Managing Performance
The Appraisal Information Pack
5HR515 (Managing Performance through People)
*Please read this booklet carefully and bring it with you to every seminar session.
Contents 1. Assignment Case study 3 2. The Clinical Support General Manager (Appraiser Brief) 7 3. The Waiting List Manager (Appraisee Brief) 9 4. Waiting List Manager: Job Description and Person Specification 10 5. Knowledge and Skills Framework (KSF) 11 Communication 11 Personal and People Development 12 Health Safety and Security 13 Quality 14 Service Improvement 15 Equality and diversity 16 6. What will happen in the Appraisal Practical? 17 7. Appraisal Practical Feedback Sheet 19 8. Appraisal Form 21
1. Assignment Case study
Susan Bell has recently been appointed as an HR partner at Middleton NHS Trust. Middleton is one of the largest NHS Trusts in the UK. With an annual budget of over £970 million and around 13,000 clinical and support staff, it provides medical services to a population of over one million patients per year and recently received a rating of ‘Good’ from the Quality Care Commission. The Trust Board of Executive Directors and Officers are responsible for setting the strategic direction of the Trust lead by the Chief Executive Officer (CEO). Its vision of providing “Exceptional Care Together” is supported by clinical, quality, people and finance strategies that aim to: put patients first; get things right first time; invest resources wisely and develop and nurture staff.
Departments are organised into four clinical divisions: medicine; surgery; cancer diagnostics and clinical support; and women’s and children’s services, each lead by a Director of Services and General Manager. There are also six nonclinical departments in the structure: operations; finance, performance and IT; workforce management; strategy improvement; corporate affairs and governance; patient experience and facilities management, each run by a non-medical Director.
Since April 2021 The Trust have implemented the pay progression framework for all of its staff. Prior to the changes, employees received automatic annual increments moving upwards through the pay points each year until they reached the top pay point for their job role. The change made movement through the pay increments dependent on individual performance as shown in the Band 5 Example below.
https://www.nhsemployers.org/system/files/media/Pay-progression-diagram-Jan-19_0.pdf
Performance is assessed through a traditional annual appraisal between a member of staff and their line manager. To move to a higher pay band, individuals must now demonstrate they have the appropriate knowledge and skills they need to carry out their roles enabling them to make the greatest possible contribution to patient care. This includes assessment against the six core dimensions of the simplified NHS Knowledge and Skills Framework (KSF):
1. Communication
2. Personal and people development
3. Health, safety and security
4. Service improvement
5. Quality
6. Equality and diversity.
At the pay step date the line manager must use information from the appraisal to make a decision as to whether the individual can progress to the next pay level. The NHS Terms and Conditions of Service state that:
To progress to your next pay step point, you must have met the following standards:
1. Your appraisal process has been completed within the last 12 months and outcomes are in line with the organisation’s standards
2. You are not in a formal capability process
3. There is no formal disciplinary sanction live on your employment record
4. You have completed all the required statutory and/or mandatory training
5. If you are a line manager- you have completed all the appraisals for all your staff
If managers conclude the employee is not meeting the requirements, the pay step will be deferred and the manager should discuss and agree a plan with the employee to bring the performance levels back up to the required standard within a clearly stated timescale, including the provision of any training and support to achieve this.
Despite this performance based payment scheme the Trust’s CEO and HR director have identified ongoing performance problems. The most recent Care Quality Commission (CQC) review reported:
“Whilst we found that the service was responsive to the local community we identified issues with the appointments system. Overbooking of appointments had become common practice which led to clinics over running and frustration for patients who experienced long waits. Five percent of patients failed to attend appointments. The hospital cancelled 10% of appointments and patients cancelled 11% of appointments.
Formal complaints processes were embedded however we did not see evidence that informal complaints were being recorded in line with the trust complaints policy
Despite the extension of the treatment centre into a state-of-the-art building, the largest investment in the Trust for over a decade increasing the number of patients who can have surgery, the department has failed to meet the government’s target to reduce the wait for elective cases to less than two years by July 2022 ( www.england.nhs.uk ). By April 2023 this should be down to less than 18 months! The Accident and Emergency Department is also under huge pressure. As a result of limited GP capacity, the number of patients attending the Trust’s A&E department has increased to nearly 1,000 patients a day. The average waiting time in the department is currently 8 hours and 20 minutes, breaching the target of 4 hours from arrival to admission, transfer or discharge.
