Completion Notes
This appraisal form is for all staff except Medics/GMC registered who have their own separate paperwork to complete.
Please note that all sections are compulsory and MUST be completed. Once completed a copy needs to be stored on the personal file and a copy given to the individual. To complete the appraisal please notify the team by email to giving the name of the appraisee, the date and the name of the appraiser.
When completing an appraisal, you find additional assistance on the Trust intranet under A. It is recommended that you view these pages when preparing for your annual appraisal. If you require any additional information about the appraisal process or training courses, please email
There are seven sections to your appraisal form. Please complete sections 1 to 4 prior to your appraisal and return them to your appraiser 1 week before your appraisal date. New starters and new to role need to complete section 1 prior to the meeting. Sections 5, 6 and 7 will be completed in the appraisal meeting.
Section 1 - Personal details and code of conduct declaration
Section 2 - Review of last year against Trust Values
Section 3 - Review of last year’s objectives/training and development activities
Section 4 - Review of mandatory training and training required by job role
Section 5 - Setting of new objectives/training and development activities
Section 6 – Evidence of CPD (Continuous Professional Development)
Section 7 - Summary

Section 1 – Personal Details and declarations

Name / Line Manager
Directorate / Band / Employee Number
Date of appraisal / Date of next appraisal
·  The Code of Conduct for the Trust requires all employees to declare any conflicts of interests and any hospitality as outlined within the policy which can be found here http://sharepoint/policies/Office%20Documents/Forms/DispForm.aspx?ID=1501
·  It is the responsibility of each and every manager to identify any breaches of the Code of Conduct which should be managed in accordance with the relevant HR policies on performance and reported as outlined within the code of conduct policy.
Individual Declaration of conflict of interest/hospitality
Appraiser Notes

Section 2 – Review of Last Year – please see guidance notes for examples

Provide an example of how you/the team have demonstrated the Trust Values of Caring, Honest, Accountable & Supportive.
Caring - Treating everyone with compassion & respect
Honest - Truthful and open with all
Accountable - Taking personal and collective responsibility for doing our best
Supportive - Working together to get things done
What do you think has gone well over the last review period? Please provide evidence of performance against your objectives. What has been your key achievement?
What do you think has not gone so well over the last review period?

Section 3 – Review of Last Year’s Objectives/Training and Development activities

Objective/Development activity / Target Completion Date / What Did You Agree to Achieve This Objective? / Evidence – Please Provide Examples / Status – Has This Objective Been Achieved?

Section 4 – Review of Mandatory Training and training required for job role for last review period.

Training Element / Date Undertaken / Date Completed / Notes
Please detail the status of your mandatory training and any other training which may be applicable for your job role. If elements are out of date, please agree with your Manager as to how you will rectify this. Non-compliance may be subject to deferral of pay progression and disciplinary action. If an increment is to be withdrawn/deferred from an individual a form ESR2 must be completed.

Section 5 – Setting New Objectives and Development/Training Activities

This section will involve discussion and agreement by the individual and manager on two areas: role objectives and development/training to support achievement of your objectives over the next 12 months.

Objectives for this review period to include development/training objectives if applicable / Target Completion Date / Measurement/What Will You Do To Achieve This/Additional Comments

Section 6 – Evidence of CPD (Continuous Professional Development)

If your role requires evidence of CPD (Continuous Professional Development), please list with dates to maintain your professional competences for registration with your professional body.

Registered Nurses and Midwives only - Revalidation readiness .

Registered Nurses and Midwives only please complete the Nurse and Midwifery Appraisal Revalidation Form which can be found under R on the intranet to discuss in your appraisal.
A copy of this form and the confirmation form to be kept on the personal file.
Appraiser notes

Section 7 – Summary

Overall Role Performance Comment - Individual / Overall Role Performance Comment - Manager
Individual Sign / Individual Date / Manager Sign / Manager Date

By signing above, you agree to the contents of this appraisal document and agree to action any objectives outlined. You also agree that if mandatory training is not completed, movement to the next pay increment could be deferred.

To complete the appraisal please notify the team by email to giving the name of the appraisee, the date and the name of the appraiser.

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