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Given the nature of Crisis Resolution Home Treatment Teams (CRHT) and the ever increasing demands made upon the service, clinical supervision can be easily overlooked and cast to one side as other pieces of work take priority. Yet, if ever there was a service in which clinical supervision was vital it has to be the CRHT given the complexity of presenting cases and high levels of risk the service has to manage on a daily basis.
In the West Essex CRHT at the South Essex Partnership NHS Foundation Trust we believed the best way forward to meet this need was via a group supervision approach, implemented once a month, each session lasting around one hour. This educational activity provides a unique opportunity to update the knowledge base and maintain resilience in the team.
The supervision took the form of a training session based around the clinical presentation and needs of any particular difficult case the CRHT had on its caseload. The Consultant Psychiatrist for the CRHT would facilitate the session and other Consultants, medical trainees and senior clinicians would be invited to give a presentation on various topics relating to work the CRHT was currently undertaking, such as "crisis assessment and management of elderly patients"; "Drugs and alcohol, risk and crisis"; "anxiety disorders/crisis management" to name but a few. As the training sessions progressed the levels of engagement and interest in the sessions of MDT rose. Feedback from those attending has been very positive. Since we started this approach we have noticed a distinct increase in the number and regularity of those attending the sessions and the quality of documentation in case notes and feedback at the twice weekly MDT clinical review.