Introducing clinical supervision for community-based nurses

City and Hackney Teaching Primary Care Trust has introduced mandatory clinical supervision for all front-line nursing staff (district nurses, health visitors, school nurses, staff nurses, health care assistants). A group model is used, with sessions occurring monthly and lasting 90 minutes. Groups include a mixture of qualified and unqualified staff. The project was introduced in two phases. First, external facilitators were used to run sessions for 18 months. An evaluation toward the end of this period found very strong staff support for the innovation. Internal facilitators were then trained to implement the second phase. A second evaluation found continuing support for clinical supervision, and a preference for multidisciplinary groups. Clinical supervision is now firmly embedded in the organization. It is primarily 'restorative', offering staff relief from the stresses of working in a very deprived and ethnically diverse area where the recruitment and retention of staff is an enduring challenge.