Workplace Clinical Supervision for Advanced Practice
Advanced Practitioners whether experienced or a trainee, should be receiving regular clinical supervision.
Introduction
Clinical supervision is a formally structured professional arrangement between a supervisor and one or more supervisees. It is a purposely constructed regular meeting that provides for critical reflection on the work issues brought to the space by the supervisee(s). This should be a safe place to be able to discuss cases in depth and identify changes or modifications to practice which are required to maintain professional and public safety. If a trainee Advanced Practitioner, the expectation is that a minimum of one hour a week clinical supervision is provided to support and assess the development of competences and capabilities in line with these two important documents:
Experienced Advanced Practitioners should also regularly revisit these documents to ensure they maintain their competences and capabilities.
Supervisor standards
Both Advanced Practice trainees and experienced Practitioners are expected to have a clinical supervisor. Currently this is most likely to be provided by our experienced GP colleagues who is usually tier 3 trained or an experienced clinician who has a PgEdCert. As more Advanced Practitioners complete their initial study and become experienced, the expectation is that they will become clinical supervisors to the next generation of Advanced Practitioners, to reduce the workload burden on GP trainers.
All Clinical Supervisor for Advanced Practitioner are now asked to confirm their understand of the Advanced Practice Supervisor Capabilities - Advanced Practice (hee.nhs.uk), when their trainee applies for funding and gives their supervisors name.
The seven fundamentals underpinning supervision in Advanced Practice
There are seven fundamental considerations which underpin supervision in advance clinical practice:
Practice context
Competence and capability
Multiple professional registrations
Individual learning plan
Professional development and transition
Integrated approach
Supervisor development
Supporting videos are available here to support clinical supervisors understanding about the seven fundamentals.
Clinical supervisors also need to be able to map trainees learning needs against the multi-professional framework as discussed in introduction, above.
Scope of the Advanced Practitioner
This core capabilities frameworks specify a range of core capabilities expected of the Advanced Practitioner, working within general practice/primary care. This includes the:
ability to take a detailed history
assess and examine as necessary
synthesise information and use clinical reasoning to diagnose and formulate a shared management/personalised care/support plan
Depending on the agreed role with their employer, this may also include the need for specialist area knowledge. For example, Womens Health, Long Term conditions, Respiratory or Diabetes.
The Advanced Practitioner will need to:
Work within the scope of their role, agreed and documented by their employer.
Work within and across multi-professional teams and draw on the expertise of all members (including health and social care) to support and meet the person’s needs and best interests to optimise the integration of their care.
Manage and escalate medical emergencies appropriately.
Identify and act appropriately on red flags.
Assess, diagnose, and collaboratively agree a way forward, including shared decision making and personalised care and support planning.
Manage medical complexity.
Complete episodes of care which may include referral for further assessment, treatment, and care appropriately.
Work with people and where appropriate, carers, to access appropriate treatment, diagnostics, care, and support within the context of individuals’ preferences, priorities and needs.
Provide continuity of care in collaboration with the person, considering all their physical, mental, and psychosocial challenges.
The four pillars of Advanced Practice
The four pillars of advanced practice are clinical practice, leadership and management, education, and research. The clinical practice is often the focus in clinical supervision; however, the other three pillars also need to be considered in relation to the trainees development.
Other considerations to support development
Some areas that have been identified for development by Advanced Practice leads and Advanced Practitioners who have gone through MSc study, is the need to gain practical skills, competences, and capabilities in, assessment and interpretations of blood results etc. These are areas that are often not covered in depth during MSc study. It has also been identified as a great assistance for development, if trainees could spend time working alongside experienced Advanced Practitioners.
For more information about workplace supervision for Advanced Practice see links below:
Workplace Supervision for Advanced Clinical Practice - Advanced Practice (hee.nhs.uk)
Minimum standards for supervision - Advanced Practice (hee.nhs.uk)
Advanced Practice Supervisor Capabilities - Advanced Practice (hee.nhs.uk)
Supervision and assessment resources - Advanced Practice (hee.nhs.uk)
Support for Clinical Supervisors
We recognise that being a clinical supervisor for the future advanced practitioners workforce is a very important role. It is however appreciated, that if you are not working in an Advanced Practice role yourself, you may have questions you would like to explore to support your role as clinical supervisor. The Training Hub would like to provide a support network for you. This can be in the form of a 1:1 discussion with the Advanced Practice lead, attendance at a regular forum or any other format you may find useful.
HWE Advanced Practice Clinical Supervisor Forum dates:
TBC |
Please email the hwetraininghub@nhs.net with your preferred option(s).