APPRAISAL DOCUMENT – V3 JUNE 2017

APPRAISAL AND REVIEW FORM

NAME AND JOB TITLE OF APPRAISEE
NAME AND JOB TITLE OF APPRAISER
APPRAISAL /REVIEW TIMETABLE / PLANNED DATE / COMPLETED
REVIEW OF PREVIOUS YEARS PERFORMANCE AND SET OBJECTIVES AND PERSONAL DEVELOPMENT PLAN FOR THIS YEAR
6 MONTH REVIEW
END OF YEAR PERFORMANCE REVIEW. SET OBJECTIVES AND PERSONAL DEVELOPMENT PLAN FOR FOLLOWING YEAR

The appraisal system is designed to help all staff:

  • Appreciate how their role contributes to the Clinical Commissioning Group (CCG)’s objectives.
  • Know how they are doing and receive recognition for a job well done.
  • Identify the skills and competencies they need to fulfil their role and the education, training and development they need to achieve these.

East and North Herts CCG objectives:

  1. To commission safe and appropriate healthcare services.
  2. To commission effective services that enhances the wellbeing of our residents with the resources available.
  3. To engender a culture of engagement in the decision making processes amongst partners and stakeholders to ensure ownership of service priorities.
  4. To build an organisation with the capacity and capability to deliver agreed service priorities.

Setting objectives:

Make sure objectives are SMART :

  • Specific. Objectives should specify exactly what the individual should be able to achieve. There should be no vague or ambiguous language.
  • Measurable. It should be possible to measure objectively the extent to which objectives have been met.
  • Achievable. People should be able to achieve their objectives. Setting unrealistic targets demotivates. However, this does not mean that they should be too easy; they should be challenging and stimulating.
  • Relevant. Objectives should have a clear purpose and benefit
  • Time-bound. People should know how long they have to complete their objectives and what the deadlines are.

OBJECTIVES

No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review:
No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review:
No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review:
No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review:
No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review:
No / Objective / Link to CCG objective / Actions / Date for completion / Notes on attainment
(to be completed by appraiser and appraise)
6 month review of progress:
End of year review

OBJECTIVES AGREEMENT DISCUSSION

Appraisee Comments:
Appraiser Comments:
Outstanding Learning/ Performance needs identified and agreed actions:
Date:
Signed: Appraisee:
Signed: Appraiser:

PERSONAL DEVELOPMENT PLAN

1. MANDATORY TRAINING

Required Training / Frequency / Completion Date/date booked on / Renewal Date
Conflict Resolution / One off
Equality and Diversity – General Awareness / One off
Adult Safeguarding – Part A / Every 3 years
Fraud and Bribery Awareness / Every 3 years
Information Governance / Yearly – by 31st January
Managing Conflicts of Interest / Yearly – by 31st January
Safeguarding Children Awareness – Level 1 / Every 3 years
Health and Safety Induction:
  • Fire safety
  • Incident and near miss reporting
  • Risk management
  • Manual handling
  • Display screen equipment
  • Slips, trips and falls
/ Every 2 years

2. ADDITIONAL TRAINING / DEVELOPMENT OPPORTUNITIES ATTENDED IN YEAR

Date / Training/Development Opportunity / Learning outcomes relevant to role

3. IDENTIFIED LEARNING NEEDS

Links to individual objective / Identified needs / How are needs to be met / By when / Completion/
Comments

APPRAISAL DISCUSSION – 6 MONTH REVIEW

Appraisee Comments:
Appraiser Comments:
Outstanding Learning/ Performance needs identified and agreed actions:
Date:
Signed: Appraisee:
Signed: Appraiser:

For staff requiring clinical or professional revalidation see Appendix A (nursing staff) or Appendix B (other professional/clinical groups)

APPRAISAL DISCUSSION – END OF YEAR REVIEW

Appraisee Comments:
Appraiser Comments:
Date:
I confirm that :
  • The above named employee is deemed competent to perform the duties in their current role.
  • Professional registrations related to the role are up to date.
  • All mandatory training is up to date or a date for completion has been agreed.
  • Any relevant disability/specific personal needs and/or access requirements have been discussed and actions identified.
Signed :
Appraisee:
Appraiser :

APPENDIX A

Discussion re: Nurse Revalidation Requirements

Revalidation date:
6 Month Review Discussion
Progress on:
:450 hours of practice
:35 hours of CPD
:5 pieces of reflective practice
:5 pieces of feedback
End of Year Discussion
Progress on:
:450 hours of practice
:35 hours of CPD
:5 pieces of reflective practice
:5 pieces of feedback

APPENDIX B

Discussion re: Professional/Clinical Revalidation Requirements (where relevant)*

Revalidation date:
6 Month Review Discussion
End of Year Discussion

*An opportunity to discuss how evidence collection is progressing and whether further support is needed for revalidation.

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