NHS FORTH VALLEY. Clinical Supervision Policy for Nursing, Midwifery and Allied Health Professionals

Transcription

1 NHS FORTH VALLEY Clinical Supervision Policy for Nursing, Midwifery and Allied Health Professionals Date of first issue 06/10/2012 Approved 06/10/2012 Version Version 2 Current issue 26/08/2013 Review date 26/08/2015 EQIA 15/05/2012 Author/Contact Group Committee, Final approval Chris Beech Nurse Consultant Older Peoples Services/Eileen Sharp AHP Practice Education Lead Joint Clinical Governance Group Page 1 of 23

2 This document can on request be made available in alternative formats Name of document to be loaded Area to be added to Clinical Supervision Policy for Nursing, Midwifery and Allied Health Professionals * see areas available on the policy web-page Type of document Policy Guidance Protocol X Other (specify) Priority Immediate 2 days 7 days 30 days X Questions Understanding Yes No X Required Archive file Yes No X Options Where to be published External and Internal X Internal only Default setting Target audience NHSFV wide X Specific Area / service August 2009 Contributing Authors Consultation Process Chris Beech, Eileen Sharp, Anne Cook, Sandra Campbell, May Fallon, Sarah Murdoch, Claire Lamza, Robyn MacLeod, Allison Ramsay, Viccy Chisholm, Helen Gray, Fiona Grant, Therese McGoldrick Circulated to Senior Nurse Group, AHP strategic lead, General Managers, Head of Clinical Governance Distribution Section NHS FV Intranet, internet, senior charge nurses, General Managers, Department of Nursing Stirling University, Director of Nursing, AHP strategic lead Page 2 of 23

3 Change Record 20/4/10 Development of draft 1 of policy by amalgamating other health board policies, for discussion at policy group meeting on 18 th may /6/10 Amendments made following group meeting, draft 1.1 now most up to date 30/9/10 small working group made amendments now version /03/11 changes made to policy following meeting now version1.5 23/06/11 changes made to policy following meeting now version /08/11 changes made to policy following meeting now version /10/11 Version 1.9 final version for consultation 13 th February 2012 version 2 - changes made following consultation Page 3 of 23

4 Table of Contents 1. Introduction 5 2. Definition 5 3. Aims and objectives 5 4. Clinical supervision is 6 5. Drivers 7 6. The Clinical Supervision process 8 7. Education and training Audit and Evaluation 13 Appendices 17 References 21 Page 4 of 23

5 1. Introduction NHS Forth Valley is committed to the development and regular use of Clinical Supervision, reflective review, to help staff deliver safe, effective patient care to the highest standards. These activities also contribute strongly to enhancing a learning organisation. This in turn has many positive benefits for recruitment, retention, and governance. Supervision has three components: management, professional and Clinical. This policy concentrates on Clinical Supervision only. For Allied Health Professionals the model of Supervision will contain all three areas and this is outlined in further detail in Appendix Definition There are probably as many different definitions of Clinical Supervision as there are models, however ever since the National Health Services Management Executive (NHSME) issued the following definition in 1993 it has been recognised that Clinical Supervision is A collaborative process between two or more practitioners of the same or different professions. This process should encourage the development of professional skills and enhanced quality of patient care through the implementation of an evidence-based approach to maintain standards in practice. These standards are maintained through discussion around specific patient incidents or interventions using elements of reflection to inform discussion. Clinical Supervision is part of the Clinical Governance framework. It should be included within working practices and not considered as an add on. It is integral to delivering a quality service and should be embraced by the practitioner to enhance professional practice. 3. Aims This policy has the aim of ensuring that all nursing, midwifery and allied health professionals have access to high quality Clinical Supervision that supports delivery of safe and effective patient care. This will be achieved by supporting the development of effective and sustainable Clinical Supervision structures and continuing to support existing good practice in Clinical Supervision. 3.1 Objectives To outline a consistent approach to Clinical Supervision throughout the organisation To identify training needs and standardise training provision To support staff throughout the organisation by ensuring that Clinical Supervision is integral to life-long learning for all nurses, midwives and allied health professionals To provide guiding principles to support services and staff To identify appropriate supporting documentation Adhere to the principles/codes of conduct of professional bodies Review the Clinical Supervision structure and function on an annual basis Page 5 of 23

