Allied Health Professionals Professional and Clinical ... · Allied Health Professionals Professional and Clinical supervision Protocol Last amended: 21 September 2017 Professional

Allied Health Professionals Professional and Clinical Supervision Protocol

Ref CLIN-0036-v4

Status: Approved Document type: Protocol

Ref: CLIN-0036-v4 Page 2 of 29 Approved date: 21 September 2017 Allied Health Professionals Professional and Clinical supervision Protocol Last amended: 21 September 2017

Contents 1 Introduction ....................................................................................................... 3 2 Background ....................................................................................................... 4 3 Supervision Guidance by Profession .............................................................. 5 3.1 Art Therapists ..................................................................................................... 5 3.2 Dietitians ............................................................................................................. 5 3.3 Occupational Therapists ..................................................................................... 6 3.4 Physiotherapists ................................................................................................. 7 3.5 Speech & Language Therapists .......................................................................... 8 4 Governance ....................................................................................................... 8 5 HCPC & PROFESSIONAL REQUIREMENTS FOR AHPs ............................... 10 6 How this procedure will be implemented ...................................................... 11 6.1 Training needs analysis .................................................................................... 11 7 How the implementation of this procedure will be monitored ..................... 11 8 References ...................................................................................................... 11 9 Document control ........................................................................................... 13 Appendix 1 - Equality Analysis Screening Form .......................................................... 14 Appendix 2 – Approval checklist ................................................................................. 19 Appendix 3 – AHP Protocol / Components .................................................................. 21 Appendix 4 – Allied Health Professions professional clinical supervision contract ....... 26 Appendix 5 – Allied Health Professions professional clinical supervision record ......... 27


1 Introduction AHP Supervision Protocols support and operationalise the Trust’s Clinical Supervision Policy (CLIN-0035) The Trust’s Supervision Policy applies to all staff (both regulated & non-regulated) including Allied Health Professionals (AHPs). AHP Supervision Protocols cover regulated AHP staff registered with the Health and Care Professions Council (HCPC) and AHP support staff. AHP staff members directly employed by the Tees, Esk & Wear Valleys NHS Trust (TEWV) are subject to the requirements of both the Supervision Policy and the AHP Supervision Protocols. Accurate in April 2016, 17 professional groups are regulated by the HCPC, 12 are Allied Health Professions (AHP`s). Of these, and either directly or via a service level agreement with other providers, the Trust currently employs the following groups of AHPs: • Art Therapists • Dietitians • Occupational Therapists • Physiotherapists • Speech & Language Therapists

Trust policy recognises the requirements placed on AHPs as part of HCPC regulation, and the professional bodies that AHPs may belong to. TEWV also recognises AHPs employed by the Trust in roles that do not immediately identify their professional affiliation (e.g. somebody working as a ’mental health practitioner’). These staff may or may or may not be aligned to structures that support professional governance or supervision. It is recommended however, that in line with the requirements of the HCPC or a professional body, these staff members individually assess their supervision needs with reference to the TEWV AHP Supervision Protocol and support from the relevant professional lead in their area. If practitioners in these roles wish to deliver some of the AHP therapy for which they are registered, and have this job planned into their role in agreement with their line manager, they must seek clinical supervision for delivery of that therapy via the relevant AHP professional clinical lead. Clinical supervision for therapeutic intervention that is not physiotherapy, dietetics, speech and language therapy, occupational therapy or art psychotherapy e.g. that completed by those in “any profession” roles does not have to be sourced from an AHP. It should be provided by an individual with significant experience in delivering the same interventions/service as the clinical supervisee where possible. This enables the supervisee to develop knowledge and competence in that role, ensuring best quality and safe practice in it, and ensures that the supervisee keeps up to date with current best practice in their daily domain of concern.


Professional supervision via the relevant AHP group will remain available to these individuals and will be co-ordinated via the relevant AHP clinical/professional lead. It is also expected that AHPs employed by other Trusts, but working into TEWV Trust as part of a ‘service level agreement’, will implement the professional / clinical supervision policy and protocols of their host organisation / professional body that will remain responsible for their clinical governance, in collaboration with TEWV AHP leadership. AHPs working into TEWV Trust, but employed by an external agency (e.g. locums), will implement the supervision protocols of their host organisation whilst adhering to Trust policy throughout. It is recommended that these staff have an individual assessment of their supervision needs with reference to TEWV Supervision Policy, and AHP Supervision Protocols.

2 Background The HCPC regulates AHPs and requires them to adhere to the HCPCs ‘Standards of Conduct, Performance and Ethics’ (HCPC 2016), as well as ‘Standards of Proficiency’ (HCPC 2013 and 2014 for Speech and Language Therapy) as outlined for each Professional Group. The HCPC also recognises, refers to, and supports adherence to the various AHP standards and codes of conduct issued by each Professional ‘Body, Institute or College’ which detail requirements in relation to the need for supervised practice. Reflecting the diverse range of AHPs employed by the Trust and the various HCPC / Professional standards they are expected to adhere to, AHP Supervision Protocols outline a set of principles and guidance relating to each professional group. Operationally, it is accepted that each professional group may have unique requirements in order to ensure that their supervision needs are met. Each AHP professional body has published guidance relating to supervision standards, routinely outlining supervision in terms of managerial, professional, and/or clinical. AHP Supervision Protocols summarise each profession’s key ‘supervision’ statements with the recommendation that guidelines relating to a specific profession should be consulted for further detail.


