Integrated Performance Management System

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					             Performance Management System summary 20th January 2012

1. The HSE is introducing a formal Performance Management System in fulfilment of the terms of
   the Public Service Agreement. The system will cover all grades and professional disciplines and
   will be introduced on a phased basis commencing with grade VIII and equivalent upwards
   including comparable clinical grades in 2012.

2. The object of the Performance Management System is to improve the performance of the
   organisation, develops the capacity and capability of its employees, identifies and
   acknowledges good performance and addresses underperformance in a timely and constructive
   manner.

3. The HSE’s Performance Management System consists of consists of 4 elements
       A Performance Review Cycle (PRC)
          The   Performance    Improvement    Plan,   a   supportive   approach   to   addressing
           underperformance
          Supporting HR and Professional Practices
          Relevant HSE performance measures

4. The Performance Review Cycle will be introduced on a phased basis commencing in 2012.
   In National Directorates Phase I introduction will extend from the National Director to grade
   VIII and equivalent including comparable clinical grades reporting directly to the National
   Director or Assistant National Director in each Directorate.

   In the Regions Phase 1 implementation will be on a step down basis from RDO’s Management
   Team through Area Management Team to those reporting to members of the Area Management
   Team.

5. Phase 2 will see the introduction of the process to grades below Grade VIII and equivalent
   including comparable clinical grades. The process to be used in Phase 2 will take into account
   the numbers of individuals reporting to a manger, the multidisciplinary o nature of teams and
   effect of rostered working. Discussions on the appropriate process for Phase 2 will commence
   in 2012 with the relevant unions.

6. Education and Briefing sessions will be delivered by nominated managers supported by Area
   HR Teams and the National HR Directorate. These briefing and education sessions will
   commence in February 2012. A standard HSE briefing pack and a Performance Review Cycle
   Guide will be provided. This material will be supported by existing HSE and Regional
   Performance and Development material. The draft contents page of the standard HSE material
   is attached for information purposes.

7. The Performance Improvement Plan will be introduced in 2012. The Performance Improvement
   Plan (PIP) is a time bound process designed to address in a formal manner a performance issue
   that has not been corrected following normal formative feedback. This process is designed to be
   managed within a department or unit between the two parties involved and requires constructive
   discussions between a manager and their direct report where performance problems are
   identified and persist. If performance does not improve following the use of the Performance
   Improvement Plan consideration should then be given to moving to other corrective or
   supportive HR processes, e.g. EAP, Occupational Health, Disciplinary Process, etc.

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8. Existing practices relating to the payment of increments will continue for year one of each
   phase. In January 2012 separate discussions on the treatment of increments for all grades will
   take place. Separate discussions will also take place in February on the connection between the
   Performance Review Cycle and promotions following advice from the Commission for Public
   Service Appointments

9. The evaluation of Phase 1 will be assessed using a questionnaire and focus groups Draft
   questionnaire attached. Learning from Phase 1 will be incorporated into the development of the
   next phase.

10. Supporting HR and Professional Practices
    HSELanD support available for the Performance Management System-attached
    Regional Learning and Development programmes
    Support from Medical Education and Training, Director of Nursing Services and Nursing and
    HSCP Education and Development
    Pilot Management Development programme currently being piloted in DNE.




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                                Performance Management System
  th
18 January 2012
                                                Contents

1. The HSE’s Performance Management System
      1.1. Context and Purpose                                    2
      1.2. Performance Management in the HSE                      2
      1.3. Components of the Performance Management System        3
      1.4. Phased introduction                                    3
      1.5. HSE Values                                             4
      1.6. Assumptions                                            4
      1.7 Key elements of the Performance Management System       4

2. The Performance Review Cycle
      2.1. Purpose                                                5
      2.2. Process                                                5
      2.3. Objectives                                             5
      2.4. Storage, confidentiality and access                    5
      2.5. Resolution of disagreement                             6
      2.6. Incremental Progression                                6
      2.7. Promotion                                              6
      2.8. Performance Management Cycle process evaluation        6