Susan reviewed the hospital’s National Staff Survey results published in March 2022. At Trust level results are largely in line or slightly above the national average, however there is still a decline in the number of people who would recommend the Trust as a place to work (60.1%) and an increase in the number of staff thinking about leaving the organisation (30%). Only 33% said they were satisfied with their level of pay, 44% said they felt able to meet all the conflicting demands on their time at work and 26% said there were enough staff at the organization for them to do their job properly. She was unsurprised therefore to see that 47% said they had felt unwell as a result of work related stress in the last 12 months. A recent report from the Health and Social Care Committee estimated a shortage of 50,000 nurses and midwives and 12,000 hospital doctors in England alone (Ford, 2022). With accompanying concerns about staff wellbeing, an environment of chronic stress, and burnout, The Nursing Times reported 1/3rd of healthcare workers ‘feel overwhelmed at least once a week,’ almost half are considering a job change and nearly a fifth plan to leave the care sector all together.
Digging deeper into the data she notices that the Clinical Support Division have a number of results below the Trust and National average (shown below).
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National average |
Clinical Support |
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We are compassionate and inclusive |
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My immediate manager: · Works together with me to come to an understanding of problems
· Is interested in listening to me when I describe the challenges I face
· Cares about my concerns
· Takes effective action to help me with any problems I face |
66.8% 69.3% 68.4% 64.6% |
54% 49% 45% 57% |
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We are recognised and rewarded |
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My immediate manager values my work |
70.6% |
62% |
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We each have a voice that counts |
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I am trusted to do my job |
90.4% |
78% |
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We are always learning |
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There are opportunities for me to develop my career in this organisaion |
52.9% |
48% |
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I feel supported to develop my potential |
52.5% |
45% |
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My appraisal: · Helped me improve how I do my job
· Helped me agree clear objectives for my work
· Left me feeling that my work is valued by my organisation |
20.4% 30.9% 29.8% |
14% 22% 19% |
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We are a team |
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My immediate manager encourages me at work |
69.9% |
52% |
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Staff Engagement |
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I look forward to going to work |
52.5% |
43% |
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Morale |
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I often think about leaving this organisation |
31.1% |
47% |
In a meeting with the Clinical Support general manager, Susan tried to explore the Staff Survey results further. He told her that a new waiting list manager was appointed in June 2021, about 4 months before the hospital staff completed the recently published survey. The manager has strong hospital experience, working for 3 years as a receptionist in the radiology department, followed by 2 years as a team leader/supervisor in the hospital call centre. They are young and enthusiastic and have already made an impact on the department’s KPI’s (key performance indicators) by implementing changes to some of the systems and processes. Patient waiting times and ‘no shows’ have gone down and he speculates that this may have had an impact on the small increase in patient satisfaction scores that have been reported this month.
However, the new manager is also young and relatively inexperienced in the people management aspects of his role. While the appraisals have been completed within his department Susan notices that the staff have all been set the same objectives. The personal development plans have little detail and the departments training budget is underspent. She also notices there are a number of missing return to work interviews and that the absence rates in the department are higher than the hospital as a whole. The Head of Clinical Support also confesses that he has some concerns about how he has heard the new young manager speaking to some of his staff members when he has been walking through the department. He has observed the manager holding morning meetings with his team where he passes on hospital information and allocates tasks for the day but thinks that overall his style is very autocratic and has been picking up on some friction within the team.
Further resources
Department of Health (2004) The NHS Knowledge and skills framework (NHS KSF) and the Development Review Process [Internet] Available at https://www.nhsemployers.org/system/files/2021-07/The-NHS-Knowledge-and-Skills-Framework.pdf Accessed January 2023
Ford, M. (2022) Concerns NHS and social care face ‘greatest workforce crisis in history’, Nursing Times, 27th July
NHS (2022) Survey Documents [Internet] Available at https://www.nhsstaffsurveys.com/survey-documents/ Accessed January 2023
NHS Employers (2019) Pay progression [Internet] Available at https://www.nhsemployers.org/articles/pay-progression Accessed January 2023
NHS England (2022) Delivery plan for tackling the COVID19 backlog of elective care [Internet] Available at https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/C1466-delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care.pdf Accessed August 2022
Nursing Times (2022) Third of healthcare workers ‘feel overwhelmed at least once a week’, [Internet] Available at https://www.nursingtimes.net/news/workforce/third-of-healthcare-workers-feel-overwhelmed-at-least-once-a-week-12-08-2022/ Accessed August 202
2. The Clinical Support General Manager (Appraiser Brief)
You are the General Manager of Clinical Support at Middleton NHS Trust. You have 10 department managers who report to you, each of whom are directly responsible for a small team of staff and liaison with staff, clinicians and managers, throughout the hospital to support the delivery of a high quality clinical service to patients and to quickly resolve patient queries or complaints. One of them, the Waiting List Manager, was appointed in June 2021, 9 months ago, following an internal advertisement and a selection procedure in which you took part. Previously they had worked for 3 years as a receptionist in the radiology department followed by 2 years as a team leader/supervisor in the hospitals call centre. They are young, only 25 years old, and married with one young child. This manager is now in charge of a group of 10 mainly mature ladies responsible for appointments and waiting lists for the whole hospital.