3 Supervision Guidance by Profession The Health Professions Council ‘Standards of Conduct, Performance and Ethics’ (2016) applies to all registrants; http://www.hcpc-uk.org/publications/standards/index.asp?id=38

3.1 Art Therapists Clinical supervision has a primary function related to providing time to enhance practice by looking at patterns of practice; expand clinical techniques and theory; examine transference / counter transference; compliance with code of practice; analyse clinical material; review the aims of therapy and intervention time scales; and help identify turning points in therapeutic relationships. Wherever possible, art therapists should be supervised by an experienced art therapist who is an accredited supervisor with BAAT (listings of accredited supervisors are available through BAAT). If this is not possible /available, the art therapist should receive clinical supervision from an experienced and noted supervisor with training and experience compatible with the approach appropriate for the client group and have undergone supervision themselves as part of training. BAAT recognises the value of peer supervision but emphasises that peer supervision alone is not sufficient (BAAT 2014).

Related Links

HCPC: Standards of proficiency - Arts therapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=39

Professional Body:

British Association of Art Therapists (BAAT) http://www.baat.org/ BAAT State Registered Art Therapist Guidelines for Supervision 2014

Professional: Code of Ethics 2014 http://www.baat.org/Assets/Docs/General/BAAT%20CODE%20OF%20ETHICS%202014.pdf

3.2 Dietitians Clinical supervision is seen as a structured, formal process that enables dieticians to discuss their work with an experienced practitioner who is trained to facilitate clinical supervision. Discussion is aimed at being a guided reflection on current practice and ensuring that the supervisee builds on their learning and experience. Supervision should enhance personal and professional development; provide a framework for personal learning and practice objectives; and safeguard standards of practice. Clinical supervision, appraisals, reflection, and Continuing Professional Development (CPD) are identified as sharing a common goal whilst running the risk of overlapping. It is recognised that supervision may be individual or as a group, with someone from the same or a different professional background (BDA 2008).

http://www.hcpc-uk.org/publications/standards/index.asp?id=38

http://www.hpc-uk.org/publications/standards/index.asp?id=39


http://www.baat.org/

http://www.baat.org/Assets/Docs/General/BAAT%20CODE%20OF%20ETHICS%202014.pdf

http://www.baat.org/Assets/Docs/General/BAAT%20CODE%20OF%20ETHICS%202014.pdf


Related Links

HCPC: Standards of Proficiency for Dietitians http://www.hpc-uk.org/publications/standards/index.asp?id=43

Professional Body:

The British Dietetic Association (BDA) http://www.bda.uk.com/

Professional: https://www.bda.uk.com/professional/practice/professionalism/code_of_conduct

3.3 Occupational Therapists Reflecting a diverse range of supervisory relationships, professionally-led clinical supervision has a clear emphasis on issues that reflect professional values and principles. These include professional development; skills and knowledge development (in particular linked to the delivery of occupational therapy); quality assurance; and ensuring adherence to professional standards. Clinical supervision defines a relationship that ensures good standards of clinical occupational therapy practice; encourages professional development; and in terms of clinical activity provides clarity and assurance with reference to accountability and responsibility. Professional supervision and clinical supervision have a recognised role to play in Continuing Professional Development (CPD) as regulated by the HCPC, as well as supporting staff through schemes such as preceptorship or return to practice. Occupational therapy staff of all grades should be supported in all aspects of their occupational therapy clinical practice, with a demand for supervisors who are themselves occupational therapists of a higher grade or who have greater experience of the clinical area. For occupational therapists receiving clinical supervision for occupational therapy delivery, their professional supervision will be interwoven, with clinical and professional supervision combining as one supervision process. The Accreditation of Practice Educators Scheme (https://www.cot.co.uk/accreditation-practice-placement-educators-apple/apple-scheme ) is recognised by occupational therapists as a means of assessing the supervisory skills necessary to assume the responsibility of being a supervisor to other occupational therapy staff.

Related Links

HCPC: Standards of proficiency - Occupational therapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=45

Professional Body:

The British Association of Occupational Therapists and Royal College of Occupational Therapists (BAOT / RCOT) httphttps://www.rcot.co.uk/

Professional: Professional standards for occupational therapy practice (2017) https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/professional-standards



http://www.bda.uk.com/

https://www.cot.co.uk/accreditation-practice-placement-educators-apple/apple-scheme

https://www.cot.co.uk/accreditation-practice-placement-educators-apple/apple-scheme



http://www.cot.co.uk/Homepage/

https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/professional-standards



RCOT Standards and Ethics (2015) https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/rcot-standards-and-ethics

3.4 Physiotherapists Physiotherapists define the principles of clinical supervision as supporting and defining practice; developing skills which narrow the gap between theory and practice. It is a collaborative process between two or more practitioners of the same or different professions. It involves the development of professional skills and the implementation of an evidence-based approach to ensure the maintenance of practice by discussion of specific patient incidents using reflection to inform the process. It is recognised that the clinical supervision is separate from other areas of support such as appraisal and peer review but may at times overlap and in some cases identify the need to access other areas of support.

