At a time when health and social care systems are under pressure to grow, adapt and work more closely together, Sarah Kingdom-Mills, now Education Development Manager at Health Education and Improvement Wales (HEIW) recognised an opportunity to rethink how and where student nurses learn.
Through her Bevan Exemplar project, she led the creation of practice learning environments within care homes, helping to increase student nurse placement capacity and strengthen the integration between health and social care. The initiative sought not only to open new placement opportunities but also to raise awareness of the social care sector as a skilled, rewarding and essential part of nursing practice in Wales.
The Challenge
Access to high-quality clinical placements is vital to developing the future nursing workforce. However, health care placements are frequently over capacity while opportunities in social care remain underused. The social care sector offers untapped potential — a diverse environment where students can develop key skills in person-centred, long-term and holistic care.
There are challenges concerning placements in care homes, including limited connections between education providers and care homes, uncertainty about standards and supervision, and a lack of understanding about how social care settings could meet nursing learning outcomes.
This project aimed to overcome these barriers by developing the infrastructure, partnerships and governance needed to make placements in care homes a sustainable and high-quality option for students.
The Innovation and Impact
Working initially in Carmarthenshire, Sarah collaborated with local authorities, health boards, education providers and care home managers to design a structured model for student placements within care homes. This included developing clear processes for educational audit, supervision and assessment; aligning placements with Nursing and Midwifery Council (NMC) standards; and ensuring compliance with Care Inspectorate Wales requirements.
The approach demonstrated that with the right support, care homes could provide rich and varied learning experiences. Students gained valuable insight into multidisciplinary teamwork, leadership, and long-term condition management — areas often less visible in hospital-based placements.
Many students who completed care home placements went on to take up their first posts in the social care sector, helping to address workforce challenges and build confidence across the system. Feedback from participants highlighted how placements changed perceptions of social care, revealing it as a dynamic environment offering professional development and meaningful relationships with residents.
The project also benefited care homes by strengthening professional links, improving staff confidence, and increasing opportunities for collaboration on wider initiatives — such as verification of expected death and continuing education programmes.
While not defined in financial terms, the project’s value lay in its social and system-wide impact — expanding placement capacity, improving understanding between sectors, and enhancing the visibility of social care as a learning environment. The project proved that with the right support, social care can play a pivotal role in training the next generation of nurses.
Support from the Bevan Exemplar Programme
The Bevan Exemplar Programme provided the structure and tools to help shape, communicate and sustain the work. Techniques such as stakeholder mapping, elevator pitching, and the ‘five whys’ approach helped Sarah to identify key influences and articulate the project’s impact. These tools not only shaped the project design but also helped Sarah communicate its importance to senior stakeholders and national networks.
Professional Growth and Wider Influence
Participating in the Bevan Exemplar Programme gave Sarah the confidence to present at conferences, publish findings and network across Wales, building the foundations for ongoing collaboration.
“It pushed me outside my comfort zone — engaging with people from different sectors and learning how to adapt improvement tools to different contexts.”
It has also had a lasting impact on Sarah’s professional journey. It contributed to her successful Queen’s Nurse application and inspired her to take on wider leadership roles, including Regional Lead for Wales for the Queen’s Institute of Community Nursing. She continues to mentor others embarking on their own innovation journeys, often encouraging them to consider the Bevan Exemplar Programme.
Her project findings were also published in the International Journal of Nursing Practice (2024) under the title “Expanding Student Nurse Placement Activity in Welsh Care Homes: An Evaluation Study.”
“It’s given me a much wider perspective — I now think strategically about workforce and system design, not just direct clinical practice.”
Legacy and Next Steps
The pilot quickly gained momentum. What began in one local authority expanded to regional implementation across North, South-East and South-West Wales, supported through HEIW. Dedicated regional roles helped scale the model, creating consistent processes and quality standards for placements.
Although dedicated funding for these roles has since ended, the placements created remain active — now maintained through local placement teams — demonstrating the project’s sustainability and embedded value.
Sarah continues to draw on the project’s evidence to inform workforce planning and policy, advocating for social care to be recognised as a key component of nurse education. Her work has influenced HEIW’s Education and Training Plan and ongoing discussions with the NMC about commissioning models across the UK.
Conclusion
By creating practice learning environments within care homes, Sarah Kingdom-Mills’ Bevan Exemplar project has reshaped how student nurses experience social care — demonstrating its potential as a rich, high-quality learning environment and vital part of Wales’ health system.
Her work continues to influence workforce planning and policy, inspiring others to look beyond organisational boundaries and achieve change together. In doing so, it embodies the spirit of the Bevan Commission and builds a more connected, confident and compassionate workforce for the future.
