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Face up to doing the dreaded appraisals


Well-designed discussions about performance benefit care and can be positive and constructive experiences.

Appraisals, personal development reviews, annual assessments…for line managers and leaders, the prospect of conducting these discussions can sometimes initiate that “heart-sinking” feeling.

But we know how important regular, well-designed and properly conducted discussions about work performance are in managing people and, by extension, to patient care. How can we make these positive and constructive?

Whatever the terminology used, there is no doubting the importance of appraisals, for both managers and staff.

Receiving positive feedback confirms and exemplifies best practice and good care and, if there are any performance problems, the appraisal process is an established tool to help deal with the issues.

The annual NHS Staff Survey has a range of questions about whether appraisals take place and how well survey respondents felt the appraisal was conducted.

Work by Professor Michael West a decade ago at Aston University into links between HR practice and patient care identified good appraisal processes as key.

The best appraisal systems allow for flexibility in method, and have only a light touch of regulation.

The best leaders report that conducting an effective appraisal is common sense, in that it is little more than a planned, structured conversation. Equally, the best HR departments will provide some form of training or more personalised coaching for those who are unsure or new to people management.

If you haven’t had an appraisal yourself, schedule it in with your line manager. The cascade approach, where appraisals flow down through hierarchies, is ideal because this will allow you to empathise with your own staff when doing their appraisals, and confirm key organisational objectives for you.

Five tips for appraisals

  • People, not paperwork. The main points of an appraisal need to be recorded, but don’t focus so much on this that the discussion suffers. Most good HR departments will allow flexibility about forms if you can show the appraisal was meaningful
  • No surprises. The appraisal should not be the only time you talk to staff about performance. It should be an overview of issues that have already been identified and worked through – work to the “no surprises” principle
  • Keep it regular. The main annual appraisal should be reinforced through quarterly reviews to ensure things on are track. This will also help with the principle of “no surprises”
  • Keep it simple. Discussions should focus on the past 12 months; what has gone well and not so well; and plans for the next 12 months. Use this structure to keep discussion focused
  • Prepare. With busy schedules, it is too easy to panic half an hour before the appraisal. Set some time aside, perhaps a week in advance, and think about incidents that illustrate the points that you want to discuss

Steve Gulati has held a wide range of senior HR roles in the NHS, and is a visiting lecturer at the Health Services Management Centre


Readers' comments (6)

  • tinkerbell

    what you mean the appraisal where myself and my manager get together and nearly end up in tears because we are wading around in ideological treacle whilst OUR NHS is being dismantled whislt we speak. Oh yeah already done mine for this year.

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  • Oh dear. Another lot of tosh written by someone completely unaware the reality of a nurse's life in today's NHS.

    Do us a favour mate, roll your sleeves up, get down and dirty on living, breathing ward for a few days. I'll give you five tips.........

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  • Appraisals are ok but so booming false all that matching up it's such a yawn - I have recently retired and have returned to work in a specialist role via the Trusts own Bank ( so NHS) The pay is rock bottom, from now on all MANDATORY updates must be done in our own time - we will NOT BE PAID! - anyway from now on we have got amended contracts ( HR say they made a mistake in the original!!! and one "sweet woman at HQ told me "WELL IF YOU WANT THE WORK YOU'LL DO IT !!! OMG) what a way to treat staff, staff they depend upon to fill in in emergencies, sickness A/L, in the last week I have been called out 4 times to go in etc - does anyone know where we stand here - I'm just so shocked at being treated so disrespectfully. I think once my Mandatory training that can't be done on line - like ILS and paed ILS runs out I should tell them to stick the job... any comments?

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  • tinkerbell

    Anonymous | 18-Mar-2012 6:40 pm

    sounds like we will all become like Olivers Army' mercenaries just doing it for the money and lesser pay to boot. What ever happened to paying a living wage to those who are dedicating their lives in the service of others? Perhaps in Abraham Masows hierarchy of needs we now have to sacrifice altruism for own own survival. How sad is that?

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  • tinkerbell


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  • Don't you just dread it when you read the title and start line of articles like this. No surprise to find out that it is written by someone who has never had his positive experienced cluttered with the needs of pressing patient care.

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