Improving Performance Appraisal

Performance appraisal has become common practice in most GP surgeries over recent years for a variety of reasons.

Some use it to focus their training plans and spend their training budget wisely; some use it to help achieve the practices’ objectives in a more strategic fashion; some carry out appraisals as a way of motivating and engaging the team and there are some practices that do it for QOF points and get very little in the way of benefits in return for their investment.

I feel that there are two main ways in which appraisal can be beneficial to an organisation:

  1. It helps to focus all goals, development and plans on moving the organisation forward and improving the ways they operate
  2. It encourages everyone to reflect upon the contributions they make and how they can influence good performance

In addition to this, it is an opportunity for managers to give positive encouragement and feedback to the team. However, managers have many opportunities to talk to their team, give feedback, praise and recognition – they must make sure that they make good use of them and do not rely on an annual appraisal as their only opportunity to do these things. In short appraisal is a mechanism to connect the following:


The Problems

Working with practice managers over recent years, I have detected a feeling that appraisal is no longer providing benefits and has become a “tick the box” exercise. Many describe it as being “boring”, “pointless” and “predictable” – comments I hear reinforced by team members. If this is the case – it is time for a change.

One of the positive aspects of working in an independent contractor organisation is that you are free to create your own working systems that suit your own organisation. Appraisal is one of these areas where it is vitally important to keep the process moving forward and fresh if you want to achieve a positive response and benefits for the practice.

The Possibilities

There are many options for the way in which you design and deliver an appraisal scheme but there are a few underpinning principles that need to be considered:

  • Appraisal is about performance and not personality. Any feedback given must be related to the skills and behaviours required for the job
  • It is an opportunity to motivate and encourage – not used for performance management. Poor performance or conduct issues must be dealt with as they occur
  • Appraisal is about development and moving forwards so at least ¾ of the time should be spent looking forwards
  • Objectives need to be linked to the organisation’s plans  so there must be something in place which defines the future direction

And for any feedback to be accepted and acted upon, the person giving the feedback must satisfy two important criteria:

  • Their opinion must be valued and respected by the person they are giving feedback to; and
  • They must know sufficient about the person’s role and  input to talk meaningfully about it

Team Appraisal

One way that some practices are taking appraisal forward is by developing a process of team based appraisal. This works well where:

  • A practice has clear development objectives
  • Teamworking is good, and
  • Performance is generally of a high standard

If these criteria are in place, Team appraisal can be a good way of consolidating motivation and getting everyone on board with achievement of the objectives. It can be done as a whole practice team, or broken down into smaller teams – such as a nursing team, reception, administration etc. Remember that this is not the managers’ only opportunity to talk to team members individually.

Step 1

Establish the practice objectives and make sure that they can be easily understood by the whole team. Team appraisal centres on an interactive team meeting with each member creating their own personal development plan afterwards.   The leader of the meeting needs to prepare a clear plan or agenda for the meeting and paperwork to help the individuals through the process.

Set an appropriate time and date for the meeting – allowing 1½ to 2 hours for the session and sufficient time for preparation. The manager needs to prepare by:

  • Understanding what the objectives mean for each staff group
  • Gather information on what development and training is available
  • Negotiate the training budget
  • Consider how performance or standards needs to change to meet the challenges of the future

Step 2

Facilitate the meeting. As an overview the manager needs to facilitate discussion that will ensure that everyone recognises what needs to change and why – and be able to create their own development plan based on the future requirements. The following could be used as an outline:

  1. Brief discussion on positive aspects of the previous year – recording where the team has excelled, achieved previously set objectives  and used newly learned skills
  2. An explanation of what the future holds and questions to establish understanding
  3. Discussion on how things will need to change including standard of performance that might need to be set

Step 3

Create a simple personal development planning sheet that each team member can use to write up their own personal objectives.

This can be linked with a “Training Passport” - a document that hold details of any statutory or mandatory training that the staff need to attend. In light of CQC requirements, record should be kept of all training that takes place and particularly elements that demonstrate compliance such as:

  • Health and safety related training
  • Information governance and confidentiality
  • Safeguarding
  • Infection prevention and control
  • Etc

The NEWLY UPDATED Thornfields@fpm workshop, Appraisal Skills for Practice Managersincludes everything you need for updating and revamping your appraisal process including a framework for team appraisals, a training passport and suggestions on carrying out 360° Appraisal in general practice. Contact us for details of the course agenda or to book.


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Practice Manager - Bristol, BS40 6HF

Closing Date: 30 June 2020

Salary: £43,700

Practice Manager - London, Clerkenwell

Closing Date: 10 June 2020

Salary: According to experience

Practice Manager - Bristol, BS40 6HF

Closing Date: 30 June 2020

Salary: £43,700

Practice Manager - London, Clerkenwell

Closing Date: 10 June 2020

Salary: According to experience

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