Finding and developing placements: responsibilities and procedures

Participants were asked about the process of finding placements, their perceptions as to where responsibility lay for finding these and the nature of their own role in this respect. All the trust participants commented as did most of their HEI counterparts (senior educationalists 3/5,

programme directors 4/6, lecturers with a link to practice 7/7 and a placement allocations officer). In Chapter 4, Section 4.4.2, it was noted that one HEI had had a dedicated placement allocation officer with a support team for some time and whom we interviewed, whereas the other HEI had only just recently appointed a placement allocation officer and who was not included in the project. 6.1.1 Responsibilities for finding placements

A response from one of the HEI senior educationalists summed up the main finding that emerged in relation to responsibilities for finding placements:

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“It lies everywhere and nowhere. I mean it really does it doesn’t lie anywhere. That is constantly negotiated.” (HSE3)

HEI and trust participants expanded on this notion of responsibility. Some HEI participants attributed overall responsibility for finding placements to the senior educationalist with a practice education remit and/or to the staff of the placement allocation office. A senior educationalist described their role thus:

“On paper I have responsibility for finding placements but in practice this is undertaken by a team of administrators and the lead lecturer for the [learning community of practice] who works on a day-to-day basis with the PEFs who actually look for the placements. My role would be to formalise this in [one of the committees].” (HSE5)

Programme directors referred to the diffuse nature of responsibility for finding placements; for example:

“There is no one person responsible, all of us are responsible to look and listen out for new

placements. That’s all our roles, not just one person’s role…. We are all constantly listening out as are the link lecturers but no one is specifically responsible.” (HPD1)

Another acknowledged that finding placements was part of her role but would have preferred a dedicated post-holder with this remit:

“In an ideal world it would be good to have somebody to whom we could give a plan with suggestion of types of placement and they could go and find new placements and do all the organisation required. A lot of the planning is done by others but it is part of my job and would be nice not to have. But I think it’s part of what we have to do.” (HPD2)

In HEI-1, the placement allocation officer said the post did not involve finding new placements and that this responsibility lay with other HEI colleagues and with the trust PEFs. There was some indication, however, from HEI-2 participants that the newly appointed placement officer did have a role in finding and developing new placements, with the community cited as the current focus of attention.

From a trust perspective, the PEFs described the nature of their role in finding placements while the senior educationalists said that responsibility for finding placements lay with PEFs rather than with them personally but that they liaised closely on the subject.

6.1.2 Finding and auditing suitable areas for placements

Participants gave details of new areas that they had identified, the process of assessing the

suitability of the area as a learning environment for students and, in some instances, decisions about which member of the HEI staff would be the link lecturer. Particular attention was devoted to settings where it was felt that there was room for expansion: GP practices; nursing care homes in the private sector, and in the community more generally. They either made arrangements for other staff to assess the suitability of newly found potential placements for students but often undertook this task themselves.

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A PEF described the auditing process once a new area had been found:

“Once we know of a new team or new service we would start exploring whether or not there will be capacity for students; for example the staffing profile, the number of mentors. If we decide it’s a good place for students then we do an audit, and start working with the team and the

manager.” (TPEF8).

An HEI programme director observed that although there were formal systems for developing placements, and identified personnel with a remit to this effect, informal contacts developed though close working with practice settings meant that they could achieve the process more quickly if undertaking it themselves. Examples of areas being developed included the following:

GPs surgeries: An HEI senior educationalist described how, despite initial reluctance, general practitioners were beginning to recognise the advantages of having students based in the practice and being able to contribute to patient care with tasks such as taking blood pressures. The placement agreement had been the starting point for negotiations that had included matters of insurance and liability. The practice nurses were also keen on having students and were now taking the mentorship course as part of the practice nursing course. Similar negotiations with GP practices were reported by PEFs.

Nursing homes: An HEI link lecturer discussing the inclusion of new nursing care homes in the placement circuit, said that a consideration was whether any of the link lectures were able to include it in their existing workload, particularly given the distances that might be entailed. A link lecturer for the independent sector described the detailed nature of the audit required for a new home that had recently expressed interest in having students. The audit entailed: making judgements about the types of students who could go there; the sort of support they would need; how many students could be placed there and so how many mentors will be needed; deciding who will take on the link lecturer role for the home; and having discussions with colleagues to ascertain whether the home could be included straight away in a hub and spoke model of practical experience or whether its inclusion would have to wait until mentors were in place.

Specialist mentors: A link lecturer described finding two specialist mentors who had agreed to be mentors (a cardiac failure and a diabetic nurse specialist) and went on:

“I then had to go out and have a discussion with both these people and do a practice environment profile and then discuss with them the expectations we have of them as a mentor and what they would expect back from us.” (HPL5)

Community: A link lecturer for a primary care trust described a broad-minded approach to developing settings in the community:

“Yes, anything I see not being used I will open up. In the community there is more and more we can look at which is not necessarily nursing – not district nurses or health visiting and we’ve got to look at care near home e.g. walk in centres, palliative care, inpatient unit in the community, community hospitals where we’ve got day surgery. Anything I can find we will use as long as it’s linking into a total programme.” (HPL1)

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Settings in which nurses were not present raised the issue of ‘due regard’ when auditing the area’s suitability for students. A PEF expressed concern about the NMC dictum in relation to assessment:

“It says ‘other professionals may be used if they are adequately prepared’ and we all think well what does that mean’?” (TPEF7)

Finding new placements was a resource intensive undertaking and this could limit the amount of new areas that could be brought into the placement circuit. For example, at the time of the

interview, a PEF said that they had reached saturation point in terms of the amount of time they had available to audit new areas.

6.1.3 Key points on responsibilities for finding placements

Finding placements emerged as a fairly major pre-occupation for HEI personnel who were constantly on the look-out for new areas to develop.

PEFs likewise were alert to how new services in their trust could offer practical experience for students.

Finding placements depended upon detailed knowledge of local services and responsibility was thus diffused among HEI and trust personnel and not located within one group. A substantial amount of work was involved for HEI and/or trust personnel in auditing new areas as suitable learning environments and capacity to do so could limit the number of new placements that could be included in the placement circuit.