COMMENT

EDITORIAL BOARD Irene Anderson, Principal Lecturer and Reader in Learning and Teaching in Healthcare Practice, University of Hertfordshire Russell Ashmore, Senior Lecturer in Mental Health Nursing, Sheffield Hallam University Steve Ashurst, Critical Care Nurse Lecturer, Maelor Hospital, Wrexham Christopher Barber, Freelance Lecturer and Writer Dimitri Beeckman, Professor of Skin Integrity and Clinical Nursing, Ghent University, Belgium Jacqueline Boulton, Lecturer in Adult Nursing, Faculty Lead for student mobility, electives and global health, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London Beverley Brathwaite, visiting senior lecturer, Middlesex University Nicholas Castle, Head of Professions/ Assistant Executive Director, Hamad Medical Corporation Ambulance Service, Qatar Jothi Clara J Micheal, Group Director – Nursing, Global Hospitals Group, India Emma Collins, Nurse Consultant, Sexual Health In Plymouth, University Hospitals Plymouth NHS Trust Alison Coull, Lecturer at Queen Margaret University, Edinburgh Angela Grainger, Senior Lecturer, BPP University Michelle Grainger, Ward Manager, Moseley Hall Hospital, Birmingham Barry Hill, Programme Leader and Senior Lecturer, Northumbria University Helen Holder, Senior Lecturer, Nursing Studies, Birmingham City University Mina Karamshi, Specialist Sister in Radiology, Royal Free Hospital, Hampstead Jacqueline Leigh, Professor Nurse Education Practice School Health & Society, University of Salford Joanne McPeake, Acute Specialist Nurse/ Senior Staff Nurse in Critical Care; Honorary Lecturer/Practitioner in Critical Care, University of Glasgow John McKinnon, Senior Lecturer, School of Health and Social Care, University of Lincoln Michelle Mello, Deputy Director: Workforce Development / National Clinical Lead, Personalised Care Group, NHS England/ NHS Improvement Aby Mitchell, Senior Lecturer Adult Nursing, University of West London Ann Norman, RCN Criminal Justice Services Nursing Adviser and Learning Disability Nursing Adviser Joy Notter, Professor, Birmingham City University & Saxion University of Applied Science, Netherlands Hilary Paniagua, Principal Lecturer/Head of Doctoral Studies Faculty of Health & Well Being at the University of Wolverhampton Ian Peate, Director of Studies, Head of School, Gibraltar Health Authority Kendra Schneller, Nurse Practitioner, Health Inclusion Team – Vulnerable Adults and Prevention Services, Guy’s & St Thomas’ NHS Foundation Trust John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham Geoffrey Walker, Matron for Medicine, Cardiology and Specialist Nursing Services Poole Hospital NHS Foundation Trust Jamie Waterall, Deputy Chief Nurse, Public Health England; Honorary Professor, University of Nottingham Jo Wilson, Director, Wilson Healthcare Services, Newcastle Cate Wood, Research Fellow, Oxford Brookes University.

The supervisor conundrum Kate H Knight (k.knight@chester.ac.uk), Jacqueline Leigh, Victoria Whaley, Gay Rabie, Marie Matthews and Kate Doyle

Nurse education providers across the UK have seen a significant growth in applications to pre-registration nursing programmes, with a rise of 34% in England alone (Health

Education England (HEE) (2021). In response, HEE pledged £15m for additional clinical placements across nursing, midwifery, allied health professions and healthcare science. However, one could argue that, even with funding to support extra supervision and coaching models, there is limited capacity to increase student numbers within an already saturated NHS. Instead, it requires leaders of practice learning to lobby our regulatory body (Nursing and Midwifery Council) (NMC) to remove barriers that prevent the expansion of practice learning environments to deliver practice education for the future workforce.

There is a growing shortage of clinical placements due to the government policy of recommending care is brought closer to home away from the acute sector (NHS England/NHS Improvement, 2019). The halving of hospital bed numbers in England between 1987‑1988 and 2018‑2019 to 141 000 (Anandaciva, 2020) coincided with increased student intake.Therefore, there is a need to better use private, independent and voluntary organisations (PIVOs). These have often been established by unregistered professionals with personal experience of a particular social need who are often living the experience, who often have personal links with populations they serve.

Since 2018, however, higher education institutions (HEIs) have had to implement Standards for Student Supervision and Assessment that require practice supervisors to be health or social care registrants. Kyle et al (2021) highlight the value of having such registrants in addition to the nursing role and, although unregistered experts can contribute to student learning as part of a supervisory team, they cannot provide supervision for a full placement (NMC, 2018).This prevents students from professionally socialising in progressively integrated health and social care systems.

HEIs are trying to circumvent the restrictions by funding both long-arm supervision and assessment. However, if the registrant requirement were removed to allow supervision by a suitably prepared ‘competent enabler’, pre-registration nurses would have the opportunity to gain practical insight and develop socialisation skills within a social or PIVO arena as part of a standalone placement.

HEIs have excellent relationships with PIVOs but many organisations are no longer able to support student learners because they do not employ any health or social care registrants.The availability of PIVO placements would not only help develop the holistic practitioners of the future we need, but also increase capacity outside traditional NHS areas. It would also see a return to a better balance of health and social care, which was previously available to students through learning hubs and spokes.

In summary, for practice supervisors working with nursing students a suitably prepared ‘competent enabler’ could replace the need for a registrant for the entirety of a placement. Placements beyond the NHS arena would once more provide students with innovative opportunities to learn to communicate effectively with individuals across the life span, including people with learning disabilities, challenging behaviours and clients with mental health needs from diverse cultural and situational backgrounds.

HEIs will work closely with the practice learning environment to benchmark the experiences offered against placement learning outcomes.The use of a team approach to learning can empower students to achieve the proficiencies required for practice while receiving support from peers, service users and staff (registered and non-registered). HEIs will audit, evaluate the quality, impact and value, and continue to check the placement suitability, safety and provision as with any assurance processes. BJN

Anandaciva S. NHS hospital bed numbers: past, present, future. 2020.

https://tinyurl.com/6rbzyhw2 (accessed 2 November 2021) Health Education England. Expansion of clinical placements gets a £15m boost from HEE. 2021. https://tinyurl.com/4bfsa5fh (accessed 2 November 2021) Kyle RG,Atherton IM, Lasater K. Context, complexity and cross-

pollination: nursing leaders’ views of the role of the voluntary and community sector in nurse education. Nurse Educ Today. 2021; 99:104732. https://doi.org/10.1016/j.nedt.2020.104732 NHS England/NHS Improvement.The NHS long term plan. 2019.

https://tinyurl.com/y6dzmk2o (accessed 2 November 2021) Nursing and Midwifery Council. Standards for student supervision and assessment. 2018. https://tinyurl.com/aravcujp (accessed 2 November 2021)

Kate H Knight, Director of Practice Learning, University of Chester; Jacqueline Leigh, Professor, Nursing Education Practice, University of Salford; Victoria Whaley, Deputy Director of Practice Learning, University of Chester; Gay Rabie, Senior Lecturer, University of Chester; Marie Matthews, GM Enabling Effective Learning Environment Implementation Lead, University of Manchester; and Kate Doyle, Lecturer in Mental Health Nursing, Placement Lead, University of Salford td

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British Journal of Nursing, 2021, Vol 30, No 20