6 Enable NHS Forth Valley to meet the requirements within the national and local policies identified below in section Scope Clinical Supervision encompasses action learning, reflection, case review and peer review. NHS Forth Valley have introduced a formal project to work towards the goal of all registered and unregistered nurses midwives and Allied Health Professionals (AHPs) having access to high quality Clinical Supervision. This goal will be achieved in incremental phases. Whilst the value of informal supervision is recognised, this policy focuses on a formal, structured process of Clinical Supervision. This approach is based upon the premise that dedicated time for shared reflection on practice within Clinical Supervision supports: Safe and effective delivery of patient care Service development Professional and personal development A culture of openness and continuous quality improvement This document should be read alongside relevant professional guidance. 4. Clinical Supervision is Participants describe events/ experiences from work which are pertinent to them e.g. discussing a case. They then reflect on their experiences and explore alternative approaches to similar situations should they arise again, and then discuss what they have learnt and how they will apply this knowledge in practice. The purpose of supervision is to: Provide professional support Develop the supervisees clinical and work management competencies Reduce clinical risk. Subjects for discussion within Clinical Supervision may therefore include: Clinical case Organisational/management issues Personal development Professional development plan (and eksf) Communication issues interpersonal/interprofessional Decision-making and problem solving. It is facilitated and supported by a trained supervisor who listens, inspires, challenges, is a role model, and supports growth and development of the individual or group. 4.1 Clinical Supervision is not Caseload supervision Line management Page 6 of 23

7 Performance management. It is expected that the line manager and supervisor roles will be separate. However there are occasions where this may not be feasible and in this instance a clear distinction should be made between the business part of the meeting and professional supervision. Formal teaching or in-service session Gripe session Personal counselling Primarily related to administration issues Coaching/mentoring for information on these topics please see NHS Forth Valley policy on coaching (Coaching information) 5. What are the drivers? The main national guidance documents regarding Clinical Supervision policies are listed below: 5.1 National Rights, Relationships and Recovery: The Report of the National Review of Mental Health Nursing in Scotland (2006), this was updated in 2010 by Rights, Relationships and Recovery: Refreshed. Action 12 within this document requires that all mental health nurses undertake regular Clinical Supervision held as a minimum every 6 weeks for at least one hour. Clinical Governance and Risk Management: Achieving safe, effective, patient-focused care and services (Standard 3) published in 2005 asks NHS Board to demonstrate that there are policies and standards on Clinical Supervision for each professional group. Nursing and Midwifery Council (NMC 2008) state that Clinical Supervision should be available to registered nurses throughout their career. This they suggest enables constant evaluation and improvement of the contribution to care. The Healthcare Quality Strategy for NHSScotland (2010) suggests that staff have a vision of high quality healthcare services; there is a need to capture and sustain the enthusiasm and commitment. It is important to balance the drive with the support and development for staff to feel engaged, valued and empowered in driving quality Delivering Care, Enabling Health (2006) suggests that Clinical Supervision is particularly important in developing the workforce. Clinical Supervision is sufficiently flexible to allow delivery through a variety of means to underpin different approaches to supporting practitioners. Building on success: Future Directions for the Allied Health Professions in Scotland (2002) states that It is essential that Allied Health Professionals build strong foundations of learning for staff of all grades, beginning with induction and clear role expectations through to in-service training opportunities and structured supervision and appraisal system. Page 7 of 23

