Clinical supervision sits at the heart of the UK Government's agenda for improving the quality of service delivery (Department of Health, 1997, 1998, 1999). The practice in the workplace was introduced as a way of using reflective practice and shared experiences as a part of continuing professional development. Clinical supervision has ensured that standards of clinical care remain a key mechanism for monitoring the performance of Trusts, with clinical performance measures being given equal weight to financial and accounting measures. Each Trust is required to have a clinical supervision lead and a clinical supervision committee. The clinical supervision process within Trusts is performance managed through annual reports scrutinised by Strategic Health Authorities. (Kohner 1994; Faugier 1992) The Commission for Health Improvement review teams focus, during their visits, on the clinical supervision process. There are therefore several mechanisms for monitoring the delivery of clinical supervision.
Clear national standards for services and treatment support the development of high-quality services.
The National Institute for Clinical Excellence Guidelines and technology appraisals are sent to all Trusts with a requirement that they be implemented. Other key drivers for clinical supervision include National Service Frameworks, Effective Healthcare Bulletins, Cochrane reviews and national audits including Suicide and Perinatal Mortality. Trusts are expected to establish robust management mechanisms to ensure that this national guidance is implemented.
In addition to the implementation of national standards, a further requirement for clinical supervision is to ensure that good ideas are facilitated locally, and form an integral part of clinical improvement. (Butterworth 1992; (Farrington 1995)) This requirement recognises that many improvements that will make a real difference to patient care will be identified by clinicians working directly with patients. Clinicians and patients together are often able to identify local factors, which will make a real difference to the local delivery of care.