Related Links

HCPC: Standards of proficiency – Physiotherapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=49

Professional Body:

The Chartered Society of Physiotherapy (CSP) http://www.csp.org.uk/

Professional: CSP `Code of Members` professional values and behaviours http://www.csp.org.uk/publications/code-members-professional-values-behaviour 2013 Appendix A – Core professional concepts http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values-behaviour/appen Appendix C – Mapping the code to HCPC standards http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values/appendix-c-mapp CSP: A brief overview of clinical supervision 2017

csp_clinical_supervision_2017.pdf

https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/rcot-standards-and-ethics

https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/rcot-standards-and-ethics



http://www.csp.org.uk/

http://www.csp.org.uk/publications/code-members-professional-values-behaviour

http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values-behaviour/appen

http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values-behaviour/appen

http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values/appendix-c-mapp

http://www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values/appendix-c-mapp


3.5 Speech & Language Therapists Speech & Language Therapists (SALTs) describe supervision as a formal arrangement which enables the practitioner or support practitioner to discuss their work regularly with someone who is suitably experienced and qualified. A requirement for both managerial (line management supervision), and clinical (non-line management) supervision is identified. Elements in SALT ‘line management’ guidance suggest that the line manager needs to be a qualified and experienced SALT and that it should include: relating theory to practice (thereby promoting CPD); and knowledge of / facilitating adherence to professional standards. Clinical supervision is a formal process where SALTs can discuss their clinical practice including the opportunity for personal reflection. A range of delivery models such as collegial, co-supervision, peer, telephone, and group supervision are recognised. It is typically carried out by a peer although where the practitioner has a predominantly counselling role, from a psychiatrist/psychotherapist who can enable the SLT to explore the psychodynamics of the therapeutic relationship (Communicating Quality 3, RSSLT Guidance on best practice in organisation and provision, RSSLT 2006)

Related Links

HCPC: Standards of proficiency - Speech and language therapists (2014) http://www.hpc-uk.org/publications/standards/index.asp?id=52

Professional Body:

Royal College of Speech & Language Therapists (RCSLT) http://www.rcslt.org/

Professional: RCSLT (2016). CQ Live. Available at: https://www.rcslt.org/cq_live/introduction Supervision, accountability and delegation of activities to support workers https://www.rcslt.org/docs/free-pub/Supervision_accountability_and_delegation_of_activities_to_support_workers

4 Governance Professional / clinical supervision is a governance issue. As such the agreed model recognised by the Trust ensures that the governance element of the AHP Professional Structure focuses on the following areas: • Professional regulation and standards (including professional audit of standards). • Preceptorship • Registration competency, including professional / clinical supervision, appraisal, and CPD

standards.


http://www.rcslt.org/

https://www.rcslt.org/cq_live/introduction

https://www.rcslt.org/docs/free-pub/Supervision_accountability_and_delegation_of_activities_to_support_workers




• Capability and fitness for practice The interplay between supervision (managerial, professional, and clinical supervision), appraisal, and preceptorship is considered as an imperative for AHPs employed by the Trust and should not be seen as independent elements. This is especially pertinent for those line managed by personnel from a different professional background who may at times fail to fully appreciate professional imperatives and demands. The recognition that professionally-led clinical supervision is distinct from managerial supervision, or appraisal is paramount; the model that identifies the three main functions of supervision as ‘management, education and support’ working as effectively for both managerial and non-managerial supervision, as for professional clinical supervision (Smith 2005; COT 2015).

The following grid maps professionally-led professional / clinical supervision against non-professionally-led ‘managerial supervision’ as applied to AHPs:

‘Professionally-led professional / clinical supervision’

Mapped against ‘non-professionally led managerial supervision’ as applied to AHPs

Element

Managerial Supervision Professional / Clinical Supervision

Workload management

* *

Professional and clinical Competency/capability

* *

Clinical/Professional Supervision

*

Professional Conduct * *

Assessing continuing professional development and training needs (including as part of appraisal process)

* *

CPD/Study leave - Multi-disciplinary

* *

CPD/Study leave – Professional

* *

Annual leave (1)

* *

Work performance - general (time keeping etc (2)

* *


Job planning/deployment * *

Return to work/sickness/well-being * *

(Those marked 1 have a focus on cover across multiple line management areas to ensure continuity and equity of service, those marked 2 have a focus on the impact on therapeutic alliance)Those areas marked green indicate the lead role in that area.

In ‘Standard of Conduct, performance and Ethics’ (2016) the HCPC states that AHP’s must only delegate work to someone who has the knowledge, skills and experience needed to carry it out safely and effectively and AHP’s must continue to provide appropriate supervision and support to those you delegate work to.

