This page summarises our findings from reviewing education providers and programmes in recent years.
It provides our view on the quality of practice-based learning, including our regulatory requirements, and what we commonly see in programme design and delivery.
This information should be considered by education providers when developing new and existing programmes, linked to this area.
Our threshold requirements
- there is a thorough and effective system in place for approving and ensuring the quality of practice-based learning (SET 5.3); and
- practice-based learning takes place in an environment that is safe and supportive for learners and service users (SET 5.4).
- practice-based learning is of the required quality to support learners to progress through programmes, and meets our requirements for registration.
Summary reflections
Systems are in place to ensure that practice-based learning is initially approved and regularly monitored, to ensure it is of good quality and undertaken in a safe environment.
There are normally well-established audit processes for practice-based learning, covering areas such as availability of experiences, supervision expected, and whether relevant policies and processes are in place to ensure a safe and supportive learning environment. Audit tools normally include ensuring that appropriate staff are in place in the practice setting. These audits enable education providers to make specific judgements on the quality of practice provision and the safety of learners within that provision. There are also normally mechanisms to gather and act on feedback from learners and practice educators.
Strong strategic and operational relationships with practice partners were helpful in resolving any issues and maintaining or improving the learning experience to required standards.
Education provider approaches
To ensure and maintain the quality of practice-based learning, there are defined quality arrangements such as:
- initial and ongoing review and sign off of practice learning providers;
- embedding of arrangements into contracts; and
- feedback mechanisms for learners and practice partners.
Education providers also often consider external reference points and assessments relating to practice education, such as:
- National Education and Training Survey (NETS) results, only applicable for HEI education providers in England, which are focused on learner experience of practice-based learning;
- Care Quality Commission reports, to enable intervention and ,if needed, removal of learners, where practice education providers were failing;
- the NHS Education Contract 2021-2024, which is the “formal mechanism for the relationship between [Health Education England] HEE[1] and [practice education] providers”[2]; and
- regional groups, for example groups run by NHS England Workforce, Training and Education Directorate aimed at refining practice-based learning audit processes and addressing issues.
Education providers in Wales are part of a national placement allocation and quality model, (the All-Wales Placement Reference Group, which is overseen by Health Education and Improvement Wales. Education providers are also part of the All-Wales Student Healthcare PACT (Partnership, Accountability, Credibility, Trust), which is a set of pledges co-produced by education providers through the All-Wales reference group, to help empower positive learning experiences.
When proposing new programmes, education providers align proposed programmes with internal and external quality assurance assessments linked to practice-based learning.
[1] Health Education England merged with NHS England in 2023, as the functions performed by HEE are now undertaken by NHSE’s Workforce, Training and Education directorate
[2] New NHS Education Contract | Health Education England (hee.nhs.uk)
Current sector focus and challenges
There are some challenges with the quality of practice-based learning, particularly stemming from needing to secure additional practice-based learning opportunities due to programme expansions. Education providers identify these challenges through existing quality mechanisms, which shows they are working well, and are able to put specific interventions in place where needed to ensure good practice-based learning experience for learners.
Some education providers could do more to consider external assessments of practice education providers, and will set clearer expectations that all information about the quality of practice-based learning should be considered when making decisions about continuation of, and support for, learners in practice settings.
Sometimes it was difficult to interpret NETS results, with low response rates for the exercise.
Areas commonly explored further through our assessments
Proportion of performance review assessments with quality activities / referrals
Quality of practice-based learning:
Quality activities
Referred to performance review
Referred to focussed review
Baseline - all quality activities/referrals:
Quality activities
Referred to performance review
Referred to focussed review