Please confirm the details of this appraisal below - … · Appraisal paperwork 2014 1 Please confirm the details of this appraisal below Review period from/to Date of appraisal:

Appraisal paperwork 2014 1

Please confirm the details of this appraisal below

Review period from/to

Date of appraisal:

Appraisee’s name:

Appraiser’s name:

Job title:

Job title:

Ward/Department:

Ward/Department:

Email:

Email:

Incremental Date: Valid professional registration

Yes No Not applicable


PREPARE This form has been designed to help both the appraiser and appraisee prepare for the annual appraisal discussion. Think about the past year and consider the questions below - you may find it helpful to make notes and take these to the meeting. Remember it is also useful to review the job description and person specification and check that they are up to date. You should also use your personal Evidence log (against your objectives and the values) – at Appendix B to help you to prepare for your Appraisal.

APPRAISEE PREPARATION APPRAISER PREPARATION

1. Have I achieved my objectives this year? What have I done particularly well? Have I achieved any work over and above my agreed objectives? What examples of my work demonstrate this?

Has the appraisee achieved their annual objectives? What has the appraisee done particularly well? Has the appraisee completed any work that is over and above their agreed objectives? What examples of their work demonstrate this?

2. What have I done that has been less successful or enjoyable this year and why? Are there any objectives I did not achieve? Why? What examples of my work demonstrate this?

What has the appraisee done that has been less successful this year and why? Are there any objectives the appraisee has not achieved? What examples of their work demonstrate this?

3. How am I performing against the most relevant factors for each of the Trust values? Are there any behaviours where I have exceeded expectations and are role modelling to my colleagues? Are there any behaviours I need to develop further? What work examples show evidence that I have demonstrated at least one factor for each of the Trust Values.

How is the appraisee performing against the most relevant factors for a minimum of one factor of each of the Trust Values? Are there any behaviours where the appraisee has exceeded expectations? What, if any, behaviours need to be developed further? What work examples demonstrate this?

4. What are likely to be my main personal objectives over the next 12 months?

What should be the main personal objectives for the appraisee over the next year?

5. What are the main skills and knowledge development needs that I have? How could I fill my development gaps/learning needs? What additional activities could help me to maintain or improve my performance? How could my manager support me?

What significant development needs does the appraisee have? How can their learning and development needs best be met? What additional activities could help them maintain/improve performance? What support do I need to give the appraisee?

6. Upward Feedback – Is there any constructive feedback to my manager that would support the achievement of my objectives?

Ask the appraisee if there is any constructive feedback they wish to provide that would support the achievement of their objectives?

To be completed by the Appraiser and Appraisee


REVIEW: Performance against Objectives Please review the objectives and achievements from last year using your Evidence Log against your Objectives. Overall performance for the previous year will be rated in line with the guidance at Appendix A.

Objective Summary of achievement/evidence or reason why objective not met Rating

1.

2.

3.

4.

5.

6.

1 – Exceeds Expectations 2 – Meets Expectations 3 – Partially meets Expectations 4 – Not met Expectations



REVIEW : Demonstration of Trust values & behaviours

Please discuss and rate how you demonstrate the Trust’s values and behaviours using your Evidence Log against the values to provide evidence. Demonstration of the values & behaviours will be rated in line with the guidance at Appendix A.

Value Behaviour Summary of achievement/evidence or reason why value/behaviour not met

Rating

Patients First

Ensuring that basic needs are always met

Putting yourself in others’ shoes – you could be the only word of kindness that person receives all day.

Introducing yourself, listening, explaining clearly what is happening and making sure that you have been understood.

Apologising and being open when things have gone wrong.

Personal Responsibility

Performing your duties to the best of your ability and always being punctual and prepared.

Treating people as you would like to be treated, remembering that the little things often make the biggest difference.

Continuously listening, learning and improving.

Believing in yourself and your contribution, and having the confidence to speak up and speak the truth.

Pride in the Team

Treating one another with a dignity, intelligence and respect.

