Practice Staff appraisal is now part and parcel of the annual cycle of management in UK GP Surgeries mainly as a result of the requirements of the Quality Outcomes Framework and now the required as a result of CQC Inspection.
Performance Related Pay and Appraisals
Personally, I have never liked appraisals as a result of bad experiences of annual appraisals when working in a Family Health Services Authority where appraisals were linked to performance related pay and often shared objectives were allocated to two or more staff and as you can imagine the results were inconsistent. The funding for Performance Pay ran out and was never paid, as did the willingness to take part in Appraisals.
Should All Staff Be Appraised?
In a GP Surgery I found it very difficult to carry out effective appraisals on reception, administration and secretarial staff who basically were not interested in an appraisal as such and tended to want to just make a point about someone else when the appraisal was about them. On one occasion the appraisals revealed a general and worrying problem with morale with fingers being pointed at a particular cause. The GPs decided to hold a brainstorming session led by an outsider which had devastating effects on the management of the practice that was not resolved until three staff left, paid off or of their own volition. It all left a nasty taste, which over a period of years settled with considerable team building – my own team.
The Appraisal Process
As a starting point for each appraisal I looked for a job description and took account of the changing nature of the work. I gave staff a short questionnaire to complete before the appraisal interview. I did not feel that the appraisal should be used to raise issues that might result in disciplinary action but nevertheless would mix praise with comment. I was interested in encouraging staff to think of their own objectives and would normally set them one myself and let them set the other. I also asked for a training objective. I was aware of the need to word objectives very carefully to avoid any misunderstanding, along with making the objective SMART, that is Specific, Measurable, Actionable, Relevant and Timely. I prefer using other words in my acronym. Specific would become sensible, and supportive. Measurable would become Motivating. Actionable would become achievable (makes more sense), and Relevant would become realistic. Finally Timely would become targeted or trackable. Using different words to explain SMART makes the concept more understandable. Staff both appraisee and appraiser should receive training on the appraisal system adopted in the Practice.
The Appraisal Meeting
Basically, an Appraisal is a one to one conversation, which should be held in a comfortable room, and be uninterrupted and not time constrained. It should be an open and honest conversation but not too serious and maybe accompanied by some refreshments. It should not be a session where disciplinary issues are raised. Likewise it is not appropriate for grievances to be aired. It is about the appraisee, their work and their performance. It should also be, in my mind, a chance to extend views and ideas and be as positive as possible. It certainly should end on a high note, with praise and support.
I recorded the appraisal meticulously and gave a copy to the employee. I have to say that I was not good at following up objectives during the year. The tick box nature of appraisal I found a discouragement. Yes we have done it. With a large staff, over 25, time to review objectives was not easily found.
Here are three of the documents I used – I have included a 360 degree form too, which I used for senior staff to comment on each other with some success. Be careful in your selection of trustworthy colleagues to avoid stirring up a hornets nest.
Be Flexible with Appraisals
I always felt and still feel that appraisals need to develop and change each year but to repeat exactly the same type and style of interview each year would act as a disincentive to taking part and reduce the effectiveness of the process. Have you tried group appraisals. Have you asked outsiders to do the appraisals for you. Have you delegated appraisals to other senior staff. Have you changed the documentation you use each year. Have you held an open meeting with all the staff in one go! Dangerous as you may get more than you expected.
Are you good at appraising staff?
Another issue for me was the quality of the appraisers. There was little point to me of asking others to do appraisals if they had no idea what they were doing. I certainly came across this a number of times and ended up with objectives that basically were nonsense. One way forward is to ensure that there is a consistency in the type and content of objectives. Objectives too should reflect the aims and objectives of the Practice Business Plan as a whole, but do they?
Revised October 2018