Current Situation
You are generally satisfied with the new Managers progress. They are able and energetic and have already improved the efficiency of their work section by re-organising some of the procedures and improving the methods. You are a little uncertain however whether they are adopting the right approach to the staff. Before they took over the job, you had a meeting with them in your office and among other things, advised them to start carefully, particularly bearing in mind the contrast between their existing colleagues, being their own age or younger, and the new staff most of them older than the waiting list manager and with a long background in the department. Two of their team, Jason and Anne, have long service awards with the Trust.
You don’t have much evidence there may be a problem but you do walk around the hospital departments most days and on several occasions you have passed by the manager talking to staff members. You haven’t been able to hear what was being said, but you could hear the sharp tone of their voice and see the expression on the face of staff members, some of whom looked upset. You have also over-heard conversations between staff members where the manager’s name has been mentioned in connection with bad attitudes. You have tried to keep an eye on this situation and have come to the conclusion that the manager’s approach may be creating friction with some of the staff.
The other evidence was supplied by the Anne, the data entry clerk in their team. You always make a point of talking to her for a moment when you pass by. The other day she mentioned “that young manager wants to watch their step or they’ll get a swollen head”. You don’t like listening to tales, but you couldn’t stop the clerk. She said that a week ago she had made an error updating the waiting list figures. The manager had been around at the time and had pointed this out to her. Anne made it clear she did not object to being corrected when making mistakes, but she felt that the Manager had been very undiplomatic in the way they had done so. You are afraid that bad feelings may be building up throughout the department and that this might come to affect the quality of service.
This is the major problem you want to raise with the manager in the appraisal interview. You don’t think they have done any real harm yet but you are anxious to prevent any difficulties arising in the future. You also know the manager might take offence, but that if you can put them on the right track now, they will be a valuable manager in the future.
3. The Waiting List Manager (Appraisee Brief)
You are the Waiting List Manager at Middleton NHS Trust. You are 25 years old, married, with one child. You were appointed to the managers role 9 months ago following an internal advertisement and selection procedure. Previously you worked for 3 years as a receptionist followed by 2 years as a team leader/supervisor in the hospitals call centre. You are now responsible for the management of a team of 10, mainly mature ladies, responsible for appointments including the maintenance of waiting list statistics for the hospital. You must also liaise with staff, clinicians and managers, throughout the hospital to quickly resolve patient queries or complaints. This is the first time that you have worked with older people, being used to working with young teams of students, many on part time casual contrast in the Call Centre. However you are ambitious to get on and determined to succeed. At the same time you are a little sensitive to criticism.
Current Situation
The ages of your staff members vary from 28 to 55 and most of them are nearer the top of the range. Before you took over, the General Manager for Clinical Support had a talk with you and, amongst other things, advised you to be sensitive at the start – bearing in mind the contrast between the call centre and your new staff. You were naturally a little concerned yourself at the beginning, but you were pleasantly surprised by the fact that it has not seemed as difficult as you imagined it would be. You have at least managed to keep control of your staff.
You have re-organised some of the procedures to eliminate bottlenecks and introduced some new methods. These changes have improved efficiency. Further grounds for your confidence include:
· The fact that on several occasions members of your staff have experienced difficulties, and in spite of you being quite new in the setup, you have managed to spot the difficulty and help them sort it all out. You know yourself to be a quick thinker and this has helped you considerably.
· Anne, the data entry clerk in your team is a long serving member of the department and is 48 years of age. About a fortnight ago she made an error in the calculations when updating the hospital waiting list statistics. You happened to be there at the time, and when you looked at the calculations, you showed them to her, and after a brief discussion she agreed she had made a mistake and corrected them.
In fact, generally you feel you have cause to be pleased with the way things have gone for you and you are looking forward to your performance appraisal.