In your work, prioritising the needs of your patients, teams and organisation ahead of your own.

Building positive relationships based on listening and sharing information, knowledge, skills, as well as workload, to further team and organisational goals.

Being honest and delivering what you promise or making others aware if you are unable to deliver.

Passion for Excellence

Striving to be the best.

Having an in depth understanding of your day to day practices and the impact they have on others.

Taking a proactive approach, and prioritising.

Seeking out new ideas and finding ways to put them into practice.



PLAN: Objectives and Personal Development Plan

This section should be discussed during the appraisal meeting and completed together by the appraiser and appraisee. Please consider

the job description, personal specification. Each objective should also support the delivery of organisation, departmental and/or team

objectives and demonstration of the Trust values. Objectives should be SMART (Specific, Measurable, Achievable, Relevant and Timed).

You should have between 4 – 6 objectives.

SMART Objective Expected outcome/measure of achievement (including behaviour)

Support/development/learning needed to achieve objective

Link to Trust Values

Deadline & review date

Due date

Review date

Due date

Review date

Due date

Review date

Due date

Review date

Due date

Review date



Summary and Sign off This section summarises the previous year’s performance, ratings and confirmation of the Trust requirements for pay progression. It is recommended that you complete this section at the time of the appraisal whilst both the appraiser and appraisee are together.

Manager/ appraiser’s summary comments on performance and development, including demonstration of Trust values over past year.

Appraisee’s summary comments on performance and development, including demonstration of Trust values over past year.

Overall Performance Rating for 2014/15 (please tick the appropriate box below)

Exceeds Expectations Level 1

Met Expectations Level 2

Partially Met Expectations Level 3

Not Met Expectations Level 4

Not Applicable Level 5

Please confirm the appraisee has met the following requirements:

1. Annual Appraisal has taken place within previous 12 months and the last appraisal date is recorded on ESR.

Yes/No

2. Mandatory Training for the job is completed and a copy of the appraisee’s mandatory training log attached. (Please contact Learning and Development if you do not have access to the training log held on the T Drive).

Yes/No

3. Pay Appraiser has completed the Appraisal Confirmation and Pay Approval form and email to payroll 6 weeks before the incremental date is due.

Yes/No


The appraiser, appraiser’s line manager and appraisee should print their name, sign and date below to confirm the appraisal process is complete.

Signatures

Staff member/appraisee:

Print name

Date

Manager/ appraiser(s):

Print name

Date

Appraiser’s manager/grandparent:

Print name

Date


Please note: If this form is not returned to payroll the appraisee will not receive a pay increment.

ANNUAL APPRAISAL CONFIRMATION & PAY APPROVAL

Name of Appraisee

Job Title & Band

Location

Assignment Number

Incremental Date

Date of Appraisal

Evidence Provided: Tick as applicable below:

The appraisee are up to date with all of their mandatory training requirements Have had an appraisal in the last 12 months.

Incremental pay: *Tick as applicable below:

AWARDED DEFERRED WITHDRAWN Reached maximum pay incremental point before April 2014

Date Deferred to:

Line Manager’s signature Line Manager’s Name Printed: Job Title: Date:

NB: Line manager must email this form to [email protected] from their Trust email address at least six weeks before the incremental date is due.


Performance Ratings and Indicators

NB: Annually earned pay points for Bands 8C, 8D and 9 will not be withdrawn if they were obtained before April 2014.

Performance Rating Indicators Action

1 Exceeds expectations Appraisee exceeds all their objectives and Trust values and exceeds performance expectations for the job by performing over and above their objectives, for example by completing additional projects not agreed as part of their objectives.

Consistently exceeds all performance objectives, Trust values and expectations for the role. Demonstrates high level of performance in all areas of responsibility.

Work is done independently and completed on schedule with a high degree of accuracy and independence.

Performance is what can be expected of a fully qualified and experienced person.

Errors in judgement are rare and seldom repeated.

The employee shows initiative.

