Accelerated postgraduate nursing pilot programme: an evaluation

Context: Between January and March 2019, Health and Social Care Evaluations (HASCE) at the University of Cumbria were commissioned by Health Education England (HEE) and NHS England to evaluate the delivery of the Accelerated Postgraduate Nurse Pilot Programme and its potential application to future postgraduate nursing education. The aim of this project was to provide an independent evaluation of the delivery of the Accelerated Postgraduate Nurse Pilot Programme and the students’ experiences of accessing the course. The evaluation was designed to identify what has worked well and how the learning from this pilot could potentially be adopted within other pre-registration postgraduate programmes. Methodology: The evaluation used a mixed methods approach, using semi-structured interviews and surveys to collect data, and a template analysis to organise and analyse the data. Interviews were conducted with four higher education institutions, two NHS Trusts, and four students currently on one of the Accelerated Postgraduate Nurse programmes. An online survey was distributed to all students registered on the pilot programmes, with a 49% response rate. The data was framed by a realist approach to evaluation. Themes were identified from the data and configured using a template analysis to identify the contexts, mechanisms and outcomes at work in the programme delivery and its impact on participants. Conclusions: - The postgraduate programmes delivered by the three HEIs have, to date, successfully trained 35 students in either mental health or learning disability nursing during the two-year timeframe. Although the students have approximately five months remaining on their programmes, it is evident that they will be ready to transition into the workplace. Some of the students have already received job offers, and others are in discussion with their trusts about the transition to the workplace and their preceptorship year. - Overall, perceptions of the programmes were positive from students, HEIs and Trusts. HEIs and Trusts noted the strength of the cohorts, and the growth in confidence and ability they demonstrated as the programme progressed. This can be attributed to the selective recruitment process and the collaboration between HEIs and Trusts to enable this. Recruiting mature students was also seen to be beneficial in terms of their education and practice experience, as well as their commitment to the field and in the value they place on the opportunity. - Some participants noted that where communication had been less effective, the recruitment process had been more time-pressured. Establishing clear shared goals and clear points of contact between organisations was identified as a key enabler for collaboration. - The findings indicate that programmes without APEL can present additional challenges for the students as they need to undertake more placement hours to meet the NMC requirements for nurse registration. This can be particularly problematic for students with commitments outside of work. - Students commented on the development of autonomy and resilience they felt the programmes had provided them with, and that the access to senior leaders within placements had been beneficial. From the perspectives of the postgraduate students and HEIs, the financial support for the duration of the programme was very beneficial. The funding was an enabling mechanism which allowed the students to support themselves whilst studying to progress their careers, and reduced the need to earn additional income, which ultimately enhanced their engagement and commitment to the course. - The majority of the postgraduate students felt well supported by both their HEI and NHS trust. Most had positive experiences within the trusts with access to ‘enhanced experiences’ (such as additional training, access to meetings or opportunities to develop leadership skills) and a range of support and mentoring from colleagues, lived experience coordinators and senior clinical staff. However, some of the postgraduate students and HEIs reported communication issues and unhelpful perceptions within the trust’s workforce at ground-level, indicating the need to ensure that the workforce were aware and supportive of the student’s programme, expectations and capabilities. - The focus on leadership within the programmes largely took the form of access to senior staff within Trusts, whether through regular meetings between students and staff, forms of mentoring and other support, the opportunities to attend higher level meetings and in some cases specialist training. Leadership was embedded in the HEI programmes with specific modules and projects designed to encourage the students to develop their leadership skills, to innovate and manage change. However, it was not clear from the data whether this was distinctive from other programmes or qualification routes offered. In some cases, students reported that the enhanced experiences had not always been available in particular placements. Recommendations: Based on the data presented, the following recommendations can be made: - Future pre-registration postgraduate programmes for mental health or learning disability nursing would benefit from focussing their recruitment on psychology graduates or other degrees related to human interaction, relationships, creativity, questioning and attitudes. The use of APEL is valuable with this type of programme as it reduces the number of mandatory placement hours that students need to acquire for NMC registration. Future pre-registration postgraduate nursing programmes should also consider available mechanisms for offering financial support (outside of the pilot funding) to students. This is particularly important given the impact of the accelerated programme and demand for placement hours on mature students. - For HEIs taking part in similar programmes, it is important to establish a strong rapport and collaborative partnership with the NHS trusts, and to ensure that the trusts have the capacity and resources to fully support the students during their placements. - The recruitment of existing staff from within NHS Trusts is beneficial for both the nursing student and the trust, and it would be worthwhile adopting this approach to recruitment across other pre-registration postgraduate programmes. It is, however, recommended that consideration is given to how HEIs ensure that students recruited from Trusts are treated equivalently to other students whilst on placement. - It is recommended that more attention is given to the variety of leadership models relevant to nursing roles that programmes and placements can make use of. This may support different approaches to leadership, including those oriented towards more of a collective leadership model as well as that of management roles, being embedded within placements. - It would be beneficial to conduct a further evaluation of student outcomes once the preceptorship year is underway