4. Waiting List Manager: Job Description and Person Specification
Job Purpose
Reporting to the General Manager of Clinical Support, the Waiting List Manager is in charge of the hospital appointment systems and patient liaison, including the investigation and resolution of related problems and complaints and the achievement of waiting list targets.
· Supervises appointments in liaison with relevant clinical department managers.
· Monitors the compilation of waiting list data.
· Manages the investigation and resolution of patient complaints in relation to appointment and waiting times.
· Leads and manages the waiting list team
Key Responsibilities
· To ensure safe and timely admission of patients to appropriate clinics, surgery and other interventions.
· To manage waiting lists ensuring services are delivered efficiently and effectivity meeting the outpatient and inpatient waiting time targets.
· To resolve patients complaints
· To provide regular waiting list data to heads of directorate and the senior management team
· To recruit, train and motivate members of the appoitments team.
Entry Requirements
Skills
· The ability to train and motivate a team
· Adaptability: coping with the diversity of patients and employees and their needs
· Communication and interpersonal skills
· Problem solving
· Data analysis
· Self-sufficiency
· Self-control: handling complaints
· Team leadership
· Taking the initiative
· Discretion
Qualifications
· Relevant degree or experience of working in hospitals
Experience
· Use of hospital patient administration system and/or other clinical IT systems
· Management and supervision of a team
5. Knowledge and Skills Framework (KSF)
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This dimension relates to effectively communicating the needs and requirements of patients, carers, staff and others to provide excellent care and service. Effective communication is a two way process. It involves identifying what others are communicating and the development of effective relationships as well as one’s own communication skills . |
Why it is important: Communication underpins all else we do. Effective communication is a two way process which develops and cements relationships, keeps people informed and reduces the likelihood of errors and mistakes. |
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level 1 Communicate with a limited range of people on day-to-day matters. For example: actively listens and asks questions to understand needs shares and disseminates information ensuring confidentiality where required checks information for accuracy presents a positive image of self and the service keeps relevant people informed of progress keeps relevant and up to date records of communication
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level 2 Communicate with a range of people on a range of matters uses a range of communication channels to build relationships manages people’s expectations manages barriers to effective communication improves communication through communication skills |
level 3 Develop and maintain communication with people about difficult matters and/or in difficult situations identifies the impact of contextual factors on communication adapts communication to take account of others’ culture, background and preferred way of communicating provides feedback to others on their communication where appropriate shares and engages thinking with others maintains the highest standards of integrity when communicating with patients and the wider public |
level 4 Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations encourages effective communication between all involved develops partnerships and actively maintains them anticipates barriers to communication and takes action to improve communication articulates a vision for hospital focus which generates enthusiasm and commitment from both employees and patients/wider public is proactive in seeking out different styles and methods of communication to assist longer terms needs and aims is persuasive in putting forward own view and that of the organisation communicates effectively and calmly in difficult situations and with difficult people |
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: positive patient/public/partner and colleague relationships positive patient/public/partner feedback timely and accurate performance accurate information given appropriate information given people feel communication in the hospital is effective and different parts of the hospital communicate with each other people feel patient confidentiality is respected |
Warning signs: patient/public/partner complaints about communication and unmet needs others not treated nor considered with respect over-reliance on email information given inaccurate information given inappropriate recipient not understood information given people do not feel patient confidentiality is respected |
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Personal and People Development This dimension is about developing oneself using a variety of means and contributing to the development of others during ongoing work activities. This might be through structured approaches (eg appraisal and development review, mentoring, professional/clinical supervision) and/or informal and ad hoc methods (such as enabling people to solve arising problems and appropriate delegation) |
Why it is important Everyone needs to develop themselves in order for services to continue to meet the needs or patients, clients and the public. |
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Level 1 Contribute to own personal development. For example: identifies whether own skills and knowledge are in place to do own job prepares for and takes part in own appraisal identifies (with support if necessary) what development gaps exist and how they may be filled produces a personal development plan with appraiser takes an active part in learning/development activities and keeps a record of them
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Level 2 Develop own skills and knowledge and provide information to others to help their development seeks feedback from others about work to help identify own development needs evaluates effectiveness of own learning/development opportunities and relates this to others identifies development needs for own emerging work demands and future career aspiration offers help and guidance to others to support their development or to help them complete their work requirements effectively offers feedback promptly |