3 Performance Improvement Plan                                    6

4. Performance Management Cycle –Team Management Process
      4.1. General                                                6
      4.2. Interdisciplinary Teams                                6
      4.2.1 Multi-source Feedback                                 6


5 Education and Support
     5.1. Supporting Guidance documents                           6
     5.2. Training and supports to date                           7
     5.3. Briefing Sessions on the Performance Management Cycle   7
     5.4. Future training requirements for Phase 2                7

6 Support from National Directorates and HSE Regions
     6.1. Integrated Service Directorate and HSE Regions          7
     6.2 Quality and Patient Safety Directorate                   7
     6.3. National HR Directorate                                 7

7 Performance Management System Oversight                         7


Appendices
Appendix 1     HSE Value Charter                                  8
Appendix 2     Performance Management Cycle diagram               9
Appendix 3     Performance Improvement Plan                       10




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                  The Health Service Executive Performance Management System

                “We are what we repeatedly do. Excellence then is not an act, but a habit”.
                                                                                                   Aristotle
1. Performance Management System
1.1. Context and Purpose
This document sets out the HSE’s proposals on performance management at individual level to meet the HSE’s
requirement to improve performance management under the Public Service Agreement (2010-2014).

Public Service Agreement (2010-2014) – Paragraph 1.13

        There will be significantly improved performance management across all Public Service areas,
        with promotion and incremental progression linked in all cases to performance. Performance
        management systems will be introduced in all areas of the Public Service where none currently
        exist.

Health Sectoral Agreement – Paragraph 2.9 (10)

        Strengthening of individual, professional and statutory accountability for senior management
        (General Manager and its equivalent upwards) and comparable clinical grades: preparations for
        the introduction of PMDS in 2011 will involve discussions with unions during 2010 drawing on
        experience from elsewhere in the public service;

The Performance Management System envisaged augments existing HSE and health sector organisational
performance measurement and management systems and supporting processes. The HSE recognises that
while the existing processes, for example, Performance Contracts, Team Based Performance Management,
Professional Supervision, CPD and PDP activities, Monthly Performance Reports, HealthStat, etc, are valid
indicators of organisational performance measures, the Public Service Agreement places a specific emphasis on
developing a standardised performance management and development process at the individual land team
level.

The introduction of standardisation performance management processes will serve to support the
implementation of the National Service Plan 2012 and local service plans and will also support the HSE’s Clinical
Governance Development initiative and conformance with HIQA’s draft National Standards for Safer Better
Healthcare, Standard No.5 Governance Leadership and Management.

It is therefore the policy of the HSE to implement, maintain and monitor a Performance Management System that
develops the capacity and capability of its employees, improves the performance of the organisation and
addresses underperformance in a timely and constructive manner. The introduction and continuation of the
proposed performance management system has the potential to change the culture of the organisation as it
reinforces or introduces constructive leadership and managerial behaviours and practices that are essential in a
service organisation.

1.2. Performance Management in the HSE
Performance Management is not just a process; it is, more importantly, a mindset and a way of behaving which
influences organisational outcomes.

      “A process for establishing a shared understanding about what is to be achieved and how it is to be
      achieved, and an approach to managing people that increases the probability of achieving success”

                                                                                  Weiss and Hartle (1997)

Performance management in service organisations needs to place emphasis on behaviours that affect
outcomes.

      “Because service quality is intangible, there is a strong tendency to manage service businesses by
      focusing on what is most tangible: such as numbers of customers served, costs of providing the
      service, and revenues generated. But focusing on what’s easily measured leads to ‘looking good
      without being good’ – to having measurable performance indicators that are acceptable yet not
      providing quality service. Work gets done but at a steadily poorer standard of quality,”

                                                                      Peter M. Senge, 1990. The Fifth Discipline
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Without meaningful discussion on what realistically can be achieved, having considered the resources that are
available, the risks to achieving desired outcomes and a commitment to building individual and organisational
capability and capacity, a performance management process runs the risk of becoming a dishonest annual ritual
based on compliance rather than commitment. Performance management activities must therefore be inclusive,
grounded in dialogue, communication and participation.