8 5.2 Local A principle of the NHS Forth Valley Education and Training Strategy (2009) is to support Clinical/Professional Supervision and reflective practice as a recognised learning activity. This is reflected in both the local Nursing and AHP Education and Training strategies which identifies that all staff, both registered and unregistered, are to have access to supervision and coaching to supplement formal learning and that taking time to reflect is acknowledged as good practice. Participation in Clinical Supervision underpins the principles of clinical governance and can assist supervisees in meeting the post registration education and development requirements of the Knowledge and Skills framework, particularly core dimensions 1 and The Clinical Supervision Process 6.1 Confidentiality Aspects and boundaries of confidentiality must be discussed and agreed between the supervisor and supervisee prior to commencement of Clinical Supervision in the form of a written agreement or contract. Unconditional confidentiality cannot be agreed and there may be circumstances when a confidence must be passed on to a 3 rd party. If the supervisor believes that they are bound by ethical duty +/or professional code of conduct to report a situation but the supervisee declines, they should advise the supervisee that they intend to do so including what will be shared, with whom and why this is thought to be necessary Patient/clients names, staff names and details must be anonymised in Clinical Supervision documentation; similar care must also be exercised regarding references to colleagues 6.2 Contract setting It is the responsibility of the supervisor to ensure that a supervision contract is established at the start of any supervisory relationship, making the boundaries and parameters of the relationship explicit. The supervision relationship should be founded on the principles of trust, consistency and mutual professional respect. The supervisory relationship will be formally constituted and ground rules must be negotiated and established as part of the supervision contract. The contractual agreement will include Frequency of sessions Timing of sessions Location Confidentiality Professional Accountability Rights and responsibilities of roles within Clinical Supervision (supervisor, supervisee, facilitator and participant) Discussion of understanding of the aims of Clinical Supervision including any areas of concern Page 8 of 23

9 Agreement about where appropriate guidance can be obtained if it is felt that inappropriate topics are being discussed Agreement of circumstances and steps for reviewing the supervisory process and contract at a minimum of 2 yearly For one-to-one Supervision - A copy of the contract is written out and signed off by the supervisor, supervisee and the supervisee s line manager, placing a copy in the personal file of the supervisee For peer Supervision A copy of the contract will be signed by the line manager and kept in the supervisee s personal file. The line manager will agree that peer supervision is appropriate. 6.3 Choosing a supervisor A database of experienced supervisors will be available to enable new supervisors to identify resources, or those wishing supervision outwith their discipline to have available contacts where there is not already an established process for allocation of a clinical supervisor. The choice of supervisor will be made through negotiation and mutual agreement between the individual, his/her manager and the proposed supervisor. The choice of supervisor will be based upon appropriate skills, knowledge, expertise and accessibility There can be an element of choice on the part of the supervisee in selecting an appropriate supervisor but it is acknowledged that this might not always be possible and choice of supervisor should be negotiated between the supervisee, line manager and potential supervisor (whether within or outwith own discipline.) In peer group supervision, there should be an identified chairperson or facilitator who fulfils the role and responsibilities of supervisor as described in this document. Professionals from a different discipline may provide elements of Clinical Supervision, in addition to supervision arrangements for addressing issues specific to the supervisee s own discipline The ratio of supervisees to supervisor can be adjusted according to the experience and/or circumstances of the supervisor but the supervisor will be mindful of other commitments. It is recommended that in most circumstances line managers do not provide supervision for staff who report directly to them 6.4 Roles and responsibilities Line Manager Provide appropriate level of time for staff to attend supervision Agree the contract with the supervisee and supervisor Negotiate choice of supervisor between the supervisee, line manager and potential supervisor (whether within or outwith own discipline/speciality.) Page 9 of 23

