Placements for Pre-registration Children’s Nursing Students in Primary Care Settings

This week’s EBN Twitter Chat on Wednesday 6th January between 8-9 pm (UK time) will focus on placements for pre-registration children’s nursing students in primary care settings. The Twitter Chat will be hosted by Jessie McCulloch (@jem8239) who is a Darzi Fellow based at London South Bank University and a children’s nurse and health visitor. This Blog provides some context for the Chat.

Participating in the Twitter chat requires a Twitter account. If you do not already have one you can create an account at Once you have an account contributing is straightforward. You can follow the discussion by searching links to #ebnjc (all Tweets), or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

Practice placements are an essential component of pre-registration nursing courses, comprising 50% of students’ learning. Placements enable the transition to becoming a nurse, application of theory to practice and ensuring that nurses have the skills required to become a registered professional ( Nursing and Midwifery Council (NMC) 2010). The NMC state that one of the aims of their 2010 standards was ‘to enable nurses to give and support high quality care in rapidly changing environments’ (NMC 2010 p.4).

National guidance and policy recognises children will benefit if they can be cared for out of hospital in appropriate settings (Department of Health [DH] 2010). This, in combination with the potential for better use of NHS resources and advances in treatment and care mean that more children are now cared for in the home environment (NHS England 2014). Around 25% of GP practice patients are children, and up to 40% of consultations are with children and families (DH 2010). Pre-school children visit the GP on average 6 times per year (DH 2007). Primary care is seeing rapid investment due an aging workforce, and changes to care delivery (Health Education England [HEE] 2015). The Royal College of Paediatrics and Child Health (2015) have recently recommended that GP practices should have access to a named children’s nurse and health visitor, yet most nurses in primary care come from an adult nursing background.

Acute and long term care out of hospital has moved towards provision by community children’s nursing (CCN) teams over the last 50 years (Royal College of Nursing [RCN] 2014). However, pre-registration nursing programmes usually offer hospital based placements (Roxburgh et al 2012, Cable et al 2015, Willis 2015). Government policy is committed to out of hospital care (NHS England 2014). To develop a modern workforce education programmes need to adapt to meet the need with greater provision of integrated, multidisciplinary placements in out of hospital settings (Cable et al 2015).

There are several studies supporting the importance and value of adult nursing students receiving community based placements (Cable et al., 2015). However, few studies have explored the needs of pre-registration children’s nursing students. Whiting et al. (2014) identified that widening access to out of hospital placements could prepare nurses with the skills to work in community children’s nursing teams at the point of qualification. This would support the current policy agenda to provide more skilled nurses able to provide acute and long term care outside of hospital settings (NHS England 2014). However, as there are capacity issues in relation to the number of placement available with CCNs, pre-registration children’s nursing courses offer placements in health visiting and school nursing teams but there have been few opportunities in other primary care settings.

Out of hospital placements enable students to understand the importance of public health, to change the perception of care delivery being totally hospital based and will encourage more nurses to work in community settings at the point of registration. Expanding the provision of placements in primary care settings could support the transformation of health care services and ensure we provide high quality care for children and their families.

We would be interested to hear your views and opinions on the following:

  1. What out-of-hospital learning environments are used for pre-registration children’s nurses in your area?
  2. What are the benefits and challenges of mentoring pre-registration children’s nurses in out of hospital learning environments?
  3. What inter-professional learning opportunities are there in out of hospital placements?
  4. How could mentors and students be better supported in primary care learning environments?

Jessie McCulloch, HEE NCEL Darzi Fellow and Senior Lecturer in Children’s Nursing, London South Bank University


Cable, C., Dickson, C. and Morris, G. (2015) Inspiring undergraduates towards a career in community nursing, Nursing Management, 22 (6), pp. 18-25.

Department of Health (2005) Evidence to inform the National Service Framework for Children, Young People and Maternity Services. London: DH.

Department of Health (2007) Making It Better: For children and young people. London: DH.

Department of Health (2010) Getting it right for children and young people: overcoming cultural barriers in the NHS so as to meet their needs. A review by Professor Sir Ian Kennedy.

Department of Health, Department for Children Schools and Families. (2009) Healthy lives, brighter futures – The strategy for children and young people’s health. London: DH, DCSF.

HEE (2015) The future of primary care. London: Health Education England.

NHS England, Care Quality Commission, Health Education England, Monitor, Public Health England, Trust Development Authority (2014). NHS five year forward view. London: NHS England. Available at:

Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice. NMC standards for mentors, practice teachers and teachers (2nd ed.). London: Nursing and Midwifery Council.

Nursing and Midwifery Council (2010) Education Standards for Pre-registration Nursing Programmes. NMC, London.

Nursing and Midwifery Council (2015) The Code. NMC, London.

Roxburgh, M., Conlon, M. and Banks, D. (2012) Evaluating Hub and Spoke models of practice learning in Scotland, UK: A multiple case study approach, Nurse Education Today, 32 (7), pp. 782-789.

Royal College of Nursing (2014) The future of Children’s Community Nursing: Challenges and Opportunities. London: RCN

Royal College of Paediatrics and Child Health (2015) Facing the Future: Standards for Acute General Paediatric Services. London: RCPCH

Whiting, L., Donnelly, M., Martin, D. & Whiting, M. (2014) Delivering effective nursing care to children and young people outside of a hospital setting. Final report. University of Hertfordshire: Hatfield

Willis, P(2015). Raising the bar. Shape of caring: a review of the future education and training of registered nurses and care assistants. London: Health Education England. Available at: [Accessed 09/11/15]

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