![Practice based learning](https://www.rcn.org.uk/-/media/Royal-College-Of-Nursing/Images/Hero-Images-Full-Screen-1900x380/Professional-Development/Practice-based-learning.png?h=380&w=1900&la=en&hash=E021A945D2D8F01B4B9ACEDC8FCCA8C0)
Practice placements in Independent Health and Social Care settings
Gaining experience across the breadth of health and social care service provision is a vital aspect of nurse training.
Whilst opportunities to undertake practice placements in the independent health and social care (IHSC) sector have always been an important part of nurse training, the introduction of Integrated Care Systems (ICSs), have seen an exponential growth in capacity for student nurses and trainee nurse associates (TNAs). The importance of organisations coming together to work in partnership will enable a consistent approach to health care and a seamless transition between services for those requiring care and support. The King's Fund explains more about the role of Integrated Care Systems.
Some Integrated Care Boards (ICBs) are working with NHS England’s Workforce, Training and Education Directorate to develop placement capacity and innovative opportunities for nursing students and TNAs across both NHS and IHSC settings. These opportunities can enhance students’ understanding of the breadth of health and social care services and increase knowledge around the journey of the patient or service user. It is vital that registrants understand the importance of the IHSC sector, so that a skilled and collaborative workforce can provide the best standard of health care provision.
“Social Care offers a diverse and broad experience for undergraduates on all programmes. The fundamentals of care is one aspect but the complexity of working with multiple agencies, governance, compliance, management, leadership building strong sustainable relationships with those using services and their families. Social Care is more than Care Homes, it’s about specialist settings, people’s own homes, drug and addiction services, Learning Disability services, Autism, older and younger working age adults. The autonomy and complexity of care means you will be working in Nurse led services, social care nurses must have honed assessment skills, best clinical judgement and tenacity to get the job done. You will learn to support people to live their best lives, be creative and stand on your own two feet. It’s also fun as you work and support people every day to experience the best of it.”
Deborah Sturdy, Chief Nurse Adult Social Care, Department of Health and Social Care
The student experience
Commencing a practice placement can be a nerve-wracking time for any nursing student or TNA. Nursing students can feel apprehensive about working with an unfamiliar team and uncertain about what is expected of them and how they will fit in. Often, organisations in the IHSC sector can add an additional layer of unfamiliarity, and this can sometimes increase feelings of apprehension. However, it is inevitably the case that practice placements in the sector provide a positive experience, with nursing students and TNAs gaining new and unique skills and knowledge that can only be found in IHSC settings.
Placements in the IHSC sector provide student nurses and TNAs with the opportunity to gain skills and knowledge in individualised, person-centred care and support across a vastly diverse range of services. Service provision across the sector comes with its own challenges, both in terms of management, regulation and governance, as well as the unique lived experience of those individuals requiring support. No day or person is the same across the sector, and this can result in nursing students and TNAs developing a whole new creative outlook to the provision of individualised care.
In this blog, Sioned Wyn Jones shares her experience of a nursing home placement which shattered her preconceptions about social care and care home nursing.
Services in the IHSC sector include the following examples, although the list is not definitive:
- health care provision in criminal justice, including prisons, police and courts
- hospice and end of life care
- nursing and care homes
- independent hospitals
- low, medium and high secure environments
- general practice nursing
- school nursing, including schools for pupils with additional learning needs
- drug and alcohol dependency services
- mental health, learning disability and autism services etc.
“As a second-year Learning Disabilities nursing student, I have had the privilege of experiencing placements in both public and private voluntary independent (PVI) sectors, providing me with a well-rounded perspective. My time in the PVI sector has exposed me to many patient demographics, care settings, and healthcare practices. This exposure has played a pivotal role in honing my adaptability and resourcefulness, empowering me to navigate diverse healthcare environments confidently. Exploring different management structures and operational models has deepened my understanding of the administrative side of healthcare delivery, granting me a more comprehensive grasp of healthcare systems. Consequently, I am much more equipped to tackle the challenges of professional practice.
Given the dynamic evolving nature of healthcare, with an increasing number of services being outsourced, I strongly advocate for students to have opportunities in both public and PVI sectors. This balanced approach fosters collaborative learning, enabling students to draw from each sector's unique insights. My experiences in PVI sector placements have sparked my curiosity, leading me to innovate and explore alternative care delivery models tailored to the specific needs of various populations. This journey has refined my patient-centred approaches to healthcare delivery and deepened my understanding and empathy as I prepare for my future healthcare career.”
Larissa Haldane, Second Year Learning Disability Nursing student, Winchester University
Practice placements in the IHSC sector offer insightful opportunities to learn and work in a wide range of environments with an array of approaches to holistic, creative, person-centred, and person-led care. It is important that the value of IHSC provision is recognised as part of the educational journey of the student nurse and TNA.
“My experiences both clinically and from an HEI perspective indicate that Nurses often struggle to understand the implications of living with social care support whether that be in independent living environments, or congregated settings. This can have significant consequences for individuals and their support staff, as while the individual might be deemed ‘medically fit for discharge’, the question as to whether they are ‘safe to return home’ can be more pertinent to ask. In my experience, Nurses who have had practice placements in social care, including private and voluntary and independent providers, are better able to ask nuanced assessment questions and effect better quality continuity of care.”
Daniel Marsden, Senior Lecturer and Professional Lead, Learning Disabilities, Canterbury Christ Church University
A nursing workforce fit for the future
To build a nursing workforce with the skills and knowledge required to meet the contemporary challenges of health care provision, it is vital that our nursing students and TNAs are exposed to the wide range of experiences offered across both the NHS and the IHSC sector.
The unique and varied environments that shape health care provision provide endless opportunity to develop robust, creative, individualised and person-centred approaches to meet the needs of those who we support across every health care setting. It is part of our duty as nurses to meet the challenges that are presented across every environment in which we offer support, and this is only possible with access to a diverse range of experiences throughout the student nurse and TNA journey.
“Social care placements offer a wealth of opportunities for student nurses and nursing associates. These opportunities are often undiscovered until a student experiences their first placement in a social care setting. We’ve heard from students that doing so immediately dispels any myths or preconceptions about social care nursing. At Skills for Care we are committed to increasing the development of nursing placement opportunities in social care environments because of the value of these within pre-registration nursing programmes. Our guidance highlights the benefits for students, staff, employers and most importantly people who draw on care and support. The future nurse needs to be equipped to work in any potential work setting and exposure to social care opens up a whole world of possibility for a nursing career which truly encapsulates the meaning of person centred care.“
Claire Leenhouwers, Registered Nurse, Mental Health, National Professional Lead, Skills for Care