10 6.4.2 Supervisee To be clear and honest in seeking support Being open to challenge To reflect, think through and explore options Assume the initiative in negotiating the agenda for Clinical Supervision sessions Receive structured facilitation of your reflection on practice within Clinical Supervision sessions To be responsible for own learning and active in the pursuit of own development To inform supervisor if plans cannot be implemented Ensure supervision sessions, especially outcomes and agreed actions are adequately and clearly recorded Supervisor To promote best interests of the person being supported and to acknowledge the experience and contribution of the individual being supported To meet legal, ethical and professional standards To seek and use guidance and knowledge when appropriate Provide a safe supportive and focused space for the supervisee to reflect on issues Help supervisee explore and clarify own thinking, feelings and beliefs and encourage reflective practice Have and make use of their own supervision and support networks Undertake training in Clinical Supervision skills (section 7) Be aware of the organisational contracts under which the supervisee operates Model good professional behaviour and boundaries Have access to appropriate training and support Joint responsibilities Make the process work by:- Sticking punctually to appointments and use time effectively Acting in anti-discriminatory manner Coming prepared for the session and actively listen and participate Being allowed to have own opinions, to disagree, to learn from mistakes, to be unsure or not to know Giving and accepting constructive feedback Having agreed how communication difficulties will be raised and addressed Regularly reviewing plans Protecting time for Clinical Supervision sessions: support to be released from clinical responsibilities in order to attend without unreasonable interruption Prioritising the safety and well-being of patients above confidentiality Completion of a Clinical Supervision contract Page 10 of 23

11 6.5. Supervision for senior staff and extended scope practitioners Practitioners working at a senior level and in an extended scope capacity may require to source supervision from an appropriately skilled and experienced supervisor. 6.6 Documentation Clinical Supervision is a formal process and documentation has to be kept for audit purposes. Supervisees are required to maintain minimum documentation of Clinical Supervision and submit these for audit purposes as required by the organisation. The minimum documentation required is: A supervision contract (Appendix 2) A Session Attendance Record (Appendix 3) A record of Clinical Supervision sessions (Appendix 4) Agreement on note taking should be formed between Supervisor and Supervisee. Templates to record the above are in the appendices. Supervisees may wish to keep a record of their Clinical Supervision by maintaining a reflective diary or supplementing their personal portfolio. Supervisees should take responsibility for such records, which are private and confidential. (Section 8) 7. Education and Training In order to implement this policy on Clinical Supervision successfully, it will be necessary for NHS Forth Valley to ensure appropriate education is available to the relevant staff. Anyone undertaking the role of supervisor must understand the governance issues in Clinical Supervision (RCN 2002). The education framework will reflect the policy in addressing how staff will be trained to undertake supervision. Staff who will provide Clinical Supervision should be appropriately trained and competent to do so (Ooijen 2003). Staff who wish to provide Clinical Supervision should meet certain pre- requisites or criteria Educated to degree level or equivalent band 6 and above (senior band 5 staff with relevant experience ) previous experience in either teaching or facilitating groups desirable Have developed own self awareness in relation to their Personal Development Plan and Knowledge and Skills Framework Be able to facilitate reflection of difficult material have attended relevant training Page 11 of 23

12 Training will consist of a two day programme that encompasses the theoretical background and application of Clinical Supervision. This training will initially be provided by external facilitators. The programme will incorporate the principles of the models outlined in the policy: one to one group peer group team The training programme will include audit and evaluation, facilitation skills and will be compatible with the organisational needs. (Lynch and Happell 2008) The education will also ensure potential supervisors are aware of the ethical implications, consent and boundary setting (Bernard and Goodyear 2009) advocating a focus on developing the supervisory relationship. An overview of the responsibilities of the supervisor will be an essential part of the training (RCN 2000). This will include a minimum of providing four supervision sessions per year to maintain competence. The programme will meet the following learning outcomes: Define the purpose of Clinical Supervision; Differentiate between the variety of Clinical Supervision needs; Choose and apply the most appropriate model of Clinical Supervision for practice settings; Identify and apply the principles of giving and receiving effective feedback; Develop an action plan to enable you to implement the NHS Forth Valley Clinical Supervision Framework within teams. Less experienced supervisors may work with a more experienced supervisor who will facilitate the appropriate skills and experience. In accordance with NMC recommendations (2009) a flexible approach to training of supervisors should be maintained to allow for the programme to be adapted according to individual needs of those attending the training. It is envisaged that senior members of the supervisors group would adopt a train the trainers approach to develop more supervisors in the coming years as per action plan. Less experienced supervisors will work alongside experienced supervisors Peer support for the supervisors is recommended with access to regular debriefing if required. All those undertaking the supervisor training will do so in agreement with their managers as part of their Personal Development Plan(PDP). The role of supervisor will be included in their Knowledge and Skills Framework (KSF) outline. A database of supervisors and training undertaken will be held. Page 12 of 23

