Workforce, training and education
East Midlands

Enhanced Supervision

An enhanced supervision period is typically described as:

a short, intensive period of enhanced supervised practice, focused learning activities and direct observation of clinical activities with the aim of enabling trainees to return to normal duties safely and confidently. It is expected that during this time trainees may not be required to undertake any out of hours arrangements if adequate supervision isn’t available.

In order to rapidly regain clinical knowledge and confidence, doctors returning to training following a sustained period of absence are strongly encouraged to participate in a period of enhanced supervision for a two-week period (10 working days) on their return to work, and this should be on a pro-rata basis for LTFT.

During this period;

  • You will participate in closely supervised work and by the end of the period you should be working at a level commensurate with re-entry into the training programme.
  • You will be paid for this period at your usual rate via payroll, as if you had returned to your usual working pattern.

What if I don’t want to have Enhanced Supervision?

If you feel enhanced supervision is unnecessary, you should discuss this with your FPD / TPD / Supervisor during your Pre-Return meeting in advance of your anticipated return date. Your intention to opt out of enhanced supervision must be clearly indicated on the Pre-Return Form.

We strongly recommend even the most senior trainees undergo Enhanced Supervision. Senior trainees often experience a degree of non-technical skills attrition during time away from training, so a period of additional supervision can be extremely helpful, regardless of clinical experience and knowledge.

How do I arrange enhanced supervision?

After discussion with your supervisor or TPD during the Pre-Return meeting, your Supervisor should disseminate your SuppoRTT plan to colleagues who will be working with you and any rota coordinators.

It is strongly advised that you also contact your Trust’s SuppoRTT Champion (if one is available). They can liaise with medical staffing and rota coordinators to ensure your SuppoRTT period is protected and your period of Enhanced Supervision is being arranged appropriately.

Can I work out of hours/on call during the enhanced supervision period?

You can work out of hours/on-call during the enhanced supervision period providing there is adequate senior supervision.

If you wish to participate in out of hours or on-call this should be discussed and agreed in advance with your TPD/ES during your Pre-Return meeting.

Will the period of Enhanced Supervision count towards my CCT?

The “Training clock” typically restarts once you and your supervisor agree you are working safely and able to restart training. For some Doctors in training the Post-Return meeting is an opportunity to agree this.  

GP Trainees returning to Practice Placements

When returning to a general practice placement, for the first two weeks, the trainee should be offered the usual GP practice induction period. This should include the opportunity to sit-in with various members of the practice team and a general reorientation to practice systems and protocols. Joint surgeries and home visits should be considered and regular / daily debriefs should also take place. Tutorials during this induction period should focus on identifying individual learning needs and planning how to meet these, including refreshing the trainee’s clinical skills. They should have a meeting with their supervisor towards the end of this period to ascertain that they are confident to return to ‘normal’ consultations.