Pre-appraisal pack 2014-15
To be completed by the appraisee prior to appraisal
Name:
Job Title:
Department:
Appraiser Name:
Date of Appraisal:
Note: blank pages are included for double-sided printing
CONTENTS
Review of last year ........................................................................................... 3
Preparing for your appraisal discussion ............................................................ 4
Vision, values and behaviours .......................................................................5-7
Preparation of objectives and personal development plan .............................8-9
INSTRUCTIONS
Prior to your appraisal, please complete this pack as far as you are able so that you are prepared
for your appraisal meeting, and give some thought to your objectives and personal development
plan (PDP) for the coming year.
When you attend for your appraisal, you should make sure that you provide your appraiser with
completed forms (appendices 1-4).
From 2015, appraisals will be directly linked to pay progression. Therefore it is essential that you
fully understand what is expected of you for the coming year. For further information about
changes to the Appraisal process, please speak to your line manager or refer to the Appraisal
Policy which is available on the Intranet.
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Review last year - make notes here to discuss at your appraisal
Your objectives from last year
Objective
Achieved?
Comments
Met successfully /
not met required
standard
Include evidence to show why the objective has
or has not been met
Was your mandatory training compliance 80% to
100% at one point in the last 6 months?
Overall summary – have all objectives been
achieved?
(Note: from 2015, if your objectives have not all been
successfully achieved, your pay progression may be
affected.)
Your Personal Development Plan (PDP) from last year
PDP Activity
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Achieved?
Comments
Met successfully /
not met required
standard
Include evidence to show why the PDP activity
has or has not been achieved
The following questions are to help you to prepare for your appraisal.
Whilst you do not have to answer them all in detail, it would be helpful for you to review these
questions to prompt discussion during your appraisal meeting.
How would you describe the last year of working in your role?
What do you consider to be your most important achievements of the past year?
What have been the most significant challenges for you in the last year?
What is the biggest obstacle at work that you are facing?
What action could be taken to improve your performance in your current position by you, your
manager or systems/processes?
What contribution would you love to make in your current role?
What are you really good at?
How could teamwork in your immediate team be improved?
What opportunities do you see for growth and development in your existing role? Do you have
career aspirations, if so, what area of personal development would be of benefit for you in your
career aspirations?
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Vision, Values and Behaviours
Our new vision, values and behaviours document was launched on 31 January 2014. The full document (available on the Intranet) is
outlined below. The table on page 7 should be used to form a discussion about your behaviours at work.
We are committed to delivering ‘Quality Care for Everyone, Every Time’ and will do this through Caring, Teamwork and Innovating &
Improving.
Our Vision: “Quality Care for Everyone, Every Time”
What does this mean to you in your role? How do you contribute to providing quality care? Is there anything exceptional that you have done in the last year?
Our Values: We Care, We are a Team, We Innovate and Improve
We Care…
What’s excellent
about everyone’s
safety &
wellbeing
What’s expected
What we don’t want
I ensure that the work environment is safe & healthy
for myself & others, free from harassment, bullying,
discrimination & inappropriate behaviour
I ensure that the work environment is safe & healthy for
myself & others, free from harassment, bullying,
discrimination and inappropriate behaviour
I promote this to others & look for ways for myself &
others to improve and learn from mistakes
I personally follow safe practice & policy & I raise
concerns when things are going wrong
by valuing &
respecting every
person
I always greet and treat people courteously & as an
individual & encourage others to do the same, even
in the most challenging & stressful situations
I always greet and treat people courteously & as an
individual
I am openly critical of others, do not actively
participate in discussions, and am not interested
in the views expressed by others
by being open &
honest
I consistently display ‘do what you say you are
going to do’ behaviour & I take responsibility if
something goes wrong or not to plan
I take responsibility if something goes wrong or not to
plan
I blame others when mistakes are made
I challenge poor practice & bad behaviour & raise
concerns appropriately
I ignore poor practice and behaviour
I always make eye contact and pay attention to others
I avoid others, even though I know they need
help.
I challenge poor practice and bad behaviour & raise
concerns appropriately & encourage others to do
the same & learn from mistakes
by finding time
I always make eye contact and pay attention to
others, consistently going ‘the extra mile’ for others
& I don’t wait to be asked
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I put myself or others at risk of harm by not
following safe practice and policy
I do not learn from mistakes or look for ways to
improve safety for myself and others
I say ‘it’s not my job/department’
We are a Team..
