A timely look at staff appraisal

Extract from the second issue of Mastering Management in Healthcare: a practical resource

In this issue:


This article is all about developing you and your staff. The advice is kept as  practical as possible and include things that you can apply immediately. The intention is to try and provoke you to think differently about how you manage and encourage you to innovate and experiment.

Staff Appraisal – chore or golden opportunity?

A common challenge facing clinicians entering management roles is how to conduct appraisals for the staff now reporting to them. Quite apart from practical issues such as finding the time and an appropriate environment, the employer may also have a particular format to follow, and the whole process can end up looking like one big distraction from the main objective – providing care.

However there is both anecdotal and independent research evidence to show that good, regular staff appraisal can actually improve your team’s performances, and the time/effort required is easily repaid further down the line. Michael West’s seminal study (1) into teams in the NHS showed a link between good, regular appraisal and effective performance, including patient mortality! Put simply, the majority of staff welcome their manager taking a genuine interest in them, they want to get feedback on how they are doing, and they want to have a say in what will happen to them in the coming months. Good appraisal also offers a golden opportunity for you to find out more about your people, including how to get the best out of them in future

So what are the ingredients of an effective appraisal discussion and what can you do to establish (or re-establish) these in your workplace?

  • Appraisal works best when it is genuinely owned by the member of staff and not imposed upon them by the manager. Have a discussion about the potential value of the session and how it is there to help them. Then let the person influence when the meeting takes place, where, and for how long, and you immediately give an important message that this is their session, not yours.
  • Don’t over engineer the process. A simple structure of reviewing past performance, setting out priorities and interests for the coming period, and agreeing what each of you will do to help move forward, will be sufficient. Don’t let the paperwork get in the way of a genuine discussion.
  • In this discussion let the member of staff assess their performance first. Don’t just start off with what you think and expect them to agree. After all, whose session is it? Once they have started to talk about themselves you will be able to gauge where to agree and where to probe further.
  • Never bring up negative performance issues for the first time in the appraisal discussion. People do not like being ambushed with events that might have happened some time ago and should have been addressed at the time. Surprises like that undermine trust and give appraisal a bad name.
  • Make sure that there will be no interruptions during the discussion. Choosing a suitable place will help but even if it has to be near the action do not allow anything to get in the way. Allocate enough time so that you don’t have to excuse yourself half way through. Interruptions let the employee know how little you value the process.
  • Use the discussion to explore not only specific performance areas but also motivation, interests, and any unused talents and skills. You may be surprised to find out just what your staff are interested in, and the talents they are willing to bring to the workplace, if they feel truly valued and supported. However if they are just labelled as a grade and a job description, don’t be surprised if that is all they give you.
  • Ask the person how you are doing as a manager and how they would prefer to be managed in future. If your intentions are genuine and you are trusted, you will gain valuable insight on how to get the best out of the other person. Of course if you are already doing great, why not let someone tell you that?
  • Ensure that the actions that follow are clear and agreed, that there is a shared responsibility for moving them forward, and that the process of monitoring progress is also fit for purpose.

Finding the time for conducting appraisals, particularly for those managing larger teams, is a challenge. However, our experience is that, without regular appraisals, even more time will be spent through the rest of the year by those same clinical team leaders – dealing with role clarity issues, missed performance targets, lack of motivation, high sickness and absence, staff turnover, personality clashes etc. Worse still these crises will not line up in an orderly fashion waiting for a slot in your diary. They will arise unexpectedly and disrupt your work in a more damaging way. You may need to manage upwards, by letting your own manager know that a) you are currently in ‘appraisal’ mode, that b) this activity will be given the protected time it deserves, and that c) you are sure you can count on their support!

In summary, good appraisal is an investment, with an excellent rate of return – a rare commodity in these troubled economic times!

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