BNU research highlights ‘supervision gap’ facing NHS advanced practitioners
Advanced practitioners across the NHS are taking on increasingly complex roles in busy services, and new research from Buckinghamshire New University highlights the need for more consistent and structured professional support.
The project, led by Senior Lecturer Hasan Alsararatee, alongside colleagues from BNU’s Advanced Practice team and Dr Yetunde Dairo, points to a growing 'supervision gap' between what advanced practitioners are expected to do and the support available to them in practice.
These roles sit at the heart of patient care, with practitioners working autonomously across clinical practice, leadership, education and research. But in reality, supervision is often inconsistent, informal or dependent on local workplace culture, rather than built into the role itself.
Hasan Alsararatee said: “Advanced practitioners are making difficult decisions every day in busy NHS services. They are expected to manage complexity, lead change and support safer care, but supervision has not always kept pace with the demands of these roles. This is not unique to advanced practitioners, as many healthcare professionals are working under significant workload pressures and workforce shortages. The project is therefore about making professional support visible, structured and meaningful.”
The study found effective supervision is linked with improved confidence, clearer decision making, reflective practice and emotional resilience. Where it was lacking, practitioners were more likely to report isolation, uncertainty and reduced confidence in their role.
The research also a wider issue. While clinical supervision is widely encouraged, there is still limited evidence connecting it directly to measurable patient or service outcomes – something the team says needs to be addressed as the role continues to expand.
To tackle this, the BNU team is developing the INSIGHT Framework - a new model designed to bring clinical practice, leadership and management, education and reflective practice into a more joined-up approach to supervision.
The aim is to offer something more consistent and practical for NHS organisations looking to better support advanced practitioners.
“For patients, this matters because supported practitioners are better able to reflect on risk, discuss complex decisions and strengthen their judgement,” Mr Alsaratee added.
“Clinical supervision may sound like an internal workforce issue, but it has real implications for safer and more compassionate care.”
The work forms part of a wider BNU programme focused on advanced practice, workforce sustainability and patient safety, supported by a £10,000 award from the University’s Policy Support Fund.
Further studies will explore how the INSIGHT framework can be tested and applied in real healthcare settings, including its impact on workforce development and patient care.
BNU is now seeking to work with NHS organisations and policymakers on the next phase of the project.
