CONFIDENTIAL

Appendix 1

HSE Performance Management System

Performance Review Cycle (PRC) Form

Version 3 (May 2013)

Year ______

Important Note

Please read Chapter 5 ‘Guidelines for Completing the Performance Review Cycle (PRC) Form’ before completing this form.

Meeting 1 - This section of the form is completed before / during the Performance Planning & Personal Development Meeting (Meeting 1).Section 1.2 should be completed by the Individual in advance of the meeting. The other sections should be completed by the Individual in conjunction with his / her manager during Meeting 1.

1.1: Personal Details
Your Name / Your Grade
Your position title / Service
Years in current role / Your PRC meeting dates: / Meeting 1:
Meeting 2:
Meeting 3:
No. of staff reporting to you / No. of PRC meetings held with staff: / Meeting 1:
Meeting 2:
Meeting 3:
Manager’s Name / Manager’s Job Title / Grade
  • 1.2: Review Of Previous Year (Summary of accomplishments and challenges from previous year). It may be helpful to consider the following areas:
  • Service Delivery / Client Service / Customer Service
  • Governance / Regulatory / Internal Processes
  • Financial / Contribution to financial efficiencies / use of resources in an efficient manner
  • Learning & Growth

1.3: Purpose & Prioritiesof Role In Current Cycle
Purpose of role:
Priorities / objectives for the period under review: ( may be described in more detail in locally developed objective setting / service plan documents or by using the Action Plan in the Performance Management Guidance Document))
Risks (list internal and external as appropriate)
Resources available/resource issues (Financial and Human)
1.4: Learning and Growth(Developmental activities for the coming period)
1.5: Meeting 1 Sign off
Individual’s signature / Date
Manager’s signature / Date

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HSE Values: Respect, Fairness & Equity, Excellence, Leadership, Accountability & Responsibility Version 3

CONFIDENTIAL

Meeting 2 – Mid Cycle Review Meeting (Meeting 2)

The self reviewsections (2.1 and 2.2) should be completed and sent to the manager for consideration in advance of the meeting.The manager will complete section 2.3 during the meeting having discussed it with the individual during the meeting.

2.1: Mid Cycle Self Review
(Highlight changes in context, priorities, resources, etc. that impact on achievement of objectives since Meeting 1)
2.2: Self Review
(Summary of personal input and progress on the priorities /objectives as described in the locally developed objective setting / service plan document or Action Plan):
2.3: Manager’s Mid – Cycle Review(Manager completes after discussion with individual during the meeting)
2.4: Meeting 2 Sign off
Individual’s signature / Date
Manager’s signature / Date

Meeting 3 – Cycle End Performance Review & Developmental Evaluation Meeting (Meeting 3)

The individual should complete Section 3.0 and 3.1 and give the form to the manager in advance of the Cycle-End meeting. The Manager will complete section 3.2 during the meeting, having discussed it with the individual during the meeting.

3.0: Cycle End -Self Review
(Highlight changes in context, priorities, and resourcesduring the period that impact on achievement of objectives since.)
3.1: Cycle-End Self Review
(Summary of personal input and progress on the priorities /objectives as described in the locally developed objective setting / service plan document.)
Learning & Growth plan;(outcome of developmental activities undertaken/ planned for next cycle.)
3.2: Cycle - End Manager’s Review) (Based on achievements of priorities )Manager completes after discussion with individual during the meeting)
Learning & Growth plan; (outcome of developmental activities undertaken/ planned for next cycle.)
3.3 Meeting 3 Sign off
Individual’s signature / Date
Manager’s signature / Date

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HSE Values: Respect, Fairness & Equity, Excellence, Leadership, Accountability & Responsibility Version 3