13 7.1 Delivery Models Reflection and Supervision Clinical Supervision is a formalised, focused activity undertaken between supervisor and supervisee. It may be undertaken utilising a variety of models some of which are listed below. Staff should identify the most appropriate Clinical Supervision model for their needs. Clinical Supervision does not always have to be face to face, staff should consider the use of technology such as telephone, videolink etc. One to one (1:1): Between a supervisor and supervisee. The supervisor may be equally or more experienced/knowledgeable than the supervisee. This is the most common model of Clinical Supervision. Some sources suggest that this offers the greatest potential for professional growth (Gilmore 1999). Group: More than one supervisee receives Clinical Supervision from one Clinical supervisor. The group may be multi-disciplinary and is appropriate where the group share similar Clinical Supervision needs. Groups should contain no more than 6 people. Peer Group: All participants offer mutual support through sharing, rather than receiving Clinical Supervision from a single supervisor. The role of supervisor may be rotational. This model is usually more suited to experienced staff. The group may be multi-disciplinary. Team: All staff within a team receives Clinical Supervision together from one supervisor, this may be multi-disciplinary. Network: A network of peer Clinical Supervision arrangements, with the group involved periodically coming together for a collective, facilitated Clinical Supervision session. Staff working in relative isolation might find this approach most helpful All of the models can be supplemented by telephone or contact between sessions as agreed between supervisor and supervisee. 8. Audit and Evaluation Evaluation of clinical supervision is needed to assess how it influences care, practice standards and the service. The NHS Forth Valley Clinical Supervision policy recognises the importance of confidentiality in the relationship between a supervisor and supervisee and yet, it is equally important that the process is effective. By using some evaluation techniques, practitioners and managers can assess the utility and usefulness of clinical supervision and its impact on the workforce. At a minimum, Clinical Supervision will be formally monitored by at least one of the following ways: Through the annual Personal Development Planning (PDP) and review interview which will record the number (but not the content) and dates of supervision sessions given / received in the preceding year. Page 13 of 23

14 Using annual audit by the organisation of clinical supervision systems for both frequency and effectiveness. This audit may include the use of questionnaires and interviews to demonstrate impact in practice. Although the specific content of a supervision session will remain private, the following points should be discussed and supporting evidence gathered, at regular intervals. This can then be added to the PDP: How has clinical practice improved Is working practice effectively challenged Has there been planned learning How has the supervision contributed to clinical development Is there increased awareness of new areas of professional knowledge Has there been reflection on strengths/weaknesses Has the process assisted in managing stress at work Does clinical supervision improve self confidence Has team working improved Managers can audit practitioners PDP s to determine whether the process of clinical supervision is effective. Information gathered from clinical supervision contracts (Appendix 2) and clinical supervision logs (Appendix 3) may produce evidence on the types of models being used, helpful support materials that have been used, frequency and duration of meetings, and reasons for cancellation of meetings. Using data from the above areas can assess if the supervision process is working well. Supervisors, managers and organisation-wide departments such as Clinical Effectiveness, Organisational Development (OD) and Human Resources may consider the use of formal validated assessments to evaluate clinical supervision. There are a range of these, some that are field-specific to nursing, others that are specific to AHP. Some examples of frequently used questionnaires are: Manchester Clinical Supervision Scale (Copyright of Osman Consulting 2000) General Health Questionnaire (Goldberg & Williams 1988) Maslach Burnout Inventory (Maslach & Jackson 1986) Specifically, NHS Forth Valley s Quality Improvement department may audit the following processes to evaluate the impact of clinical supervision: If individuals engage with supervision/reflective review of some kind Is the activity is regular That it is sustainable That it is recorded formally, where appropriate If it plays a part in personal and professional/work development That it has a positive impact on quality of working, including patient care where applicable Does it create a positive experience for growth That it leads to the identification and delivery of actions Page 14 of 23

