Understanding the three different types of supervision

This chapter focuses on NHS England’s three types of supervision, exploring the purpose and wider benefits of each type.

The chapter will demonstrate how each supervision type can support supervisees in their professional development, enhance patient safety and boost team work. There will be an opportunity to review your own organisation’s supervision, and consider what could be done differently to work towards effective supervision within and across your teams.

Learning outcomes

•What is supervision?

•What are NHSE’s different types of supervision?

•What is the purpose of supervision / what different things does it need to achieve?

•Things to consider to ensure on-the-day (clinical) practice supervision is effective

•Wider benefits of effective supervision

Chapter resources:

The following resources are available to share with your practice team or to support you to work through the workshop learning:

A narrated slide deck on the chapter is available to watch or download, so you and your team can work through it at your own pace.
Workbooks with space to complete exercises and note your reflections on key concepts and reinforce learning; one in PowerPoint format to add your own responses, and one on PDF format which can be printed.

Additional resources

NHS England supervision guidance for primary care multidisciplinary teams

This guidance supports primary care networks (PCNs) and GP practices to provide effective supervision for their growing multidisciplinary teams (MDTs). It:

sets out principles of supervision for roles new to general practice
identifies best practice to support the development of good clinical governance
provides guidance on training and developing the workforce.

NHSE Supervision Guidance

Case studies

NCL practices have provided feedback on how changes made relating to themes in this chapter have had a positive impact on supervision and multi-professional teamwork:

What needed to change (what needed improvement)?	What changes were made? Who led and supported change?	What were the results? How has this improved daily work at the practice / within the team?
Supervision of ARRS clinicians (Physiotherapists & Paramedics) was handled by the duty, which meant the supervising GP was short on time/had other distractions (urgent calls) while overseeing clinical cases.	Clinical cover was reorganised so that another senior GP in the practice can provide supervision to ARRS staff. If complex clinical cases arise, it’s the responsibility of the supervising GP to deal with the urgent issues, but to ask the supervising clinician to go through the case in more depth/detail during their tutorial.	This resulted in safer supervision outcomes for staff and patients. It also helped to clarify responsibilities and communication channels for the named clinical supervisor, supervisee, and wider team working on the day.
Ensuring adequate supervision for all team members at the practice.	This was discussed at an all-staff meeting, where it was agreed that the practice timetables: a named supervisor for each practice session; and a supervision lead for each trainee.	Supervision cover is managed so that support is always available and accessible for trainees, resulting in safer practice and patient care.
The practice wanted to improve supervision arrangements to be responsive to supervisee needs and to help address supervisor fatigue.	The practice restructured supervision schedules to minimise confusion and wait times for trainees needing help, while considering any additional burden on supervisors.	A practice framework now exists to support sustainable supervision model that considers the needs of both supervisees and supervisors, informed and updated based on feedback. This has led to safer supervision in practice.