Clinical supervision models in the UK and their implications for advanced practice: a systematic review

Background: Despite long-standing theoretical support and strong policy endorsement, uncertainty persists regarding which clinical supervision models are most effective and sustainable for nurses within UK healthcare settings. Aims: To examine models and frameworks of clinical supervision used in nursing practice within UK healthcare settings and to explore the reported outcomes and contextual factors associated with their implementation. Methods: A systematic review of qualitative, quantitative and mixed-methods studies was conducted. CINAHL, Cochrane Library, Embase, MEDLINE/PubMed and PsycINFO were searched. Results: A total of seven studies conducted in the UK between 1997 and 2019 met the inclusion criteria. Supervision based on Proctor's model delivered broad formative, normative and restorative benefits, with reflective and person-centred methods strengthening thinking and identity, and restorative approaches boosting wellbeing and cohesion. Implementation depended on organisational support, time and clear supervisory roles. Conclusions: Evidence from UK nursing contexts indicates that structured and reflective clinical supervision is associated with reported benefits for professional learning, accountability and practitioner wellbeing. However, the evidence base is largely qualitative and evaluative, and comparative effectiveness between supervision models remains uncertain. Implications for practice: The findings provide insight into how clinical supervision may support professional development and governance within nursing practice and offer a conceptual basis for designing supervision structures for nurses working at, or progressing towards, advanced level practice.