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Sustaining roles

An integral part of introducing new roles is ensuring that plans are put into place to sustain them. This ensures the desired outcomes for workforce redesign and patient care are achieved.

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Key learning points to sustaining roles are:

  • Key to ongoing success is monitoring where changes have been made and their impact.

  • Experience shows that engagement must be ongoing with the team and community around the new role, all playing a part in supporting it.

  • Working closely with education providers will ensure that there is a supply of new staff recruited with the right values and trained with the right skills to fulfill the posts.

  • Appropriate preceptorship schemes will enhance patient care and experience, improve recruitment and retention, reduce sickness and absence and result in more confident, skilled staff that are more satisfied in their role (NHS Employers 2021).

Why should we have preceptorships?

The beginning of a newly qualified practitioner's career can be a challenging time and their initial experiences can shape how they develop in their career. To ensure the best possible start for new healthcare professionals, a preceptorship programme is essential. The Nursing and Midwifery Council (NMC) defines a preceptorship as 'a period to guide and support all newly qualified practitioners to make the transition from student to develop their practice further'. The following outcomes from a preceptorship scheme will support sustainability of a new role: 

  • An adjustment period for the increased responsibility and accountability.

  • Opportunities to build further awareness of the role including by working with others such as support teams or clinical educators.

  • Additional supernumerary time to support the transition from qualified to confident practitioners, including extra support and training to ensure they were meeting their professional standards.

  • Extra time to ensure that those in new roles have good working knowledge of their roles and can reflect on how they can best integrate within their team/setting.

  • Development of peer support networks, where preceptorship programmes were divided into specific cohorts.


Action learning from those who have done it

The following is a collation of advice from interviews with those who have introduced and sustained new roles in their work:


  • Have a detailed plan at the beginning and a shared understanding of the role across the service.

  • Understand what the role is as much as possible before embarking on the change, become an expert in it and understand both the positives and the compromises.


  • Make yourself available as an ambassador to talk through with all parties involved, be sure that you give a realistic honest appraisal of the commitment required – this will save time later.

  • Early engagement and a consistent communication strategy will help you navigate any potential resistance, you must be prepared to tackle the difficult conversations head on.

  • Get everyone around the table from day one. Create an open and transparent space for honest discussion where everyone understands the roles and responsibilities of the project team and stakeholders, with actions that are clearly defined.

  • Include patient representation in your design and rollout to ensure that the change is understood and can be justified to meet patient need.

  • Work with as many different community groups and education settings as you can to promote the roles, this will give you an inclusive workforce representative of the community it serves. Work with your demographic for the population and the workforce, that will help you build a solid foundation for pragmatic change.

  • Ensure that you have appropriate clinical representation when developing a career pathway.

  • Spend time working across professional silos and bridging them, understand what is already in place for the service you are trying to introduce.

  • Have good partnerships with different organisations, work proactively with your stakeholders.

  • Do not underestimate the amount of pastoral care and wider support that those taking up the roles will require.


  • The change is not a straight line, you will need to allow your change project to have flexible boundaries so it can become embedded and work with and for the services that are already there.

  • Do not set it up with the view that there can’t be some failures, just make sure that it is safe to navigate bumps in the road and learn them when they happen, because they will happen. This will increase your chances of success and result in your change becoming embedded and business as usual.

  • Ensure all deadlines are understood to keep the programme on track.

  • Finally deliver the change in bite sized chunks, recognise that you are delivering it for the long term, so it needs to have clear metrics and be evaluated as part of making the change sustainable.


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