5 HCPC & PROFESSIONAL REQUIREMENTS FOR AHPs

To practice competently AHPs must possess the knowledge, skills and ability required for lawful, safe and effective practice coupled with adherence to HPC standards and guidelines, and those of the relevant professional body. The Trust recognises this professional obligation and that all AHPs undertaking clinical work should be supported to engage in professional / clinical supervision as a professional imperative. The Trust also recognises that AHPs can be line managed by someone who sits outside of their professional group, but that supported by a professional structure. the supervisee is best placed to attend to issues relating to professional responsibility, accountability, and clinical governance. In line with the Trust’s Supervision Policy (CLIN/0035/v5.1), AHP Protocols identify minimum standards related to the components required for effective professionally-led clinical supervision. With the overall ambition of ensuring that optimum benefit is gained from the commitment to professional / clinical supervision, recognition and adherence to these components will contribute significantly to:

• better patient care • the development of reflective & reflexive AHP practitioners • the refinement and development of professional skills • improved quality of service provision • increased job satisfaction


6 How this procedure will be implemented

• This procedure will be published on the Trust’s intranet and external website.

• Line managers will disseminate this procedure to all Trust employees through a line management briefing.

• All staff recruited into posts that deliver direct patient care will be made aware of the clinical supervision policy at Trust and local induction.

• The trust will make commit to making clinical supervision available to all staff to whom this policy applies.

6.1 Training needs analysis

Staff/Professional Group

Type of Training Duration Frequency of Training

AHP’s Supervision e-learning

supervisee

1-2 hours No expiry

AHP’s Supervision e-learning

supervisor

1-2 hours No expiry

OT APPLE accreditation scheme

Visit www.cot.org.uk/apple

Every 5 years

7 How the implementation of this procedure will be monitored Please see Appendix 1 for more information

8 References Professional standards for occupational therapy practice (2017) https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/professional-standards Standards of conduct, performance and ethics (2016) http://www.hpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf Health care professions council (HCPC) http://www.hpc-uk.org/ Standards of proficiency - Chiropodists / podiatrists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=41 Standards of proficiency - Arts therapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=39

http://www.cot.org.uk/apple



http://www.hpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf

http://www.hpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf

http://www.hpc-uk.org/






Standards of proficiency – Dietitians (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=43 Standards of proficiency - Occupational therapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=45 Standards of proficiency – Physiotherapists (2013) http://www.hpc-uk.org/publications/standards/index.asp?id=49 Standards of proficiency - Speech and language therapists (2014) http://www.hpc-uk.org/publications/standards/index.asp?id=52 Your guide to our standards for continuing professional development (2011) http://www.hpc-uk.org/publications/standards/index.asp?id=101












9 Document control

Date of approval: 21 September 2017

Next review date: 21 September 2020 (AHP protocols will be reviewed every 3 years, sooner if changes in AHP Professional Bodies or HCPC guidance require it).

This document replaces: CLIN-0036-v3

Lead: Name Title

Tim Cate Head of Psychology and AHP’s

Members of working party: Name Title

Alison Bullock Christiana Liddle Jo Smith Janet Telford Shaun Wassall

Professional Head of Occupational therapy and Head of Art therapy Professional Head of Physiotherapy Professional Head of Dietetics Professional Head of Speech and Language therapy Art Therapy Clinical lead

This document has been agreed and accepted by: (Director)

Name Title

Tim Cate Head of Psychology and AHPs

This document was approved by:

Name of committee/group Date

AHP Professional Heads Group

January 2018

An equality analysis was completed on this document on:

17 January 2018

Change record Version Date Amendment details Status 4 Jan 2018 Updated hyperlinks and references Published


Appendix 1 - Equality Analysis Screening Form Please note; The Equality Analysis Policy and Equality Analysis Guidance can be found on InTouch on the policies page

Name of Service area, Directorate/Department i.e. substance misuse, corporate, finance etc.

ALLIED HEALTH PROFESSIONALS (AHP)

Name of responsible person and job title Alison Bullock Professional Head of Occupational therapy and Head of Art therapy Jill Martin Occupational therapy clinical lead

Name of working party, to include any other individuals, agencies or groups involved in this analysis

Joanne Sowerby Occupational therapist Jill Martin Occupational therapy clinical lead

Policy (document/service) name Allied Health Professionals professional and Clinical Supervision Policy

Is the area being assessed a; Policy/Strategy x Service/Business plan Project

Procedure/Guidance Code of practice

Other – Please state

Geographical area Trust Wide

Aims and objectives The Trust’s Clinical Supervision Policy applies to all staff (both regulated & non-regulated) including AHP’s. AHP Supervision Protocols cover regulated AHP staff registered with the Health and Care Professionals Council (HCPC) and AHP support staff. Reflecting the diverse range of AHP’s employed by the Trust and the various HPC/Professional standards they are expected to adhere to. AHP Supervision Protocols outline a set of principles and guidance relating to each professional group. Operationally, it is accepted that each professional group may have unique requirements in order to ensure that their supervision needs are met.