Level 3 Develop oneself and contribute to the development of others assesses how well met last year’s objectives and helps set this year’s. Assesses self against KSF outline takes responsibility for meeting own development needs identifies development needs for others emerging work demands and future career aspiration enables opportunities for others to apply their developing knowledge and skills actively provides learning and development opportunities to others actively contributes to the evaluation of the effectiveness of others’ learning/development opportunities and relates this to others ensures all employees managed have annual appraisals and personal development plans in place and comply with mandatory training |
Level 4 Develop oneself and others in areas of practice contributes to development in the workplace as a learning environment actively creates opportunities to enable everyone to learn from each other and from external good practice uses a coaching approach to encourage others to develop
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: identified development needs and feedback accepted positively people feel they have the knowledge and skills to do their jobs people feel there is strong support for learning and development in their area time and provision are made for on the job and informal development everyone has a PDP that they understand people feel responsible for developing their own expertise people feel they have opportunities to progress |
Warning signs: staff defensive about development needs staff do not feel they have the knowledge and skills to do their jobs development frequently cancelled or senior staff too busy to offer informal development to others people do not feel there is strong support for learning and development in their area PDPs not completed or incomplete people feel development is done to them and it is not their responsibility development needs and training/development opportunities available do not match |
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This dimension focuses on maintaining and promoting the health, safety and security of everyone in the organisation or anyone who comes into contact with it either directly or through the actions of the organisation. It includes tasks that are undertaken as a routine part of one’s work such as moving and handling |
Why it is important Everyone needs to promote the health, safety and security of patients and clients, the public, colleagues and themselves |
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Level 1 Assist in maintaining own and others’ health, safety and security. For example: follows hospital policies, procedures and risk assessments to keep self and others safe at work helps keep a healthy, safe and secure workplace for everyone work in a way that reduces risks to health, safety and security knows what to do in an emergency at work, knows how to get help and acts immediately to get help reports any issues at work that may put self or others at a health, safety or security risk
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Level 2 Monitor and maintain health, safety and security of self and others looks for potential risks to self and others in work activities and processes manages identified risk in the best way possible works in a way that complies with legislation and hospital policies and procedures on health, safety and risk management takes action to manage an emergency, calling for help immediately when appropriate reports actual or potential problems that may put health, safety or security at risk and suggests solutions supports and challenges others in maintaining health, safety and security at work |
Level 3 Promote, monitor and maintain best practice in health, safety and security identifies and manages risk at work and helps others to do the same makes sure others work in a way that complies with legislation and hospital policies and procedures on health, safety and risk management carries out, or makes sure others carry out risk assessments in own area. Checks work area to make sure it is free from risks and conforms to legislation and hospital policies and procedures on health, safety and risk management takes the right action when risk is identified finds ways of improving health, safety and security in own area |
Level 4 Maintain and develop an environment and culture that improves health, safety and security evaluates the extent to which legislation and hospital policies and procedures on health, safety and risk management have been implemented across the hospital, in own sphere of activity evaluates the impact of policies, procedures and legislation across the hospital in own sphere of activity identifies the processes and systems that will promote health, safety and security in the hospital regularly assesses risks and uses the results to make improvements and promote best practice takes appropriate action when there are issues with health, safety and security investigates any actual or potential health, safety or security incidents and takes the required action |
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: Hospital procedures are followed including for hand hygiene confidential information is kept safe and secure work areas are clean and tidy health, safety or security risks or incidents are reported, at all levels behaviour is monitored and action taken when necessary incidents are handled appropriately and acted up immediately at all levels health, safety and security incidents are declining |
Warning signs: legislation, policies and processes around health, safety and security are not followed confidentiality is breached incidents are not reported or not reported by staff at all levels there is not monitoring of compliance or monitoring exists but action is not taken when required people do not know what to do if an incident occurs health, safety and security incidents are increasing (which is not due to increased reporting) |
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This dimension relates to maintaining high quality in all areas of work and practice, including the important aspect of effective team working. Quality can be supported using a range of different approaches including codes of conduct and practice, evidence-based practice, guidelines, legislation, protocols, procedures, policies, standards and systems. This dimension supports the governance function in organisations – clinical, corporate, financial, information, staff etc. |
Why it is important Quality is a key aspect of all jobs as everybody is responsible for the quality of their own work. It underpins all the other dimensions in the hospital KSF. |
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Level 1 Maintain the quality of own work. For example: works as required by relevant hospital and professional policies and procedures works within the limits of own competence and area of responsibility and refers any issues that arise beyond these limits to the relevant people works closely with own team and asks for help if necessary uses hospital resources efficiently and effectively thinking of cost and environmental issues reports any problems, issues or errors made with work immediately to line manager and helps to solve or rectify the situation. |
