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How to manage performance

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Managing performance is a skill that can be learnt and there’s help available to do this, says Steve Gulati

Some of the most difficult conversations that managers and leaders ever have are with team members who perform poorly at work. As with many difficult issues, it is too important to ignore.

There is no need to worry about tackling poor performance, as it is a skill that can be learnt.
Problems with performance can result from any number of factors. Organisational change, new technology, issues outside work or even a run of “bad luck” can all affect performance, even for the most assiduous of professionals.

Given the primacy of patient safety and the quality of care, dealing with performance issues in healthcare - however they emerge - is vital.
Your HR department should have the policies and procedures in place to help you manage poor performance, and can provide specialist advice for specific situations.

This often means working with the poor performer, through a set of structured, measurable objectives, towards a return to competence.
On rare occasions more formal action is needed and, again, your HR colleagues will work with you on these difficult cases.

Leadership means setting clear standards of performance, ensuring staff have access to regular professional updates, and using appraisals and development plans wisely to maintain a culture of high professional standards.

If these are in place, then being willing and able to deal with matters when they go wrong should only be a last resort.

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

Five tips on how to manage performance

  • Use your skills. Nurses have highly developed communication skills, often from imparting complex or difficult news. Use these skills for difficult conversations with staff.
  • Forget the “praise sandwich” - saying “something good, something difficult, something good”. While this is fine for interview feedback, it can be confusing when talking about poor performance. Be polite and calm, but keep your message unambiguous.
  • Don’t avoid dealing with it. Not saying anything until the situation becomes critical is unfair on the employee and can compromise your own action, especially formal action. Address concerns early so there is more chance of improvement and less of matters escalating.
  • Diagnose. Poor performance can be due to competence, ill-health and conduct - all have solutions.
  • Remember the NMC code. As a leader, you need to uphold the professional standing of nurses - managing poor performance is too important to ignore.
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