In this week’s blog, Christine Strange discusses NHS Scotland’s approach to ensuring all nurses and midwives can access high-quality clinical supervision.

Participating in clinical supervision is fundamental to supporting me to develop within my role. In Scotland it is a national ambition that every nurse and midwife should have access to clinical supervision whatever their role and wherever they work. There are now national clinical supervision frameworks available to the nursing and midwifery workforce in Scotland. While the frameworks are for the NHS Scotland workforce, any organisation employing nursing and midwifery practitioners can consider them as a benchmark for good practice. In this blog, I will share some key information about the frameworks and how you can prepare for participating in clinical supervision.

Defining Clinical Supervision

Effective clinical supervision provides you with time, feedback and guidance, in a psychologically safe space, to critically reflect on your practice. ​It is a proactive process aimed at supporting you to develop and build resilience by nurturing autonomy, empowerment and professional growth ¹.

There are common principles and purposes which underpin all clinical supervision practice. These include:

• supporting you to practice safely and provide high-quality care
• helping you to develop your knowledge, skills and competence
• promoting professional practice and continuous improvement
• supporting your wellbeing and professional development so you can flourish in your role.

The Nursing 2030 Vision ² describes the importance of having measures in place to protect the health and wellbeing of care staff, including making sure that practitioners have access to ongoing support and supervision appropriate to their role. The Courage of Compassion Report ³ identifies supervision as a vital part in helping meet core workforce needs of autonomy, belonging and contribution.

The Scottish nursing and midwifery national frameworks

 The Clinical Supervision National Framework for Nursing in NHS Scotland and the Clinical Supervision National Framework for Midwifery in NHS Scotland, share the vision that an individual’s wellbeing and development are at the centre of work-based learning and support. The development of the frameworks was led by NHS Education for Scotland (NES) in collaboration with key stakeholders, including geographical and national health boards, the Royal College of Nursing, the Royal College of Midwives and Scottish Government.

The nursing framework was published in September 2023 and the midwifery framework was published in May 2024

The frameworks support a ‘once for Scotland approach’ by setting out a national benchmark that will inform local policy, provision and practice. This is turn ensures robust quality assurance processes, maintaining a consistent, evidenced based approach to the practice of clinical supervision.

The Scottish model of clinical supervision as defined in the frameworks

The Scottish model has been adapted from the work of Bridget Proctor ⁴ to meet the needs of the nursing and midwifery workforce in Scotland. It has 3 inter-related supervision components: practice, professional and restorative.

Practice Supervision – through a coaching approach, you work in partnership with a more experienced practitioner, to develop your knowledge or skill set and improve your clinical performance and quality of care.

Professional Supervision – focuses on developing your awareness of professional issues and supports you to meet regulatory CPD requirements.

Restorative Supervision – is a process of facilitated reflection. It provides a psychologically safe space to explore beliefs, values, perceptions, and behaviours and can help you process emotions you may experience in your work of caring for others.

The Scottish model is the first to distinguish these three components to ensure they are all available to all practitioners. The Scottish frameworks are distinctive in that they ensure the quantity and type of supervision you access is determined by your individual needs. To see what this looks like, in practice you can access this animated case study.

Getting ready to participate in clinical supervision

There are a range of resources available to support you to prepare to undertake the role of supervisee and supervisor. These are hosted on TURAS Learn, NES’s national digital platform accessible to health and social care staff in Scotland. The resources include:

• Clinical Supervision: supporting you to develop and thrive in your role – this interactive resource provides an overview of the Scottish model for clinical supervision and how to apply the model in practice.
• The clinical supervision capability framework. NHS Scotland nursing and midwifery workforce – This framework outlines the knowledge, skills and behaviours you need to undertake your role as a supervisee and as a supervisor and is unique in that it provides you with a self- assessment tool to assess your current level of proficiency for these roles.
• NHS Education for Scotland TURAS webpages*

Final thoughts

Clinical supervision has been a positive experience for me. It has supported me to grow and develop in my role. Through facilitated reflection, discussion and space to explore issues relevant to my practice, I have had the opportunity to focus on what I need for my learning, development and wellbeing.

Whatever your role within the nursing and midwifery workforce in Scotland you can support clinical supervision. The frameworks and the associated resources provide an opportunity for practitioners and teams, to consider how, through their roles as supervisees and supervisors, they will incorporate clinical supervision into their everyday practice.

*Note: TURAS is NHS Education for Scotland’s digital platform, developed to support health and care professionals. It contains a suite of applications, including elearning modules. To access resources users must be registered and the resources will appear once signed in.

 

Christine Strange is a Practice Educator for Nursing and Midwifery at NHS Education for Scotland. She can be contacted on @ChristineS0709

References

[1] NHS Education for Scotland (2023) Clinical Supervision National Framework for Nursing in NHS Scotland. Available at: National clinical supervision nursing and midwifery frameworks | Turas | Learn (nhs.scot)

[2] Scottish Government (2017) Nursing 2030 Vision. The Chief Nursing Officer’s long term strategy to shape the future of the nursing workforce.  Available at: Nursing 2030 vision – gov.scot (www.gov.scot)

[3] West, M., Bailey, S. and Williams, E. (2020). The Courage of compassion; supporting nurses and midwives to deliver high-quality care. King’s Fund. Available at: https://www.kingsfund.org.uk/publications/courage-compassion-supporting-nurses-midwive

[4] Proctor, B. (1986) Supervision: a cooperative exercise in accountability, in Marken, M., Paye, M. (eds) Enabling and Ensuring.  Leicester: National Youth Bureau and Council for Education and Training in Youth and Community Work