Level 2 Maintain quality in own work and encourage others to do so follows hospital and professional policies and procedures and other quality approaches as required. Encourages others to do the same. Maintains professional registration if has one works within the limits of own competence and area of responsibility and accountability. Gets help and advice where needed works to support the team. Can be counted on when people ask for help or support prioritises own workload and manages own time to ensure priorities are met and quality is not compromised uses hospital resources and effectively and encourages others to do the same monitors the quality of work in own area and alerts others to quality issues, reporting any errors or issues to the appropriate person. |
Level 3 Contribute to improving quality promotes quality approaches making others aware of the impact of quality understands own role, its scope and how this may change and develop over time in developing a high quality organisation reviews effectiveness of own team and helps and enables others to work as a team prioritises own workload and manages own time in a manner that maintains and promotes high quality evaluates the quality of own and others’ work in own area and raises quality issues and related risks with the appropriate people supports changes in own area that improves the quality of systems and processes takes appropriate action when there is a persistent problem with quality. |
Level 4 Develop a culture that improves quality initiates, implements, supports and monitors quality and governance systems and processes alerts others to the need to improve quality. Ensures others maintain professional registration is an effective member of the organisation. Works with others to develop and maintain high quality services role models quality delivery enables others to understand, identify and deal with risks to quality actively promotes quality in all areas of work responsible for continually monitoring quality and takes effective action to address quality issues. |
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: people are confident in asking for support where necessary and feel well supported respond positively when colleagues ask for help support people feel encouraged to report errors and near misses when errors and quality issues occur the focus is on resolving the issue and learning from it there is a no-blame culture resources are used effectively people adapt to changing priorities and changing quality systems high quality care and services are delivered and improving |
Warning signs: people do not feel they can ask for help or support and do not feel well supported people do not make time to help and support others when asked when errors and quality issues occur the focus is on blaming someone else resources are wasted people struggle to cope with or moan about changing quality systems or processes care and services are not considered to be high quality or are declining in quality. |
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This dimension is about improving services in the interests of the users of those services and the public as a whole. The services might be services for the public (patients, clients and carers) or services that support the smooth running of the organisation (such as finance, estates).The services might be single or multi-agency and uni or multi-professional. Improvements may be small scale, relating to specific aspects of a service or programme, or may be on a larger scale, affecting the whole of an organisation or service. |
Why it is important Everybody has a role in implementing policies and strategies and improving services for users and the public |
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Level 1 Make changes in own practice and offer suggestions for improving services. For example: discusses with line manager changes that might need making to own work practice and why adapts own work and takes on new tasks as agreed and asks for help if needed helps evaluate the service when asked to do so passes on any good ideas to improve services to line manager or appropriate person alerts manager if new ways of working, polices or strategies are having a negative impact on the service given to users or the public. |
Level 2 Contribute to the improvement of services discusses with team the likely impact of changing policies, strategies and procedures on practice. Also about changes the team can make and how to make them effective takes on new work and make changes to own work when agreed, requesting relevant help if needed supports colleagues in understanding and making agreed changes to their work evaluates own and others’ work when needed make suggestions to improve the service constructively identifies where new ways of working, polices or strategies are having a negative impact on the service given to users or the public. |
Level 3 Appraise, interpret and apply suggestions, recommendations and directives to improve services identifies and evaluates potential improvements to the service discusses improvement ideas with appropriate people and agrees a prioritised plan of implementation to take forward agreed improvements presents a positive role model in times of service improvement supports and works with others to help them understand the need for change and to adapt to it enables and encourages others to suggest change, challenge tradition and share good practice with other areas of the hospital evaluates the changes made and suggests further improvements where needed evaluates draft policies and strategies and feeds back thoughts on impacts on users and the public. |
Level 4 Work in partnership with others to develop, take forward and evaluate direction, policies and strategies involves and engages users of the service and others in discussions about service direction, improvements and the values on which they are based works with others to make sure there is a clear direction for values, strategies and policies and leads the way when interests are in conflict continually reviews the values, strategic plans and directions of the service to take account of changing circumstances works with others to develop strategic plans and business objectives for the service. These need to be consistent with values, realistic, detailed and take account of constraints communicates values, strategic plans and service direction to help all colleagues understand how they are affected. Also creates opportunities for people to contribute their views and ideas works with people affected by service improvements to evaluate the impact of the changes on the service. Feeds this information into ongoing improvements.