15 This will be done by interviewing a representative sample of relevant staff and checking the frequency, quality and effectiveness of these practices against an agreed framework. Audits would verify that : individuals engage with supervision/reflective review of some kind the activity is regular it is sustainable it is recorded formally, where appropriate it plays a part in personal and professional/work development it has a positive impact on quality of working, including patient care where applicable it is a positive experience for growth it leads to the identification and delivery of actions For other NHS Forth Valley s department such as Human Resources, Complaints and Risk, audits on the following area could evidence the wider impact of clinical supervision rates of sickness and absence staff satisfaction scales numbers of patient complaints retention and recruitment of staff critical incident reviews The LearnPro system can be used to log all details of clinical supervision, including the dates of sessions and key action points from the sessions. OD may also consider evaluating supervision using educational audits. This may include live supervision on video or audio-tape, post hoc analysis of audio or video-tape recordings and post hoc analysis of observation notes. All audit outcomes will be open to scrutiny and action taken to address any emerging issues of concern. Whilst the supervisee's right to confidentiality will be respected, NHS Forth Valley will wish to monitor the implementation and effectiveness of Clinical Supervision. The Learning & Development Department will also conduct occasional reviews to assess what additional learning support might be required for practitioners. Page 15 of 23

16 Management and professional supervision Appendix 1 The guiding principles would facilitate discussion within three main areas of supervision: managerial, educative and supportive. Management Supervision may address the agendas of both supervisor and supervisee, and has a principal focus within the managerial and educative dimensions. Professional Supervision is led by the agenda of the supervisee and has a principle focus within the support and educative dimensions. The following table will help to outline the differences between the two areas. Management Managerial Domains include monitoring and evaluating clinical work, time management and accountability for roles and tasks linked to service standards, operational policy and efficient local functioning. Educative Development of professional competence and skills required by the post, with recognition of PDP, service needs and practical issues such as funding availability. Support Awareness of current emotional stressors and effect of local pressures on the individual. Practical arrangements to ameliorate these. Professional Wider professional norms, values and ethics. In-depth, confidential reflection on clinical practice and performance of expected roles within the organisation. Exploration and reflection towards the development of professional identity, understanding and future direction. Practical guidance where requires through reflection on specific practice issues. Confidential exploration of the interface between personal and professional issues, staff dynamics and management of stress. Hawkins and Shohet 1990 Page 16 of 23

17 Clinical Supervision Contract/Agreement Appendix 2 Name of Supervisee Name of Supervisor... We have both read and agreed to our rights and responsibilities as stated in NHS Forth Valley Clinical Supervision Policy We agree to undertake (please tick appropriate box) 1:1 supervision Group supervision Other We have agreed to meet to undertake clinical supervision for (duration) and this will take place every weeks A record of attendance at clinical supervision sessions will be maintained, the supervisee s line manager may ask to see this record of attendance. The supervisor and supervisee may agree to record action and review plans Confidentiality Supervision is a confidential process with the following exceptions - when both parties agree that an issue can be shared outside of supervision - If the supervisor believes that they are bound by ethical duty +/or professional code of conduct to report a situation but the supervisee declines, they should advise the supervisee that they intend to do so including what will be shared, with whom and why this is thought to be necessary Content Supervision will focus on the acquisition of knowledge, clinical skills and casework The supervisee is responsible for bringing material from their place of work and any issues that arise from it We have also agreed the following additional points/ground rules (optional) This agreement will be reviewed before or on (date) Supervisee Date Supervisor Date Page 17 of 23

18 Appendix 3 Name of supervisee Clinical Supervision Attendance Record Date Supervisor Type e.g. group Duration Date of next session Comments e.g. reason for cancellation Page 18 of 23