Performance management systems must be sufficiently robust to meet the challenge of ever changing operating
environments. The Performance Management concept and design is therefore focused on activities that clarify
structures, reporting relationships, roles, responsibilities and personal development. Genuine implementation
will provide structure, guidance and support to employees in their roles and provide levels of personal and
professional developmental opportunities that are feasible within the constrains of the current operating
environment.

1.3. Components of the Performance Management System
     1. A Performance Review Cycle (PRC) consisting of:
           a. A Performance Planning and Personal Development initial meeting based on the relevant
                service plan (Appendix 2)
           b. Ongoing discussion and feedback with a formal Mid Cycle Review,
           c. Cycle End Performance Review and Developmental Evaluation, (for year two onwards a and b
                could be the one meeting)
    2. The Performance Improvement Plan , a supportive approach to addressing underperformance
    3. HR and Professional Practices within the organisation.
    4. Relevant HSE performance measures, HSE performance Reports, Health Stats etc.

1.4. Phased introduction of the Annual Performance Review Cycle
The Performance Management Cycle (PRC) will be introduced on a phased basis

Phase 1 Q1 2012
Implementation will follow the management structures within Service Directorates. The management layers
within each Directorate are seen as the logical pathways for introducing the process as it is dependant upon
clarity of structure, reporting relationships and roles. This step-down approach ensures that as the process is
introduced at each level the necessary conditions required for the implementation at each subsequent level have
been put in place. This approach requires managers at higher levels to hold team meetings and implement the
Performance Review Cycle so that the process can then be introduced at next relevant level.

Within the Regional structures and / or Service Directorates Phase 1 will encompass the Regional Management
Teams, Area Management Teams and individuals, grade VIIIs and equivalent and comparable clinical grades, in
management structures reporting to members of Area Management Teams., e.g. hospital management
structures.

The draft Corporate Plan 2011-2014, Section 8 Managing Performance reinforces the step down approach in
stating that

“The Key actions from the Corporate Plan, which will be detailed in the annual NSP, will also form the basis of
senior managers Personal Performance Reviews. These will be agreed, implemented and reviewed as part of
day to day performance management”.

In Support Directorates, HR, Finance, CSC, CPCP, Phase 1 will extend from the National Director to grade VIII
and equivalent including comparable clinical grades reporting directly to the National Director or Assistant
National Director in each Directorate.

Phase 2 for 2012
The roles to be encompassed in Phase 2 will be identified in 2012. As the number of individuals on teams
reporting to managers in Phase 2 will increase, the suitability of using the Phase 1 process will be assessed in
consultation with the manager’s involved, relevant representative associations and relevant professional bodies.
1.5. HSE Values
Behaviours driven by the HSE Values are necessary to achieve the inclusiveness, dialogue, communication and
participation required to make performance management activities honest.
The HSE values are (See HSE Value Charter at Appendix 1)

       Respect

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        Valuing patients/clients and each other: Recognising the fundamental worth of people through trust,
        courtesy, mutual communication and collaboration
       Fairness and Equity
        Providing health and personal service based on need and striving for an equitable health service
       Excellence
        Striving for the highest level of achievement in all aspects of our work
       Leadership
        Directing the future of the HSE
       Accountability and Responsibility
        Honesty, consistency and accountability in decisions, words and actions

1.6. Assumptions,
The assumptions underpinning the system are:
     People are viewed not as fixed entities but as potentially “in the process of becoming”
     People wish to be accepted and interact cooperatively with at least one small reference group
     Managers are “linking pins” between groups and have a powerful effect on the attitudes and behaviours
        of people in these groups.
     Due regard is given to resources available to individuals, individual input, professional considerations
        and internal and external constraints.

