Supervision in the AHP workplace - is it required and how can it be successful?

But what actually is it, and what are the key factors for it to be carried out effectively? We have been looking at the evidence to give you some guidance.

What is supervision?

There are many definitions out there, including the description used by Rothwell et al (2020), in their rapid review of the evidence surrounding the characteristics of clinical and peer supervision in the workplace:

“Supervision includes an ongoing professional workforce relationship, between two or more staff members with different levels of knowledge or expertise, for the purposes of support and the sharing/enhancing of knowledge and skills to support professional development.”

What are the benefits of supervision?

Again, a myriad of studies have looked at this including Rothwell et al (2021), which listed the following key benefits:

• Job satisfaction and staff retention - AHPs feel they are being actively supported in developing themselves, helping them to feel confident in their professional abilities, ultimately gaining more enjoyment and fulfillment from their work as a result.
• Reduced stress and anxiety - working as an AHP can sometimes be lonely, especially where you find yourself as the only one of your profession in a multidisciplinary team, or working independently. Having someone to talk things through with, especially someone with an understanding of your field, can definitely help alleviate stress and manage difficult emotions that may crop up.
• A better working environment - increased communication, knowledge sharing and problem-solving can all arise from a workplace where supervision regularly takes place.
• The increased quality of care - ultimately, effective supervision can lead to an improvement in service delivery, as the supervisee becomes upskilled, learns from the supervisor and feels supported in doing their job.

When is supervision most effective?

Snowdon et al (2020) found three main areas to emerge from a qualitative research analysis, which were all important in ensuring supervision is carried out effectively. Supervision is most effective when:

• There’s a focus on professional development - AHPs found clinical supervision to be most effective when it was used to discuss and support their professional development, rather than discussing their day-to-day performance and operation of their role. Ideally, the supervision should be flexible and adaptable to their learning style.
• The supervisor is well-trained - the sessions work best when the supervisor possessed the skills and attributes required to facilitate a constructive supervisory relationship. Professionals reported that they were more likely to prioritise clinical supervision and seek their supervisor’s professional opinion and guidance when their supervisor had expertise in their field of practice.
• There is a conducive environment - it was important that the organisation provided an environment that facilitated the supervisory relationship. There were also several practical steps identified that organisations could take to ensure the environment was suitable. These steps included ensuring a confidential space is available, providing resources such as documentation templates and a supervision contract between the supervisor and AHP, and ensuring co-location of the supervisor and supervisee.

Barriers to supervision

HCPC highlights a report by Rothwell et al (2019) which, as well as citing the key success factors mentioned above, also highlights the stumbling blocks which can occur when attempting to set up supervision in the workplace:

• Lack of time - many of the papers discussed how supervisors were unable to find time for supervision due to busy environments, which ultimately restricted supervisor flexibility and quality when they did find the time. Some studies reported that there was a lack of opportunity and time for reflection within supervision, which could leave individuals feeling that they had to ‘figure things out’ for themselves without adequate support.
• Lack of management support - if the management or organisation does not encourage or recognise the importance of supervision, then it is unlikely that it will become embedded into the organisation, thus hindering supervision from becoming the ‘norm’.
• Lack of skills of the supervisors - either around regulatory requirements, their role as a supervisor or how to signpost their supervisees.

What should employers be mindful of when setting up a scheme?

As an employer, it is clear there needs to be management and organisational support and buy-in for the successful delivery of supervision, which could involve providing time, training, and financial or technological resources.

In the research, AHPs stated very clearly the importance of working within a department or organisation where clinical supervision was valued and its purpose clearly outlined. As a result, it was more likely to be diarised and prioritised, rather than AHPs feeling guilty for taking the time out for it.

Essentially if, as an organisation, you are dedicating resources to support supervision, you want to make sure you are giving it the best chance for all involved.

If you are an AHP yourself and find there is no such scheme set up within your organisation, or you are a lone worker, then there are still options. Aside from attempting to set up a scheme yourself, consider seeking out someone external who can provide you with supervision instead. We were lucky enough to interview one such supervisor for Occupational Therapists, Margaret Spencer, who shared her insights into her supervisory role with us. Speak to your NHS Trust or your industry association to see how they can support you in finding the right supervisor for you.

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}

_{Snowdon, D.A., Sargent, M., Williams, C.M. et al. Effective clinical supe rvision of allied health professionals: a mixed methods study. BMC Health Serv Res 20, 2 (2020). https://doi.org/10.1186/s12913-019-4873-8}