19 Clinical Supervision Record (Confidential between Supervisor and Supervisee) Date of session. Name of supervisor Issues Discussed Appendix 4 Action points agreed By whom Supervisor. Supervisee Page 19 of 23

20 Appendix 5 Standard Statements The NHS FV Clinical Supervision Standard Statements 1. The NHS FV Clinical Supervision Policy and Framework document will be available in every clinical area (hard copy and/or electronic access). 2. Every nurse and AHP, registered and unregistered, will have access to Clinical Supervision. 3. Time allocated for Clinical Supervision will be authorised by the supervisee s manager. 4. The choice of supervisor will be agreed between the supervisee, the supervisor and the supervisee s manager. 5. All supervisors will have access to training. 6. A Supervision agreement will be established at the beginning of every Clinical Supervision relationship, as described in the Policy & Framework document. 7. The preparation for each session will follow the format of the Supervision Plan. 8. A Supervision Session Summary will be completed after each session.. 9. The number of sessions per supervisee per year will be no less than The duration of every Clinical Supervision session will be no less than 1 hour 11. Sessions will be held in a venue that minimises the risk of nonessential interruption. Page 20 of 23

21 References BERNARD, J.M. and GOODYEAR, R.K Fundamentals of Clinical Supervision. USA: Merrill. GILMORE, A Review of the United Kingdom Evaluative Literature on Clinical Supervision in Nursing and Health Visiting. UKCC: London. GOLDBERG, D. and WILLIAMS, P A users guide to the General Health Questionnaire. Slough NFER: Nelson. HAWKINS, P. and SHOHET, R Supervision in the Helping Professions. United Kingdom: Open University Press. LYNCH, L. and HAPPELL, B Implementation of clinical supervision in action: Part 3; the development of a model. International Journal of Mental Health Nursing, 17, pp NURSING MIDWIFERY COUNCIL, Clinical supervision for registered nurses. (Accessed on ). NURSING MIDWIFERY COUNCIL, Modern Supervision in action A practical guide for midwives. London. MASLACH, C. and JACKSON, S,E Maslach Burnout Inventory: second edition. Paolo Alto. CA consulting: Psychologist press. NATIONAL HEALTH SERVICES MANAGEMENT, A vision for the future: The nursing, midwifery and visiting contribution to health and healthcare. London: Department of Health. OOIJEN, E, V Clinical Supervision made easy. United Kingdom: Churchill Livingstone. ROYAL COLLEGE OF NURSING, Realising effectiveness and clinical governance through clinical supervision. RCN Institute in conjunction with Basildon and Thurrock General Hospitals and Southern Hospitals Trust. ROYAL COLLEGE OF NURSING, Clinical Supervision in the workplace: Guidance for Occupational Health Nurses. RCN: London. SCOTTISH EXECUTIVE HEALTH DEPARTMENT, Building on success: Future directions for the Allied Health Professions in Scotland. SEHD: Edinburgh. SCOTTISH GOVERNMENT, Rights, Relationships and Recovery: The Report of the National Review of Mental Health Nursing in Scotland. SG: Edinburgh. Page 21 of 23

22 SCOTTISH GOVERNMENT, Rights, Relationships and Recovery: Refreshed. SG: Edinburgh. SCOTTISH GOVERNMENT, Clinical Governance and Risk Management: Achieving safe, effective, patient-focused care and services. SG: Edinburgh. SCOTTISH GOVERNMENT, Delivering Care, Enabling Health. SG: Edinburgh. SCOTTISH GOVERNMENT, The Healthcare Quality Strategy for NHSScotland. SG: Edinburgh. WINSTANLEY, J., Manchester Clinical Supervision Scale. Nursing Standard,14 (19), pp Page 22 of 23

23 Publications in Alternative Formats NHS Forth Valley is happy to consider requests for publications in other language or formats such as large print. To request another language for a patient, please contact For other formats contact , text , fax or - fv-uhb.nhsfv-alternativeformats@nhs.net Page 23 of 23