What’s excellent
What’s expected
What we don’t want
working in
partnership with
others
I proactively and constantly look for ways to work with
others within & outside of the Organisation
I professionally maintain working
relationships with others
I say ‘no’ when asked to be involved
building high trust
relationships
I behave in ways that build trust
I am open and honest in my dealings with
others
I talk behind people’s backs
I combine personal responsibility with compassion &
respect for others
I make commitments & keep them
striving for excellent
communication
I always recognise the impact of methods of
communicating and tailor my approach accordingly
I actively listen but also look for opportunities for others
to be heard
acting professionally
I am able to adapt positively to different circumstances
I stay focused on achieving the Organisation’s goals
I always demonstrate commitment to upholding the
reputation of the Trust & inspire others to do the same
I do not see the benefits of working in a team
I break promises
People can trust me to do what I say I will
do
I ensure that patients and colleagues
understand what is happening and why
I actively listen
I check to make sure that my
communication is clear and understood
I do not always share information when I should
I am aware of the main goals of the
organisation
I do not express agreement with the Organisation’s
goals in a positive manner or show commitment to
upholding the Trust’s reputation
I have a ‘can do’ attitude
I ignore people & can be rude, aggressive or
impolite at times
I am inappropriately distant or over familiar
We Innovate & Improve…
What’s excellent
What’s expected
What we don’t want
by continuously developing &
learning, maintaining
competence
I ensure that my leadership, clinical &
technical competence is continuously
developed, looking for opportunities for
myself & others to learn & develop
I ensure that my leadership, clinical &
technical competence is maintained
by giving, welcoming & using
feedback to improve
I actively seek feedback & treat it as an
opportunity to learn & improve
I am able to change my behaviours &
ways of working as a response to
constructive feedback
I tend to give limited or inappropriate feedback
I always make sure that resources are
used appropriately & not wasted
I moan without attempting to change or improve
things
I make sure that I give constructive feedback
straight away to help others to learn &
improve
by trying new things; simplifying
& being more efficient
I focus on ways to use resources better &
am creative in identifying new ways of
working that deliver improvements for
patients & staff
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I do not recognise my own personal & professional
development needs
I do not recognise the value of learning &
development
I react negatively & do not embrace feedback
Use this table to form a discussion about your behaviours at work.
How do you rate yourself against this value and the statements within it?
(Rate as: ‘Excellent’ (What’s excellent), ‘Effective’ (What’s expected) or
‘Requires Development’ (What we don’t want)
We Care… about everyone’s safety & wellbeing
We Care… by valuing & respecting every person
We Care… by being open & honest
We Care… by finding time
We are a Team… working in partnership with others
We are a Team… building high trust relationships
We are a Team… striving for excellent communication
We are a Team… acting professionally
We Innovate & Improve… by continuously developing &
learning, maintaining competence
We Innovate & Improve… by giving, welcoming & using
feedback to improve
We Innovate & Improve… by trying new things; simplifying &
being more efficient
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What are your strengths? (give examples)
Where could you be even better and how? (consider this being added as an
objective)
Objectives for 2014-15
 You should think about what your objectives may be for the forthcoming year for discussion and agreement at your appraisal.
 The Appraisal Policy recommends that 4-6 objectives should be agreed; one related to values and behaviours, one to mandatory training and one related to quality.
 From 2015, appraisals will be directly linked to pay progression. This means that if it is identified at your appraisal in 2015 that you have not successfully met all
your objectives, you will remain at your existing A4C pay band point. It is therefore important to clearly understand and agree your objectives.
See appendix 5 (page 19) for examples of SMART objectives
Objective
Make sure objectives are ‘SMART’;
Specific, Measurable, Achievable,
Realistic and Time-bound
When should the objective be
achieved by?
When will the objective be
reviewed/monitored?
Are there any resources
or training needed for the
individual to achieve the
objective?
(Development should be
added to the PDP)
Mandatory training compliance should be
80-100% for at least one month in the 6
months prior to the next appraisal date.
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Personal Development Plan (PDP) for 2015-16
In order to ensure that funding is allocated appropriately and that we are able to access regional funding available, the Development and Training team have already
completed a training needs analysis for 2014-15 for all activity provided internally (e.g. IT training, leadership development) and development activities that require funding
(if you are not aware of this, please discuss with your line manager).
This PDP is for internal provision and development that requires funding for 2015-16 or other activity, such as shadowing others, that will take place in 2014-15.
The Development and Training team will be collating this information for what is required in 2015-16 during August 2014.
Ensure that study leave is discussed during the appraisal.
Personal Development Plan activity
All Mandatory Training must be completed
or booked prior to any other development
being agreed and undertaken.
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Why is this development activity being
set?
Reference to individual/department/Trust
objectives and plans.
When should this
activity be achieved by?
When will this
development be
reviewed/monitored?
Comment of Appraisee
I agree that this appraisal document represents a true reflection of the discussion that took place at
my appraisal review and I agree with the objectives and personal development plan that have been
set for 2014-15.
Signature:
Date:
Comment of Appraiser
Signature:
Date:
Comment of Senior Manager
Signature:
Date:
Note: This appraisal document should be signed by the Appraisee, Appraiser and Senior
Manager and a copy return to the Appraisee within one month of the appraisal review meeting.
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Pre-appraisal pack (Version 25.2.14)
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