Development & implementation of a performance based appraisal system to meet organisational

needs

Alan Duffell

Director of HR & OD

@LPTHRD

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

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

NHS Context – what you may not hear

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.

Our Community - population 1.17 million

LPT Numbers

Our Staff

Our staff are the single most

determinant factor in relation to

the quality of care we provide

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

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

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?

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

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

The 7 Level Rating Approach

2% 2% 14% 14% 34% 34%

1 2 3 4 5 6 7

No more paper

An IT solution

designed and built

around the model &

concept

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

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

Issues still to fully address

• Staff at the top of their incremental pay band

• Culture

• Consistent rating & normal distribution

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

Thank You & Any Questions

@LPTHRD

Alan Duffell