Start date of Equality Analysis Screening 29/11/17

End date of Equality Analysis Screening 22/01/18 – Does not require EMT approval – as is referred to and supports Trust clinical supervision policy (is part of this) and is already approved


You must contact the EDHR team as soon as possible where you identify a negative impact. Please ring Sarah Jay on 0191 3336267/3542 1. Who does the Policy, Service, Function, Strategy, Code of practice, Guidance, Project or Business plan benefit?

AHP’s and AHP support staff working in the trust, patients, carers, the public, the Trust, HCPC, AHP professional bodies.

2. Will the Policy, Service, Function, Strategy, Code of practice, Guidance, Project or Business plan impact negatively on any of the protected characteristic groups below?

Race (including Gypsy and Traveller) No Disability (includes physical, learning, mental health, sensory and medical disabilities)

No Gender (Men, women and gender neutral etc.)

No

Gender reassignment (Transgender and gender identity)

No Sexual Orientation (Lesbian, Gay, Bisexual and Heterosexual etc.)

No Age (includes, young people, older people – people of all ages)

No

Religion or Belief (includes faith groups, atheism and philosophical belief’s)

No Pregnancy and Maternity (includes pregnancy, women who are breastfeeding and women on maternity leave)

No Marriage and Civil Partnership (includes opposite and same sex couples who are married or civil partners)

No


Yes – Please describe anticipated negative impact/s No – Please describe positive impacts/s It ensures that patients receive the care they require. The policy ensures that all AHP staff will receive appropriate supervision to their roles. It gives guidance to newly qualified staff and new employee’s. It ensures that all AHP staff will receive an equal access to clinical supervision. Disability – reasonable adjustments will be made for staff with disabilities appropriate to their needs e.g. time of day of supervision, who writes up supervision, use of technology e.g. for people with dyslexia, following of accessible information standards where appropriate, use of hearing loops for those with hearing impaired where needed. Other reasonable adjustments will always be considered according to individual need. 3. Have you considered other sources of information such as; legislation, codes of practice, best practice,

nice guidelines, CQC reports or feedback etc.? If ‘No’, why not?

Yes

No

Sources of Information may include: • Feedback from equality bodies, Care Quality

Commission, Equality and Human Rights Commission, etc.

• Investigation findings • Trust Strategic Direction • Data collection/analysis • National Guidance/Reports

• Staff grievances • Media • Community Consultation/Consultation Groups • Internal Consultation • Research • Other (Please state below)

4. Have you engaged or consulted with service users, carers, staff and other stakeholders including people from the following protected groups?: Race, Disability, Gender, Gender reassignment (Trans), Sexual Orientation (LGB), Religion or Belief, Age, Pregnancy and Maternity or Marriage and Civil Partnership


5. As part of this equality analysis have any training needs/service needs been identified?

Yes/No Please describe the identified training needs/service needs below All staff complete the basic supervision e-learning training. All AHP staff have supervision guidance through their professional bodies. Supervisory skill are already discussed in the Occupational therapy APPLE accreditation scheme for students

A training need has been identified for;

Trust staff Yes/No

Service users Yes/No Contractors or other outside agencies

Yes/No

Make sure that you have checked the information and that you are comfortable that additional evidence can provided if you are required to do so

Yes – Please describe the engagement and involvement that has taken place

Those the policy affects i.e. AHP’s working within the trust were involved in the initial development of the policy and the policy review. It was discussed and approved clinical leads meetings and professional heads through the network.

No – Please describe future plans that you may have to engage and involve people from different groups


The completed EA has been signed off by: You the Policy owner/manager: Type name: Alison Bullock

Date: 22/01/2018

Your reporting (line) manager: Type name: Tim Cate

Date: 22/01/2018

If you need further advice or information on equality analysis, the EDHR team host surgeries to support you in this process, to book on and find out more please call: 0191 3336267/6542 or email: [email protected]

mailto:[email protected]


Appendix 2 – Approval checklist

To be completed by lead and attached to any document which guides practice when submitted to the appropriate committee/group for consideration and approval.

Title of document being reviewed: Yes/No/

Unsure Comments

1. Title

Is the title clear and unambiguous? Yes

Is it clear whether the document is a guideline, policy, protocol or standard? Yes

2. Rationale

Are reasons for development of the document stated? Yes

3. Development Process

Are people involved in the development identified? Yes

Has relevant expertise has been sought/used? Yes

Is there evidence of consultation with stakeholders and users? Yes

Have any related documents or documents that are impacted by this change been identified and updated?

Yes

4. Content

Is the objective of the document clear? Yes

Is the target population clear and unambiguous? Yes

Are the intended outcomes described? Yes

Are the statements clear and unambiguous? Yes

5. Evidence Base

Is the type of evidence to support the document identified explicitly? Yes

Are key references cited? Yes

Are supporting documents referenced? Yes

6. Training

Have training needs been considered? Yes

Are training needs included in the document? Yes

7. Implementation and monitoring

Does the document identify how it will be implemented and monitored? Yes


Title of document being reviewed: Yes/No/

Unsure Comments

8. Equality analysis

Has an equality analysis been completed for the document? Yes

Have Equality and Diversity reviewed and approved the equality analysis?