Employee completes additional projects not part of the agreed objectives.

The employee requires minimal supervision.

Member of staff proceeds to next increment. Appraiser works with the appraisee to identify developmental opportunities for career aspirations.

2 Meets expectations Appraisee meets all their performance objectives and a minimum of one factor for each of the Trust values and may exceed some objectives/Trust values.

A solid performance that consistently meets the performance objectives and Trust values.

May exceed some performance objectives and Trust values.

Results can be expected that are timely and accurate.

Recognises, participates in, and adjusts to changing situations and work assignments

Member of staff proceeds to the next pay increment. Appraiser works with the appraisee to identify developmental opportunities for career aspirations

3 Partially meets expectations Appraisee meets some but not all of their performance objectives. Also, the appraisee has not demonstrated they have met at least one factor for each of the Trust values.

Performance does not consistently meet all performance objectives and/or

Trust values.

Performance deficiencies should be discussed between the employee and line

manager.

A development plan must be outlined and monitored, with timelines for

improvement established.

If this is the first assessment at Level 4 individuals Band 1 – 7 and 8C, 8D and 9

in their first 4 pay bands will proceed to not the pay increment. If this is not the

first assessment at Level 4 the pay increment will be deferred for 12 months.

For pay bands 8C, 8D and 9 in their last 2 pay bands one annually earned pay

If first time performance rating of 3, the appraisee proceeds to the next increment (Bands 1 – 7 only) If this is not the first time performance rating of 3, incremental progression will be deferred for 12 months. Line manager should arrange for informal action under the

Appendix A


point will be withdrawn unless the annually earned pay point was obtained

before April 2014.

Trust’s Performance Capability Process. Capability concerns will have been discussed prior to the annual appraisal. Bands 8C, 8D and 9 in their last 2 pay points will have one annually earned pay point withdrawn at their first performance rating of 3.

4 Not met expectations Appraisee does not meet their performance objectives and does not meet a minimum of one factor for each of the Trust values.

Performance is consistently below expectations and has failed to make

reasonable progress towards agreed upon performance objectives and Trust

values.

Employee requires close guidance and direction in order to perform routine job

duties.

Performance deficiencies should be discussed between the employee and line

manager.

Line manager arranges for formal action to be taken under the Trust’s Capability Policy. Capability concerns will have been discussed prior to the annual appraisal. Incremental progression will be deferred for 12 months. Bands 8C, 8D and 9 in their last 2 pay points will have one annually earned pay point withdrawn.

5 Not applicable Appraisee has been on long term sick leave, maternity/paternity/adoption leave, etc and it is therefore not possible to rate their performance for the year.

Appraisee has not performed in the job long enough to fully demonstrate performance against objectives and Trust values. This appraisal is for feedback purposes and the appraisee will be reviewed and assessed at a later date.


Appendix B To be completed by the Appraisee


PREPARE: Evidence Log – Performance Objectives

This log is for you to record your progress throughout the year against your objectives. Please include specific examples of achievement where appropriate. This log should be used at both the annual appraisal and mid year review.

Objectives over the last year Briefly describe how well the objective has been achieved, referring to actual examples and actions where possible. If the objective has not been achieved, why?


PREPARATION: Evidence Log – Trust Values & Behaviours

This log is for you to record your progress throughout the year of how you have demonstrated the Trust Values. Please include specific examples where possible. Remember you will need to demonstrate a minimum of one factor for each value. This log should be used at both the annual appraisal and mid year review.

Trust Value

State which behaviours you have demonstrated for each value. Document the evidence you have to demonstrate this referring to specific examples and actions where possible.

If there are Trust values & behaviours that have not been demonstrated, please outline the reasons

Patients First

Personal Responsibility

Pride in our Team

Passion for Excellence

To be completed by the Appraisee

Documents

Please confirm the details of this appraisal below - … · Appraisal paperwork 2014 1 Please confirm the details of this appraisal below Review period from/to Date of appraisal: