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Development & implementation of a performance based appraisal system to meet organisational
needs
Alan Duffell
Director of HR & OD
@LPTHRD
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NHS Context – what you hear – the negative side
• Junior Doctors taking strike action
• Overspent by £1.6bn in the first two
quarters
• Missing national waiting time targets
• Mid Staffs Hospital Report
• Media reporting about patient deaths
• Whistleblowing in the NHS
• High levels of pay and payoffs for
very senior managers
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NHS Context – what you may not hear
• A&E Attendance – 22.36 million in 2014/15 (25% increase)
• Hospital admissions – 15.46 million in 2013/14 (32% increase)
• Outpatient appointments – 82.06 million in 2013/14 (8.8% increase on
previous year)
• UK population projected to increase from 63.7 million in mid 2012 to
67.13 million in 2020
• Managers and senior managers account for 2.6% of the 1.388 million
staff employed by NHS (2014)
• In comparison to ten other healthcare systems, the NHS was found to
be the most impressive overall
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NHS Context – what you may not hear
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Leicestershire Partnership NHS Trust
We provide integrated mental health, learning disability and community health services in Leicester, Leicestershire and Rutland.
Health Improvement to school nursing, health visiting , Community hospitals, community services, end of life care to Learning Disabilities to acute mental health wards, podiatry to low secure services, community paediatrics and Diana Nursing, immunisation programmes to community mental health.
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Our Community - population 1.17 million
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LPT Numbers
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Our Staff
Our staff are the single most
determinant factor in relation to
the quality of care we provide
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Performance Appraisal – NHS Context
• National guidance through the
Knowledge & Skills Framework (KSF)
• 30 domains
• 4 levels per domain
• Average 10 indicators per level
• Local Trust ownership/decision
• Staff receive annual incremental pay
steps within their band
• Only very recently has their been
national guidance for those increments
to be linked a performance element
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Previous LPT Appraisal Position
• Totally paper based – 5,500 staff
• Massive variability
• No clear established framework
• Meet
• Chat
• Some objectives?
• Some development?
• Poor quality conversations
• Very poor corporate reporting ability
• Constant data quality issues
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A Revelation & Fundamental Shift
• What is important to the
Trust?
• Patient?
• Safety?
• Being on time?
• Working relationships?
• Mandatory training
compliance?
• Organisational values?
• Etc.
Decide what's really important and why don’t we appraise performance against that?
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The Model
(2) - Patient safety/
experience
(3) - Management
(4) - Role/ Individual
Specific
(1) - Organisational Expectations
• Reliability • Trust Values • Working
relationships • Etc.
• Communication • Quality • Safeguarding • Etc.
• People & teams • Resources • Lead & motivate • Deliver objectives • Etc.
• Dependant upon level and role of individual
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The 7 Level Rating Approach
2% 2% 14% 14% 34% 34%
1 2 3 4 5 6 7
Each level has a range of descriptors
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The 7 Level Rating Approach
2% 2% 14% 14% 34% 34%
1 2 3 4 5 6 7
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No more paper
An IT solution
designed and built
around the model &
concept
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The Triple Whammy of Change
• Fundamental shift
in the model of
appraisal
• Pay increment
linked to
performance
appraisal
• Move from paper to
totally IT based
Culture Shift
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Implementation & Support • System training & communication, lots of communication
• IT system as easy to use as internet banking & can be
used at home
• IT skills training where needed
• One year amnesty
• Difficult conversations training
• Year 1 - just four key performance criteria to gain
increment:
• Disciplinary sanction
• Under formal performance process
• Mandatory training compliance
• Completed an appraisal
• Year 2 – the above plus achieved a minimum average
rating score
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Issues still to fully address
• Staff at the top of their incremental pay band
• Culture
• Consistent rating & normal distribution
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What did it give us?
• Consistency & structure of approach
• Fairer, almost universal across the Trust
• A focus on what is important to the organisation
• Virtual elimination of paperwork & excuses
• Opportunity for further developments – text
messaging
• Improved appraisal rate & quality of appraisal
conversation
• Clearer understanding of what under
performance looks like
• Excellent reporting & analysis
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Thank You & Any Questions
@LPTHRD
Alan Duffell