9. Approval

Does the document identify which committee/group will approve it?

Signature: Joanne Sowerby (Occupational therapist)


Appendix 3 – AHP Protocol / Components Component 1: ‘Policy & Protocol’

• The policy and AHP protocols will be available on the intranet. AHP protocols will be reviewed every 3 years, sooner if changes in AHP Professional Bodies or HPC guidance require it.

Benefits

• This will ensure all staff have regular access to the policy and protocols for reference

Component 2: ‘Audit & Audit Tools’ • Audits will be completed annually and results reported to the Allied Health Professions Forum (AHPF)

and relevant clinical governance groups. Where professional bodies have an audit tool available this will be the audit tool of choice. Where these are not available the relevant professional advisor in conjunction with clinical leads responsible for supervision will develop an audit tool for that professional group. The responsibility for the audit lies with the relevant clinical leads.

Benefits

• Evidence of regular clinical supervision and identification of any positive or negative aspects of same including barriers to effective utilisation

Component 3: ‘Identification of Professional / Clinical Supervisors’

• It is the responsibility of each AHP Professional Clinical Lead to identify and agree a competent professional clinical supervisor for each qualified member of AHP staff. Professional standards must therefore be taken into consideration in respect of: Art Therapists: Supervisors must be an accredited BAAT supervisor. Peer supervision alone is not sufficient. Dieticians: A supervisor may be from the same or a different professional group but if a supervisor is from a different professional group the clinical lead must be assured that the supervisor is competent and up to date in dietetic practice, skills and knowledge.

Occupational Therapists: The professional clinical supervisor must be a more experienced occupational therapist and/or from a higher grade working in the locality and practice area.

Physiotherapists: A supervisor may be from the same or a different professional group but if a supervisor is from a different professional group the clinical lead must be assured that the supervisor is competent and up to date in physiotherapy practice, standard, skills and knowledge and evidence base.

Speech & Language Therapists: The clinical supervisor must be an experienced and qualified SALT who will incorporate into professional clinical supervision all professional aspects outlined in RSCLT guidance. The exception is where clinical supervision is also sought from a psychiatrist or psychotherapist where the SALT has a predominantly counselling role.

Registered AHPs working in generic roles: Including those working as CBT therapists, assertive outreach workers etc should seek clinical supervision appropriate to their role. In situations where the clinical component of the individual’s role is agreed by both the line manager and relevant AHP clinical lead as clearly profession specific, the relevant professional clinical AHP lead should identify a


professional clinical supervisor in the same way as for other clinicians in their area of responsibility.

AHP support practitioners: AHP support staff (known as ‘assistants’, ‘technicians’, and / or by profession specific support titles) typically have clinical work delegated to them by an associated AHP practitioner. The HPC and all professional guidelines are clear that they must be supervised clinically by the person / professional delegating the task to them.

Other Support Practitioners: Other support practitioners such as nutritional assistants or nursing assistants or STR workers accepting delegated clinical tasks from an AHP must be clinically supervised by the relevant AHP for this aspect of their practice. In some situations other practitioners may seek regular specialist advice around the AHP area of speciality without the delegation of clinical tasks.

Benefits

• Assurance that supervision is distributed appropriately among practitioners and professional guidelines, governance and standards are adhered to.

Component 4: ‘Additional Clinical Supervision’ • Qualified AHPs (including occupational therapists) may seek in consultation with their clinical lead

additional clinical supervision from another supervisor of the same or a different professional background where demanded by the dynamics of a particular case; and / or extended scope practice; or where it is agreed with the clinical lead that the expertise is not readily available within the locality.

Benefits Safe practice and assurance of clinical governance.

Component 5: ‘Training & Education’ • Training, education & support provided by the Trust to AHPs will reflect the variety of professional

approaches, requirements and guidelines e.g. art therapists providing clinical supervision must be accredited by BAAT; the Apple accreditation scheme for occupational therapists is identified as providing practitioners with the requisite skills that can be utilised to facilitate professional / clinical supervision. It is the responsibility of the clinical lead to assure that any training accessed meets professional requirements.

Benefits

• Realistic and accessible training and awareness related to roles and responsibilities within clinical supervision based upon professional guidelines.

Component 6: ‘IPR and appraisals’

• Clinical supervision will contribute to both ‘Individual Performance Reviews’ (IPR) / appraisal in order to identify areas for professional development. Where professional clinical supervisors are involved in IPR / Appraisals in accordance with the AHP managerial / professional clinical supervision interface, this is achieved outside allocated professional clinical supervision time.

Benefits • Identification of localised skill requirements to contribute to a robust training needs analysis


Component 7: ‘Content of Professional / Clinical Supervision’ Art Therapists: ‘… patterns of practice; expand clinical techniques and theory; examine transference/ counter transference; compliance with code of practice; analyse clinical material and review the aims of therapy, intervention time scales; & turning points in therapeutic relationships’.

