Leeds Primary Care Student Leadership Placement

Erin Carr and Megan Preene talk about their experience of the Leeds Primary Care Student Leadership Placement.

The purpose of this blog is to evaluate The Leeds Primary Care Student Leadership Placement as part of our Adult Nursing Degree at Leeds Beckett University, which we are close to finishing in July 2023.

Prior to the placement, we received an email from the Practice Learning Facilitator (PLF), followed by a MS Teams meeting to introduce ourselves and for the PLF to outline the aims, objectives and learning outcomes for the placement. Initially, we experienced mixed feelings such as excitement, as we had not yet had the opportunity to experience a placement in primary care, but anxious too, as we knew that leading our own clinics would be a huge responsibility and would require us to demonstrate leadership skills and autonomous working.

The placement was 10 weeks in duration, working across several GP practices within the Primary Care Network (PCN), leading on three NHS health check clinics per week and one day per week working in a local third sector community hub. The placement was structured so we could gain a greater understanding of the PCN population health needs from the local walkabout, the health needs assessment workbook, and other sessions around social prescribing, health and well-being coaching and digital health. With support, the placement allowed us to become competent in venepuncture, which was a fundamental skill required to complete each NHS health check. The venepuncture proficiency was crucial for professional development and identifying long term health conditions such as diabetes and risk of cardiovascular disease.

Due to the nature of the questions in the NHS health checks, skills such as motivational interviewing and building rapport were essential in managing sensitive conversations. This promoted patient centred care, as we were able to identify and manage their health needs, providing support around what mattered to them. Health education and promotion enabled us to sign post and refer onto appropriate services following the NMC guidelines and local policy of gaining informed consent. Both the community hub days and NHS health checks clinics highlighted the importance and benefits of digital inclusion and how it allows individuals to self-manage their health and well-being. For example, booking appointments, checking test results and ordering repeat prescriptions online, which reduces pressure on the NHS and improves population health.

Overall, our experience was very positive, and all members of the multidisciplinary team were welcoming and offered constructive feedback. Being well supported and supervised allowed us to reflect and develop our practice and skills as third year student nurses. We recommend that other student nurses who are offered this placement experience fully immerse themselves in the opportunity. Following The Leeds Primary Care Student Leadership Placement, we have requested to return for our final placement and feel excited to work as general practice nurses on completion of our degree.

About the project

Hayley Ingleson – Leeds Community Healthcare NHS Trust (LCH) and Leeds Primary Care Practice Learning Facilitator – developed a new and innovative ten week practice learning opportunity as part of the Queen’s Nursing Institute Community Nursing Innovation Programme (CNIP) 2022-2023 which would provide high quality, safe and effective learning to occur in the general practice setting, whilst adding meaning to the student journey and demonstrating the value of the student contribution to service improvement and delivery.

The overall aim of the Student Leadership Placement is to expand sustainable high quality practice learning opportunities across primary care for pre-registration Adult Nursing learners. There was a focus on expanding knowledge and demonstrating leadership skills through three fundamental aspects of general practice healthcare during the 10-week placement:

1. Public Health/health needs/health inequalities
2. Preventative healthcare
3. Digital health and digital inclusion

In the first ‘structured learning week’ of the placement, the four third year adult nursing students accessed a variety of clinical teaching sessions which enabled them to gain a foundational knowledge of primary care. These sessions included a placement induction and clinical systems overview, overview of primary care, ICB population health data and the Healthy Leeds Plan, Local Care Partnerships, getting to know the primary care network, health and well- being coaching, social prescribing, digital health and inclusion. The four students were also asked to complete activities including a health needs assessment workbook, locality walkabout, case study activity and the NHS Health Check e-learning on e-learning for health.

In the second and third weeks of the placement the four students shadowed the practice nurse and healthcare assistant colleagues to learn more about their integral role in preventative healthcare, learning more about the systems and processes around delivering NHS Health Checks. The four students were supported to achieve their venepuncture skill, building on the theory and simulation gained in the academic setting and shown how to navigate both clinical systems (ICE, SystmOne).

Over the next 5 weeks of the placement, the four students (in pairs) led on three NHS Health Check Clinics per week across 6 practices within the PCN and spent time each Tuesday in a third sector community hub. Spending time in the community setting gave the students the opportunity to build therapeutic relationships with a diverse population group and enabled them to have meaningful conversations about health needs of service users, identifying what matters most to them. In the final week, the four students were provided with further opportunities to shadow the practice nurse and worked with the project lead/PLF to review each consultation looking at what they had identified throughout their clinics. This gave the students the chance to reflect on their learning journey and the difference they had made to individual health and the overall PCN population health.

The final celebration event took place on the 27^{th of} January 2023 and provided the project lead/PLF and the 4 students to share their learning and successes. Over the course of the 10-week placement the students were able to offer 380 NHS Health Check appointments, of which 299 were attended. They identified 65% of the 299 were low risk of developing cardiovascular disease (Stroke/heart attack) in the next ten years, 26.7% were medium risk and 6.68% were considered high risk. All those considered medium risk and high risk were provided with tailored support and follow up as per NHS Health check guidance. Some powerful individual impacts health system impacts were also seen.

For further information about the Leeds Primary Care Student Leadership Placement please contact Hayley Ingleson (Practice Learning Facilitator for Leeds Community Healthcare NHS Trust and Leeds Primary Care) at hayley.ingleson@nhs.net