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: staff at all levels question poor practice, process and behaviour staff at all levels feel they are involved in deciding on service improvements that affect them staff feel able to make suggestions that improve their work or their area staff feel they deliver a service to a standard that they are personally pleased with staff adapt to change consistently improving care and service are provided |
Warning signs: staff do things the way they’ve always been done, without question staff feel that service improvement is “nothing to do with them” staff feel that they are not involved in decision making staff do not feel they deliver a service to a standard that they are personally pleased with staff struggle to adapt to change or openly resist it services are considered to be static or declining rather than improving |
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It is the responsibility of every person to act in ways that support equality and diversity. Equality and diversity is related to the actions and responsibilities of everyone – users of services including patients, clients and carers; work colleagues; employees, people in other organisations; the public in general
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Why it is important This is a key aspect of all jobs and of everything that everyone does. It underpins all dimensions in the hospital KSF. Successful organisations are the ones that reflect the richness of diversity that exists in society and will include people of different: abilities; ages, bodily appearances; classes; castes, creeds; cultures; genders; geographical localities; health, relationship, mental health, social and economic statuses; places of origin; political beliefs; race; religion; sexual orientation; and those with or without responsibilities for dependants. Where diversity and equality are not integral to the organisation, discrimination may occur. |
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Level 1 Act in ways that support equality and value diversity. For example: acts in accordance with legislation, policies, procedures and good practice treats everyone with dignity and respect allows others to express their views even when different from one’s own does not discriminate or offer a poor service because of others’ differences or different viewpoints. |
Level 2 Support equality and value diversity challenges bias, prejudice and intolerance if appropriate or brings it to the attention of a manager uses plain language when carrying out duties aware of the impact of own behaviour on others.
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Level 3 Promote equality and value diversity interprets equality, diversity and rights in accordance with legislation, policies, procedures and good practice actively acts as a role model in own behaviour and fosters a non-discriminatory culture promotes equality and diversity in own area and ensures policies are adhered to manages people and applies internal processes in a fair and equal way. |
Level 4 Develop a culture that promotes equality and values diversity actively promotes equality and diversity monitors and evaluates the extent to which legislation and policies are applied monitors and act on complaints around equality and diversity actively challenges unacceptable behaviour and discrimination supports people who need assistance in exercising their rights. |
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Think about what behaviours and actions are positive indications the that the knowledge and skills of this dimension are present and those that warn that they are absent |
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Positive indications: patients/public/partners, colleagues and staff feel fairly treated people feel confident in speaking up if they feel there is bias in a system or process of if they feel they have witnessed bias, prejudice or intolerance staff understand what diversity is and why it is important. |
Warning signs: high level of staff and patient or wider public complaints about unfair treatment, bias or discrimination policies and procedures only exist in writing with little application in day to day activity bias in the application of processes affecting equality of outcome. |
6. What will happen in the Appraisal Practical?
The role play will take place in your seminar next week . It is a compulsory activity and attendance will be closely monitored at this session.
Your tutor will organise you into groups of 3 or 4 and you will decide who will play which roles. There are three roles:
1. The interviewer
2. The interviewee
3. The observer (two observers if you are in a group of 4)
Note: You will repeat the activity three times rotating roles each time so you have the opportunity to experience all three roles.
In order to make this exercise as realistic as possible we would like you to prepare carefully. A real-life appraisal can last more than one hour so you will not have time to carry out a complete review. We would like you to aim to run a 20 minute appraisal meeting. In your planning document consider how you will divide up these 20 minutes into the different tasks you need to complete during the meeting. You are required to cover three key areas:
· Review the objectives that were set at the last meeting (these are shown on the appraisal form below)
· Agree at least one objective to be achieved by the next appraisal and any development required to achieve this.
· Discuss longer term career plans
Interviewer and the interviewee
· Carefully read the briefs in this pack (p7 & 8). Remember you may not have all the information you would like to make a full and accurate review, unfortunately this is often the same in ‘real life’ where it is rare for one person to know everything about a particular person or situation.
· Where the brief doesn’t give you sufficient details, you can make up your own facts and assumptions provided they do not conflict with the main brief.
· Do not treat the exercise as a game and try to outwit your opponent – either by facts you invent or the way you act in the interview.
· Play the role in a way that seems natural to you and consistent with the brief.
Observer
· Study the feedback sheet provided below.
· Sit in a position where you are out of direct line of sight with the role-players (so you don’t put them off), but you can clearly hear and see them.
