no.” 

She added: “It’s really about is this our role or not, and we are hoping that the exploratory work and the consultation will throw a bit of light on that.”

If it is decided that preceptorship should be mandated for midwives, the NMC would also have to consider making it compulsory for nurses.

Dr Walters told Nursing Times: “I think if it came to light that it was thought to be necessary for midwives then we would have to open the box and say do you think it’s necessary for nurses as well.”

Carmel Lloyd, head of education and learning at the Royal College of Midwives, said the preferred option for the RCM would be for the course to be extended, but for the fourth year to be used for “clinical training”.

Royal College of Midwives

Carmel Lloyd

Carmel Lloyd

Ms Lloyd said more information was needed on how compulsory preceptorship would be enforced.

She added: “A period of preceptorship is currently recommended by the DH, NMC, NHS Employers, professional bodies/trade unions etc – all have statements/guidelines in relation to preceptorship, yet it doesn’t happen in practice and there is considerable variability in terms of what this looks like (length and content) as well as quality.

“We need greater clarity than we have the moment with regard to what this option might look like in reality and in particular whose responsibility it would be to ensure it is mandatory,” Ms Lloyd said. 

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