Dieticians: ‘… discuss clinical work with an experienced practitioner; using guided refection on current practice to learn from experience; provide a framework for personal learning and practice objectives; & safeguard standards of practice’.

Occupational Therapists ‘... profession specific matters (including professional development, skills and knowledge); ensuring the quality and good standards of practice; accountability and responsibility for clinical work carried out; maintaining an occupational focus; supporting all aspects of the OT process; & supporting occupational therapy staff to develop their practice.’

Physiotherapists ‘… support and define practice; developing skills which narrow the gap between theory and practice; the development of professional skills; & the implementation of evidence based approaches to maintaining standards in practice through discussion around specific patient incidents using reflection to inform the process’.

Speech and Language Therapists: ‘… relating theory to practice thereby promoting CPD; knowledge of and facilitating adherence to professional standards; & discussing clinical interventions (including feelings that are engendered).

Benefits

• Improved quality of care, development of professional skills, maintenance of professional standards, & governance.

Component 8 ‘Venue / Environment’

• To be agreed between supervisee and supervisor as a suitable environment to both parties ensuring comfort, minimum distractions or disturbance

Benefits

• Uninterrupted time to ensure optimum quality of supervision

Component 8: ‘Informal Supervision’ • Informal supervision takes place on an ongoing basis (e.g. within MDT forums, handovers, debriefs,

etc)

Benefits • Addition perspectives and information can be gained which where appropriate can be taken into formal

supervision.


Component 9: ‘Formulating the contract’ • The supervisee and supervisor will use the contract proforma (see appendix 2) subject to annual

review. Both the supervisor and supervisee will hold copies of the contract and a copy should be made available by the supervisee to the line manager.

Benefits

• Agreement between the two parties on the process to be reviewed on a six monthly basis; & awareness of managers to the supervisory commitment.

Component 10: ‘Models of Supervision’ • AHP models of supervision are based on professional guidance to life-long learning. This may include

1:1, peer and / or group supervision as identified by the appropriate AHP clinical lead, and according to their professional development needs. Additionally parties will agree a recognised model of reflection for use in supervision such as Gibbs, Fisch, Twin and Purr, Johns (2000); Rolfe, Freshwater & Jasper (2000), and / or reflective logs.

Benefits

• Appropriate professional models of supervision are identified and adhered to.

Component 11: ‘Time & Frequency’ • Agreement between supervisee and supervisor relating to the required frequency and dates as

identified in the AHP contract. Adequate notice should be given wherever possible if any members of the agreement are unable to attend a session. If cancellations occur, reasons for the cancellation need to be documented in clinical supervision records with responsibility for reorganisation resting with the party who cancelled.

Benefits

• Regular meetings between supervisor and supervisee that can be evidenced • Identified responsible person to ensure regular meetings are organised • Evidence of cancellations and reasons for same

Component 12: ‘Record Keeping’ • There should be records made of all professional clinical supervision discussions, using standard

documentation (see appendix 3). The record is held by the supervisee and supervisor.

Benefits • Evidence of on-going clinical supervision accessible

Component 13: ‘Confidentiality’ • Confidentiality must be maintained at all times between the supervisee and supervisor, in line with Trust

responsibility under the Data Protection Act, unless prior permission has been given by the supervisee. However if professional conduct or issues relating to competency or professional standards arise, these must be dealt with in accordance with professional guidelines and local trust policies with the knowledge of all parties involved. Additionally confidentiality may be breached, without permission, under demand from a court of law.


Benefits • ‘Confidentiality, professional standards. & governance’ is maintained. AHPs have a safe place to be

open and honest about concerns relating to professional practice.

Component 14: ‘Archiving’

• Clinical leads will hold a copy of each practitioner’s clinical supervision contract (see appendix 2) identifying model used, time frames, etc.

Benefits • Central record of current practices of clinical supervision within each service to assist audit


Appendix 4 – Allied Health Professions professional clinical supervision contract JOINT AGREEMENT (Supervisee and Clinical Supervisor)

As Supervisee and Clinical Supervisor, we both agree That the aims of our session together are to enable us to reflect in depth on issues affecting practice in order to develop personally and professionally towards achieving, sustaining and creatively developing a high quality of practice

To meet a minimum of one session per six weeks for a minimum of one hour

To protect the time and space for the supervisee to reflect in depth by keeping to agreed appointments and time boundaries, being punctual, ensuring privacy and no interruptions, agreeing responsibility for booking appropriate room and dates.

To maintain a record for showing the dates and times of the professional clinical supervision sessions. Any other notes made during or after the sessions will be kept by the Clinical Supervisor and Supervisee.

To work to a mutually agreed agenda based on the content section of the Trusts AHP protocols, using professional guidance on lifelong learning and established models of reflection.

Being open to discussion about the quality and content of the supervision process, being willing to accept and give constructive criticism.

To challenge any breach of this agreement, which the other does not already acknowledge or does not take seriously

To share responsibility for making effective use of the time set aside for clinical supervision

Frequency of meetings e.g. 6 weekly, monthly

Venue

Circle as appropriate: 1:1 Group Peer Model of Reflection

Signature of Supervisee(s):

Signature of Supervisor:

Date Signed

Review Date.

