Supervision throughout your career

Supervision is important at all stages of your career, regardless of your role. The type, frequency and intensity of supervision required will change as you develop your skills. For example, for newly qualified practitioners (NQP), the first 12months of registration is a period of rapid professional development to make the transition from learner to a novice autonomous professional. Supervision at this stage of career development is therefore likely to be required more frequent than someone who has been qualified for many years. It can take many forms including supervision with a more experienced dietitian at the same level or a dietitian at a higher level. There may be opportunities for peer learning and journal clubs with other newly qualified dietitians. Informal supervision may be required multiple times daily initially, becoming less frequent as you become familiar with organisational procedures. Formal practice supervision sessions should also be scheduled on a more regular basis initially.

For this reason, the BDA does not recommend that NQP work as locums, undertake bank work or work in independent / freelance practice without there being a clear structure in place for supervision with an appropriate registered dietitian. To meet this requirement, you may need to source this independently at personal cost, see What does good supervision look like? and How to identify a suitable supervisor.

Supervision is likely to look different for more experienced dietitians. They may be looking to extend their scope and take on a specific skill or task not traditionally undertaken by a dietitian which would require multi-professional supervision. For example, a dietitian may be upskilling to undertake dysphagia assessments and require supervision from a competent Speech and Language Therapist. They may be learning to place nasogastric tubes and retaining devices therefore it may be that a competent nutrition nurse is the supervisor. These skills are acquired through training and assessment and may require intense, direct supervision for a period (see  Levels of supervision).

There may be occasions where dietitians find that they are the most senior or the most experienced clinical dietitian in their team, service or organisation. There may even be occasions when they are the only dietitian in their organisation. This is sometimes seen in primary care, in eating disorder or mental health services. Those working in private practice are also likely to be working in isolation. These situations highlight that there should not be a ‘one size fits all’ approach to supervision and that a flexible approach is often needed to ensure that the supervisee derives the intended benefit that allows practice to be enhanced.

Dietetic Support Workforce

Dietetic Support Workers (DSW) work alongside dietitians but are not regulated by the HCPC. Similarly to registered staff, to develop the relevant knowledge and skills necessary to competently carry out their role, they require regular supervision. As DSW are non-registered staff, tasks and responsibilities they perform will be delegated to them by a registered professional. It is a HCPC requirement that the registered professional takes responsibility to provide appropriate supervision and support to whom they delegate work¹. This can be met by ensuring access to informal supervision whenever it is required, which may be multiple times daily, weekly or less frequently depending on the experience of, and caseload delegated to, the DSW. This will ensure that the DSW is confident and competent in completing delegated tasks but also meets the HCPC standards of proficiency for safe practice².

Equally important though is access to formal practice, restorative and management supervision.  DSW are likely to be exposed to the same challenging and distressing situations as their registered colleagues and the restorative function of supervision, is therefore, similarly needed. Whilst a registered dietitian does need to fulfil the supervision requirements of delegated care, experienced DSW who have had appropriate training could facilitate practice supervision for other DSW colleagues. Training is discussed under Training for supervisors.

Dietetic managers

Managers who are registered dietitians are still required to meet the HCPC Standards, even if they are in a non-clinical role. As such, access to supervision will still benefit their learning and wellbeing. Dietetic managers are more likely to access supervision from peers who are outside their profession or other dietetic managers in their region. They may also benefit from coaching and mentoring which is different to supervision. As with all supervision, the mode should be led by the individual based on their identified learning need.