The evidence tells us that supervision is vital to ensure we are delivering effective and efficient interventions to people who use our services, supports personal and professional development, and supports staff well-being (Rothwell et al. 20191). HCPC research (2,3) also confirms that supervision is a key scaffold to support practice, but the question remains – are we achieving this?
Supervision is described as:
“A working alliance between practitioners in which they aim to enhance clinical practice, fulfil the goals of the employing organisation and the profession and meet ethical, professional and best practice standards… while providing personal support and encouragement in relation to professional practice.” (Kavanagh et al (cited in Dawson, 2013)).
Scotland’s Position Statement on Supervision for Allied Health Professions (4) was launched in April 2018 (updated in September 2018) and defined the key guiding principles for quality supervision practice. It highlighted that ALL AHPs should be participating in effective supervision regardless of their role, banding, experience, or work setting. Although we knew anecdotally that supervision was taking place within AHP services, the national scoping exercise, undertaken at the end of 2018, highlighted a number of key issues; supervision practice was very disparate; supervision was not uniformly available; staff weren’t often sure what should be covered in supervision; lack of clarity about the type, mode, frequency and how to record supervision; staff not feeling confident (as a supervisor or supervisee) but not sure where to access education to support their practice.
The AHP Practice Education team at NES developed a national working group to support implementation of the principles identified in the Position Statement. Alongside this, funding was secured to bring capacity into the team to design, deliver and evaluate evidence-based education to enable AHPs to participate in quality and meaningful supervision practice. The team used a quality improvement approach to this, working with the workforce to identify change ideas and undertake rapid tests of change using the Plan, Do, Study, Act (PDSA) process.
COVID 19 disrupted everything…
This led to the need for our education and resources to be adapted, and upskilling of staff to be able to deliver sessions using technology enhanced learning (TEL). During this time the team:
- re-designed and re-tested our educational programme and how it would be delivered
- learned how to use new platforms and apps
- enhanced facilitation skills to ensure a quality learning experience was being provided for all participants in a digital setting
The team worked closely with the board AHP Practice Education Leads (PELs) to develop infrastructure to reach as many AHPs as possible and ensure that the implementation of this workstream was effective.
This was achieved by the team:
- holding introductory webinars for all AHP staff in Scotland – this reached 2236 participants with an additional 1965 viewed the recordings with our resource packs being downloaded 1044 times
- developing a TURAS page with information and resources. Nursing. Midwifery and AHP (NMAHP) clinical supervision units on TURAS pages have received 7155 views whilst the AHP learn site supervision pages has so far had 7386 visits.
- delivering workshop sessions for PELs and board ‘champions’ to ensure they were familiar with educational materials and sustainability was integral to the implementation process.
- 74 co-facilitated skills sessions entitled “Key skills of a supervisor and how to apply in practice’ were delivered across all boards in Scotland to 896 participants.
- undertaking national evaluation which demonstrated that:
- 99% would recommend this training to others
- 98% reported the education met the intended learning outcomes
- The confidence to undertake the role of a supervisor rose from 24.3 % pre-course to 75.8% post-course.
The next steps for the group will be to analyse the national survey data (which is out now and can be accessed here), develop a learning programme, launch the supervision units and undertake consultations on the national recording guidance and Scotland’s Position Statement on Supervision for AHPs.
A summary of the work to date can be accessed here and more detail on the education resources available to support supervision practice can be found on TURAS.
Allied health professions (AHP) supervision education sessions | Turas | Learn (nhs.scot)
If you are considering a role in education or looking to gain experience in this area keep an eye open for development opportunities that come up.
Development Opportunities | Turas | Learn (nhs.scot)
Acknowledgements
NES colleagues, AHP PELs
References:
- Rothwell C, Kehoe A, Farook SF, et al. Enablers and barriers to effective clinical supervision in the workplace: a rapid evidence review. BMJ Open 2021;11:e052929. doi: 10.1136/bmjopen-2021-052929
- HCPC. Preventing small problems becoming big problems 2015. Preventing small problems from becoming big problems in health and care | (hcpc-uk.org)
- Rothwell, C., et al (2019). The characteristics of effective clinical and peer supervision in the workplace: a rapid evidence review. Newcastle University, for HCPC. https://www.hcpc-uk.org/globalassets/resources/reports/research/effective-clinical-and-peer-supervision-report.pdf
- NES. Principles and guidance to support the provision of supervision for all AHPs and AHP Health Care Support Workers (HCSWs) working across health and social care in Scotland 2018. Scotland’s position statement on supervision for allied health professions | Turas | Learn (nhs.scot)
AHPs across health and social care. 