Ref Page 27 of 29 Ratified date: Title Last amended:

Appendix 5 – Allied Health Professions professional clinical supervision record PROFESSIONAL CLINICAL SUPERVISION RECORD

Attendees: Supervisor Supervisees Model: 1:1 Group Peer Other

Signatures of Attendees Dates Supervision: Next Supervision: Contract Renewal:

Agenda: Review of action from previous session (if any) Discussion Points

Action


Page 1 of AHP Professional Clinical Supervision Record continuation sheet Date


Discussion Points continued

Action

Page: of

CLINICAL SUPERVISION: A BRIEF OVERVIEW Looking through the practice & educational literature, there is no single definition of clinical supervision, but one that is often cited within healthcare (comes from a nursing perspective) that seems to capture the purpose of the supervisory relationship comes from Butterworth & Faugier (1993) ‘An exchange between practising professionals to enable the development of professional skills’

This is a useful definition because of how it aligns with an outcomes-based approach to CPD which is consistent with the HCPC’s expectations of registrants, & the CSP’s expectations of its members. Implementation of this model of clinical supervision can sometimes cause tension in practice – because of the link between clinical supervision & clinical governance. If clinical supervision is directly linked to clinical governance, questions need to be asked about the supervisory relationship: is clinical supervision in place to facilitate/enhance individuals’ learning & development? or is it about enabling the organisation to evaluate the competencies of individual members of staff? There is no right or wrong here. What’s important is that the supervisor & supervisee both know what clinical supervision is doing – because that will influence how the supervisory process & relationship are managed. Some of the more recent literature around models of supervision is helpful in taking the idea of supervision as an (empowering/enabling) relationship between 2 people to one that takes account of/acknowledges the organisational context in which that supervisory relationship is happening. It then becomes possible to critically evaluate how clinical supervision can enhance outcomes (at an individual & organisational level) as well as how organisational cultures/practices can limit/enhance that development. Clinical supervision in practice On a practical note, it would wise be to explore what staff want from ‘clinical supervision’ (what are the outcomes) & to consider how that aligns with organisational requirements. If they are vastly different, you would then need to start evaluating the relative benefits of different approaches - & how it might be possible to develop a model of supervision that meets staff’s expectations of supervision that also enables a department/service to meet organisational targets/demands & governance (e.g. how might your model of supervision enhance client outcomes, staff recruitment/retention, productivity etc). It would also be advisable to support your argument with reference to professional expectations e.g. HCPC’s standards of conduct, performance & ethics, & CSP’s Code of professional values & behaviours etc. Based on a review of existing models and underpinned by the Society’s approach to CPD, CSP has drafted a set of prompts to help members develop systems of clinical supervision with meet the requirements of all individuals.

http://www.hcpc-uk.org/cpd

http://www.csp.org.uk/code

http://www.csp.org.uk/code

Principles. Clinical supervision should: 1. Support & enhance practice for the benefit of patients/service users 2. Develop skills in reflection to narrow the gap between theory & practice 3. Involve a supervisor & practitioner or group of practitioners reflecting on & critically evaluating practice 4. Be distinct from formal line management supervision & appraisal 5. Be planned & systematic & conducted within agreed boundaries 6. Be explicit about the public & confidential elements of the process 7. Facilitate clear & unambiguous communication, conducted in an atmosphere of beneficence 8. Define an outcomes based action plan. The outcomes could then be more broadly developed to assist the practitioner’s professional development through the appraisal process 9. Be evaluated against set standards from the time it is initially developed & implemented The clinical supervision process should: 10. Involve all individuals in the service, signed up to by staff & supported & resourced by management 11. Be developed in partnership with managers & practitioners 12. Be supported by appropriate resources (time, training, replacement staff) 13. Facilitate practitioner access to their chosen model of supervision, as appropriate 14. Support a local system for supervisors to further develop their skills in facilitation 15. Be developed in parallel with collating a portfolio of learning, so that the practitioner is supported to develop & demonstrate skills of reflection & evidencing learning from experience. Additional resources: DoH (2010) Preceptorship framework for newly registered midwives, nurses & AHPs CSP’s Physiotherapy Framework defines & describes the behaviours, knowledge & skills used by the physiotherapy workforce – at 6 levels of practice. Its content might be helpful for thinking about the nature of/requirements for clinical supervision at different levels of practice as well as the behaviours/knowledge/skills gained through supervision. Click here to access a workbook based on the CSP Physiotherapy Framework domains/descriptors from the CSP's website.

February 2017

http://www.cmft.nhs.uk/published/UserUpload/file/DoH%20Preceptorship%20%20AHPs,%20Nurses%20Midwifery.pdf

http://www.csp.org.uk/professional-union/careers-development/career-development/professional-frameworks

http://www.csp.org.uk/news/2013/08/12/csp-physiotherapy-framework-workbook?networkid=225959

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Allied Health Professionals Professional and Clinical ... · Allied Health Professionals Professional and Clinical supervision Protocol Last amended: 21 September 2017 Professional