Preceptorship in social care: We need policy to catch up

Many newly registered nurses and nursing associates working in health settings have access to structured preceptorship, but provision within social care remains inconsistent. There are pockets of excellence within social care – and now is the time to build on this emerging progress. This unwarranted variation must be addressed to ensure equitable support for all, explain Raluca Oaten at the Florence Nightingale Foundation (FNF) and Claire Leenhouwers at Skills for Care.

The Florence Nightingale Foundation’s latest Preceptorship Pulse Check (2024/25) shows real progress in the provision of support for newly qualified nurses and midwives – 91% of early career respondents were offered a preceptorship programme, a sharp rise from just 61% three years ago.

While the survey was open to all four nations of the UK, most responses were from England, so the findings reflect the picture more strongly there than elsewhere.

Another group was notably missing. Social care made up just 1% of respondents to this survey. This absence was telling.

In follow-up interviews and roundtables, social care leaders acknowledged the progress being made – but also made clear that preceptorship in their sector faces distinct challenges that national policy must address. From these discussions, here are their main messages around social care and what needs to change.

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There is a strong foundation

We should recognise that we already have a solid foundation. The Nursing and Midwifery Council’s (NMC) Principles for preceptorship, published in 2020, made a clear and valuable case for every organisation employing nurses or midwives to adopt a preceptorship programme. By design, the principles avoided being overly prescriptive – offering helpful flexibility to accommodate the wide range of contexts in which registrants work.

This was welcomed by many across social care, and some providers have built strong, locally tailored models as a result.

But national frameworks are proving too rigid

Since the NMC published its principles, national efforts have focused on building consistency through tools such as the National Preceptorship Frameworks for Nursing in England and the development of an Interim Preceptorship Quality Mark. These aim to raise standards and offer guidance on what good looks like – important goals shared across sectors.

However, the reality is that the frameworks have introduced criteria that are often unworkable in social care settings.

And more needs to be done

In our conversations with social care leaders, several key issues came up repeatedly:

Structural expectations are out of reach

Requirements such as appointing a Senior Responsible Officer (SRO) at board level or having a dedicated preceptorship lead – make sense within NHS trusts but don’t translate into small, independent, or community-based providers that may not have board-level roles or even a formal workforce function.

Resources are stretched

Many providers support a small number of registered nurses across multiple sites. Absorbing additional roles or expectations into existing teams – particularly without funding or backfill – is often not possible, no matter how committed the organisation is.

One-to-one time is difficult to guarantee

The expectation of regular developmental conversations between preceptees and named preceptors is entirely appropriate – but in social care, where nurses often work alone or across locations, carving out protected time is especially challenging.

As it stands, even committed and capable providers are unable to meet national expectations – not because of the quality of their practice, but because the framework does not flex to accommodate different models of care. As we shift towards the neighbourhood health model and integrated health organisations (IHOs) as outlined in the 10 year health plan, this disconnect will only become more pronounced.

We risk losing talent if we don’t change this

If preceptorship policy continues to evolve primarily around NHS structures, we risk entrenching a two-tier system – where nurses in social care are seen as peripheral to workforce development efforts. This has practical consequences: fewer structured development opportunities, lower morale, and ultimately, higher attrition.

Social care is home to some of the most autonomous, complex, and person-centred nursing practice in the system. If we want to retain and grow this workforce, we must ensure that national approaches to preceptorship reflect the contribution – and potential – of every nurse, regardless of their setting.

Call to Action: Make national standards work for all

Current preceptorship frameworks must work across all settings, not just the NHS.

This means building in the flexibility to reflect the realities of social care delivery, where infrastructure, staffing models, and resources often look very different.

This is not a call for a separate social care preceptorship framework, but a clear ask:

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Adapt existing standards so that what counts as ‘gold standard’ in an acute NHS setting isn’t used as the default for all. Excellence in social care may look different – but it’s no less valid. NHS England – and, in time, the Department of Health and Social Care – must ensure that national frameworks recognise and enable excellence in social care.
Engage social care now during the piloting of the National Quality Mark. Those leading implementation should proactively involve providers across the sector to ensure relevance and feasibility from the start.
Promote and build on emerging support for preceptorship in social care. New offers – such as Skills for Care resources – represent important steps in a sector with limited prior provision. National leaders must now invest in strengthening support that is sustainable, widely accessible, consistently used, well-promoted, and designed to increase equity and standardise good practice across the sector.
Continue co-design with the sector. System leaders and policy makers work with social care to shape solutions that reflect the way social care operates.

Preceptorship must be possible — and visible — in every part of the health and care system. Let’s make that a shared priority.

Raluca Oaten, RN, is research and policy fellow at FNF, and Claire Leenhouwers is national professional lead for nursing at Skills for Care.