· Be silent during the role-play. You should take no part in the session.
· Observe the role-play process in order to be able to give valuable feedback to the participants during the discussion afterwards.
· Make notes during the interview using the checklist provided. Remember to note examples of both good and bad practice. Do NOT simply use ticks and crosses. You will need to hand your feedback to the appraiser at the end of your discussion so please try to write clearly.
Post-exercise discussion
· Review the role-play. The observer should sum up first but the interviewer and interviewee should also discuss how they ‘felt’ during the interview and how they think it could have been improved from their perspective.
· Highlight the good things as well as the bad.
· Offer comments in a constructive and helpful way, illustrating them with specific examples whenever possible. Do not belittle any of the participants.
· Make notes for your own reference of the key things you have learned from the activity. Keep these notes safe so you can refer to them in coursework 1.
7. Appraisal Practical Feedback Sheet
Appraiser: ……………………………………………..
Appraisee: ……………………………………………..
Observer: ……………………………………………….
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Environment · How well was a relationship established? · How was it done? · What was the climate like? · How relaxed was the meeting? |
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Questioning skills · Did they use an appropriate mix of question styles · Did they use open questions to get the appraisee talking · Did they ask the employee how they thought they had been performing? · Did they use closed questions to clarify information where appropriate · Did they use the funnel technique · Did they probe for further information where appropriate |
[Try to record some examples of different question types used]
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Listening skills · Did they demonstrate active listening skills · Did they demonstrate positive body language · Did they allow the speaker to finish · Did they leave appropriate silences · Did they ‘reflect back’ the appraisees comments · Did they clarify details and check their understanding |
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Feedback skills · Did they base the feedback on facts/observations · Do they gain agreement with the appraisee about how well they performed · Did they identify areas of strength · Did they describe development areas confidently and clearly · Did they help the appraisee explore how they could develop these areas · Did they help the appraisee break development plans down into achievable steps |
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Agreement · How far did they reach agreement on the waiting list managers performance and contribution to results? · What got in the way of this? · What did the appraiser do to overcome areas of disagreement? |
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The Future · Did they ask about the individuals job satisfaction · Did they find out what ‘makes the employee tick’ · Did they explore the employees career aspirations? |
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Support · What strengths were identified? · Did they agree on how to further develop these strengths? · What problems were identified? · What solutions and options were identified? · Were they agreed? · Were any training and development needs identified? · Were any interventions agreed? |
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Managing the Discussion · Did they achieve a balanced 2 way conversation · Did the appraisee do most of the talking · Did the discussion end positively · Did they agree the next steps to be taken? |
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Other
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8. Appraisal Form
Hint: You will be required to complete this form to summarise your meeting after the appraisal practical. Does your appraisal planning document cover each area.
Performance & Development Review
NAME OF APPRAISEE: NAME OF APPRAISOR:
JOB TITLE:
DATE OF APPRAISAL:
LENGTH OF TIME IN CURRENT POST:
NO. OF EMPLOYEES IN SERVICE AREA:
NO. OF EMPLOYEES DIRECTLY MANAGED:
TOTAL NO. OF DAYS ABSENCE THROUGH SICKNESS PER SERVICE TEAM MEMBER:
TOTAL NO. OF DAYS ABSENCE THROUGH ACCIDENTS AT WORK PER SERVICE TEAM MEMBER:
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NAME |
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JOB TITLE |
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1. Review: How well has the manager met the objectives set at their last meeting? Explain why this rating has been given.
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Objective |
Rating |
Explanation/Justification/Evidence |
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Complete a review of all appointment booking processes and create an action plan to improve these to achieve a 10% increase in patient satisfaction. |
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Provide evidence of weekly communication and collaborative decision making activities undertaken with the team focused on securing a 5% increase in Q4 and Q7 on the employee engagement survey. |
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2. Going forward: What objectives have you agreed the manager should achieve by your next meeting?
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Objective |
Timescale |
Success Measures |
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Learning & Development Activity |
Target Date |
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3. Support: Agree learning and development support required to achieve objectives
4. Career Aspirations: Record discussion about appraisees future career direction
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5. Comments
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Manager |
Employee |
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6. Assessment ( tick which grade applies)
· Excellent
· Good
· Satisfactory
· Unsatisfactory (Deferred)
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Review Manager (name and signature) |
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Reviewee (name and signature) |
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Date |
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Please note, the characters and incidents described in this brief are fictional and have been developed for learning and teaching purposes only
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