Super Vision #ScIL17

How ScIL gave us the super power of ‘super’ vision!

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Gail Nash, Senior Educator, AHP Practice Education Programme, NHS Education Scotland.

Follow Gail on Twitter here

September 2018 saw the Prosthetic and Orthotic staff, based at NHS Lothian SMART Centre, embark on their transformational supervision journey as a NHS Education Scotland (NES) Scottish Improvement Leaders (ScIL) project commenced.

At this point the team knew that only 22% of staff were participating in supervision and this was not regular. They also knew there was a lack of awareness about terminology and anxieties around what was required to implement quality supervision into everyday practice. The results from the national survey mirrored these anxieties. This is their journey…..


‘What did we do?’

Initially a half day workshop was undertaken providing the Prosthetic and Orthotic team with knowledge of the principles described in Scotland’s Position Statement on Supervision for AHPs. We asked a number of questions.

‘What do you want your supervision to look like and what is getting in the way?’

Screenshot 2019-06-21 at 08.01.33

The team took time to start to really look at at this and came up with this powerful wordle describing how supervision should look. This was a great starting point. You may want to use some quality improvement tools to start to ‘understand your system’ and articulate your project. This part of the process helped us define our project aim and the family of measures.


Project aim : Project measures

The team used a number of other QI tools. A fish bone diagram helped explore the barriers to undertaking supervision. The key areas were:

  • lack of process and structure,
  • individual’s confidence in their knowledge and skills,
  • the culture, and
  • staff engagement and motivation.

A driver diagram helped visualise these four primary themes, the theory of how the aim of the project would be met, which parts of the system needed to change and ideas to make this happen. Other tools which were really helpful at this point included our communication, project and measurement plans. These tools were crucial to keeping the project on track. Screenshot 2019-06-22 at 08.29.12

The team’s ‘Sparkle Board’ was invaluable as a way of displaying project outputs, key messages and a focal point where practice could be shared.


‘What did we change?’
The following provides summary of the work we undertook. Anything you can take from this?

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What are we noticing with our ‘super’ vision?’

We are now five months into the project and, though it is still early days in terms of the data that we have, we are noticing some changes. Some of our early results are below:

  • There is an upward trend of staff reporting that supervision is supporting their feeling of wellbeing. Average wellbeing scores have increased from 3.4 to 7.1 over the past five months

Screenshot 2019-06-22 at 08.27.39

  • Staff were asked for a word to describe supervision. These were collected on a monthly basis and the wordles show a change in the types of words staff are using

Screenshot 2019-06-21 at 08.09.47

  • Staff are generally valuing supervision being part of the culture in their workplace
  • Staff are now engaging in regular supervision practice. Although it is still early days in terms of data the following graph shows an increase in the percentage of staff undertaking supervision – we hope this will be maintained.

Run chart receiving supervision June 2019

  • There was the perception that time to implement supervision was a barrier and that would mean patient activity would be adversely affected. This was a concern of staff – this has not been realised. Patient activity was not affected.

I chart patient activity June 2019


‘What is next’

The P&O supervision journey has most definitely just started. It is felt that this will be sustainable if we continue to pay attention to the four key areas:

  • Culture
  • Process
  • Knowledge and skills
  • Staff engagement

We are now looking at how we can spread the findings from this project across other professions and board areas and feel it could provide learning for others wanting to implement supervision practice in their workplace.

For more information get in touch:

Gail Nash, Senior Educator, AHP Practice Education Programme, NHS Education Scotland / ScIL C17 gail.nash@nes.scot.nhs.uk @gailnahped

Nicola McCormack, Orthotic Lead, NHS Lothian, Nicola.mccormack@nhslothian.scot.nhs.uk @NicolaMcCormac7

Tom Geddes, Prosthetic Lead, NHS Lothian, Tom.geddes@nhslothian.scot.nhs.uk @TomGeddes8

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