Health Advisers and Supervision Audit results Maeve Cross Senior Health Adviser GUM Belfast

Who replied? 86 responders Others = HIV Specialist Nurse, CASH nurses, Chlamydia screening nurses, Nurse Manager

Skill mix of staff? Other = social workers, Counselors, Psychologists

Do you receive regular planned supervision?

If your answer is no, tell us why?

‘’it’s two times a year – not enough!” “previous formal support with a psychologist was withdrawn due to cost…” “manager has requested it, request has been escalated to senior team...” ‘’it’s two times a year – not enough!” “..was withdrawn, and it has been a battle to get funding for supervision ever since...”

How often are you getting it!!

…range of frequency...?

Group vs. individual?

Qualifications of supervisor

Supervision is essential to safe and ethical practice?

Pressure of work makes supervision impractical?

Supervision is only relevant for trainee/junior HA’s?

What do you use supervision for?

Persistent themes ‘I am a lone health adviser, I need supervision but get none…’ ‘supervision...is not afforded time by managers due to ongoing pressures in the service...’ ‘my manager is not a nurse, but says that the supervision she provides is clinical and managerial, which I obviously disagree with...’ ‘I changed Trusts, and my new employer doesn’t provide clinical supervision...’ ’

Towards a definition “The term ‘clinical supervision’ is reserved for a highly specific kind of interaction…to provide the supervisee with a reliable and regular ‘thinking space’ where they can choose to bring issues connected with the development...of their professional practice, including the impact that such work has on the practitioner her/himself” (SSHA, 2004)

Health Advisers code of Conduct Sexual health advisers will: 6.1.6 Seek regular managerial and clinical supervision 6.1.8 Ensure they are physically, psychologically and emotionally able to undertake duties…. (SSHA, 2004)

SSHA Standard for good practice One to one or group supervision not less than monthly Counselor supervisor who has… supervisory experience and is a qualified counselor, psychotherapist or clinical psychologist Having a supervisor who has supervisor accreditation

NMC Standard “Clinical supervision is important to help maintain and promote high quality health care. It has been advocated as requirement for all newly registered staff” (NMC, 2008)

No consistent guidance on frequency BACP – 1.5 hrs per month (depending on counselling hours For nurses – minimum every 6 months! Otherwise open to interpretation

Leverage for change… “the two most effective ways of encouraging a commitment to the need for supervision are to demonstrate the cost in not having supervision and to create a vision that demonstrates the benefits..” (Hawkins and Shohet, 2012)

Demonstrating costs… Poor or outdated practice Client complaints Staff morale Staff attitudes survey Staff turnover and sickness rates Practice audits Comparisons with best practice

In the absence of supervision….?

…a last word… ‘(Supervision) is essential for safe practice: to look after the patients, but also to safeguard our own mental wellbeing’

References SSHA Manual, SSHA, 2004, London Hawkins, P., Shohet, R., Ryde, J. and Wilmot, J., 2012. Supervision in the helping professions. McGraw-Hill Education (UK).