Appraisal_Form15-16
Appraisalfor2015/16
Post holder First Name
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Staff Number (7 digits on staff pass)
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Grade
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Appraiser name
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Line manager name
(If different to appraiser name)
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(If different to appraiser user name)
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Date of Review
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Instructions for completing this form
Please complete the form on screen. Save your document using<File<Save AS>and the following naming convention:
W, appraisee's surname, firstname, year
(e.g. for an appraisee named Susan Jones the file will be saved as Wjonessusan2015.docx)
The Appraiser should submit a copy of this completed form to HR by attaching it to an email addressed , copying in the Appraisee and the Countersigning Manager.
Please send only 1 appraisal form per email. (Please contact the OD Team if this is an issue)
See the Organisation Development website for further guidance at
Part 1: Looking Back – Annual Review of 2014/15
- Self-Assessment of achievements over the last year (to be completed by appraisee)
This part of the process encourages you to reflect on the work you have undertaken over the past year and to capture your thoughts under 4 headings, Your Objectives, Our LSBU Values, Your Learning & Professional Development and Your overall Summary of the year.
1. Your Objectives
For each objective, summarise achievements and give examples of how, over the past year, you have contributed to thedeliveryof theUniversity’sCorporatePlan 2014/15 through the relevant School orProfessional Services functions’ Local Delivery Plans (LDP). You should particularly comment on your effectiveness and achievements, and also mention any difficulties or constraints you have experienced during the past year
You can copy & paste objectives from the previous year’s work plan.
Agreed Objectives / Met(Fully/Partially/Not) / Summariseachievementagainst eachobjective
1 / Click here to enter text. / Choose an item. / Click here to enter text. /
2 / Click here to enter text. / Choose an item. / Click here to enter text. /
3 / Click here to enter text. / Choose an item. / Click here to enter text. /
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8 / Click here to enter text. / Choose an item. / Click here to enter text. /
2. Our LSBU Values (Optional)
Please outline how you believe you have demonstrated each of the LSBU Values - Excellence, Professionalism, Inclusivity, Integrity and Creativity - during the course of your work over the year.
The completion of this section is optional.
Click here to enter text. /3. YourLearning and Professional Development
Please reflect on the learning and development you have undertaken this year. Include any specific professional development training or other learning and development activities undertaken (e.g. Conferences, workshops, e-learning, work shadowing). How has this supported your progress and what have been the benefits for LSBU? What are your longer-term, career and personal development aspirations?
Please indicate which Mandatory Training has been undertaken.
Click here to enter text. /4. Your Summary of the Past Year
Please summarise your reflections on your general experience of the past year
Click here to enter text. /- Appraiser’s review of your achievements over the last year (to be completed by the appraiser)
These comments are developmental, evidenced based feedback across all objectives, including demonstration of LSBU Values, learning and development and any other contributions and achievements during the past year.
Click here to enter text. /Part 2: Looking Forward – Work Plan for 2015/16
- Objective-setting for the coming year (to be completed jointly by appraisee and appraiser)
- Your Objectives
For each objective, outline how over the coming year, you will contribute to thedeliveryof theUniversity’sCorporateStrategy 2015/16 through your relevant School orProfessional Services functions’ Local Delivery Plan (LDP). Please outline how you will demonstrate your effectiveness and measure success.
- Academics should focus on objectives relating to Teaching and Learning, Research and Enterprise and Leadership, Management, Administration and Citizenship.
- Professional Service Functions should highlight the relationship of objectives to the four operating principles; One organisation, Customer Focused, Accountable, Efficient and Effective
- Where appropriate, relate objectives to learning and career development opportunities.
- AtLEAST 1Learning Need MUST be recorded.
- The optimal number is 6 objectives. More details in the guidance notes.
- Link to business planning guidance and priorities
Agreed SMART Objective 1
Your work objective / How will this objective be measured? Note any milestones on the way
Attend Mandatory Training / By attendance and knowledge gained
If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UK Professional Standards Framework or other L&D associated with this objective, please indicate it below.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
H&S Mandatory Training / Organised by Health and Safety Services / Mandortary Training - Health & Safety / Introductory level
Agreed SMART Objective 2
Your work objective / How will this objective be measured? Note any milestones on the way
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If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UKPSF or other L&D associated with this objective, please indicate it below. If there are no learning needs please leave this section blank.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
Click here to enter text. / Choose an item from this drop down menu / Choose your learning need from this drop down menu / Choose an item.
Agreed SMART Objective 3
Your work objective / How will this objective be measured? Note any milestones on the way
Click here to enter text. / Click here to enter text.
If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UKPSF or other L&D associated with this objective, please indicate it below. If there are no learning needs please leave this section blank.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
Click here to enter text. / Choose an item from this drop down menu / Choose your learning need from this drop down menu / Choose an item.
Agreed SMART Objective 4
Your work objective / How will this objective be measured? Note any milestones on the way
Click here to enter text. / Click here to enter text.
If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UKPSF or other L&D associated with this objective, please indicate it below. If there are no learning needs please leave this section blank.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
Click here to enter text. / Choose an item from this drop down menu / Choose your learning need from this drop down menu / Choose an item.
Agreed SMART Objective 5
Your work objective / How will this objective be measured? Note any milestones on the way
Click here to enter text. / Click here to enter text.
If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UKPSF or other L&D associated with this objective, please indicate it below. If there are no learning needs please leave this section blank.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
Click here to enter text. / Choose an item from this drop down menu / Choose your learning need from this drop down menu / Choose an item.
Agreed SMART Objective 6
Your work objective / How will this objective be measured? Note any milestones on the way
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If there is any learning need e.g. TEL (Technology Enhanced Learning) Skills, UKPSF or other L&D associated with this objective, please indicate it below. If there are no learning needs please leave this section blank.
Learning Need
Learning need description / How do you expect this learning need to be addressed? / Learning Need Category: / Define level (if appropriate)
Click here to enter text. / Choose an item from this drop down menu / Choose your learning need from this drop down menu / Choose an item.
Describe any other learning and development skills or trainingto enhance your job performance, or support career progression.
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If agreed,the date set for a mid-year review
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Agreed by post holder
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Agreed by appraiser
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My countersigning manager has a copy of this reviewChoose an item.
Instructions for saving the form
Save the document using the following naming convention
W, appraisee's surname, firstname, year
(E.g. for an appraisee named Susan Jones the file will be saved as Wjonessusan2015.docx)
The Appraiser should submit a copy of this completed form to HR by attaching it to an email addressed , copying in the Appraisee and the Countersigning Manager.
Please send only 1 appraisal form per email. (Please contact the OD Team if this is an issue)
See the Organisation Development website for further guidance at
For OD use only: Date Processed
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