1.7. Key elements in the Performance Management System
The following elements are the building blocks of the Performance Management System;

(a) Value driven: Behaviours based on the HSE Values makes the system a vehicle which can bring these
values alive and which can in bed them in the way we work in the HSE.
(b) Objective driven: The HSE recognises that there must be a direct link between team/individual objectives
and relevant objectives contained in the National, regional and local service plans, relevant service sector
strategies and HSE programmes. Objectives need to be achievable while at the same time challenging.
Objectives should be,

Specific                    Clear and unambiguous

Measurable                  Must be possible to assess the extent to which the objective has been
                            achieved
Achievable                  Should be realistic , challenging enough to raise performance

Relevant                    Central to key result so that effort is directed into priority activities

Time-based, timely          Should include a timescale in which they are to be completed


(c) Balanced Scorecard approach: The Balanced Scorecard is the framework for the Performance Planning
and Personal Development discussions. The scorecard is a planning and management tool that assists in
aligning the service activities of the organisation with the service plan, and monitors performance against agreed
objectives. It is termed “balanced” because it not only looks at financial or quantitative data but the other areas
which influence individual and organisational performance and development. A separate document entitled
Using the Balanced Scorecard in Health Care is available as part of the supporting material available.
(d) Self Assessment: The Performance Review Cycle acknowledges that employees need to take ownership of
their own development and performance. The mid-cycle and cycle end review facilitate this approach through
structured self assessment and self review.
(e) Manager and employee engagement: Ongoing communication is essential to the success of the
Performance Management System. The Performance Review Cycle and CPD contain processes that not only
promote but require meaningful discussion and dialogue on goal setting, evaluation and outcomes on an
ongoing basis. Dialogue must not be solely confined to the PMC scheduled meetings but must be on ongoing
occurrence during the year.
(f) Recognising good performance: The identification of good performance is central to the system. Good
performance is acknowledged and supported so that individuals can strive to realise their full potential.
(g) Developmental: The Performance Management System facilitates professional, personal and career
development through the joint input of managers and employees in the evaluation and planning of service driven
developmental activities.
(h) Managing underperformance: The HSE acknowledges that underperformance must be identified and
managed. The Performance Management System provides the framework for identifying and analysing the

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causes of underperformance and instituting appropriate corrective measures through a Performance
Improvement Plan (PIP) if necessary.

2. The Annual Performance Review Cycle

                               Under a good general, there are no bad soldiers
                                                                                                 Chinese proverb

2.1. Purpose
The purpose of the annual Performance Review Cycle (PRC) is to provide a systematic process for managing
the cycle of activities associated with service delivery and the process whereby the HSE and individuals achieve
agreed performance and developmental outcomes. This process requires meaningful discussions between
managers and their direct reports on performance expectations, resource availability and utilisation, training and
developmental needs, appropriate recognition of personal input, achievement and early identification of
performance problems. The documentation of a performance review process is evidence of a standardised and
disciplined approach through which the required organisational and individual outcomes can be identified and
reviewed. The PRC is represented diagrammatically in appendix 2. The PRC form and Guidelines for
Completing the PRC form are available as separate documents.

2.2. Process
The PRC is a normally a twelve month cycle during which performance and development is discussed, planned,
actioned and reviewed. The cycle involves the following activities

       Performance and development planning meetings
       Implementation of agreed actions or activities
       Ongoing formative feedback during the cycle
       Mid-Cycle Performance review
       Cycle end Performance Review
       PRC process evaluation

2.3. Objectives
The implementation of the PRC is intended to achieve the following objectives:

       To link unit, team and individual goals and performance standards to service requirements; to arrive at a
        shared purpose
       To create the opportunity for employees to communicate views and receive feedback on their
        performance in their job and role in the organisation
       To create the opportunity for managers to engage with employees on service requirements and personal
        development plans
       To encourage the practice of recognising and acknowledging good performance
       To recognise and address underperformance in a structured manner
       To improve organisational performance and the service users experience

2.4. Storage, confidentiality and access
In the first year of implementation copies of the PRC form will be held by the employee and the manager. In
subsequent years the year form will be made available to the manager’s manager and will form part on the
review discussions between the two managers. The PRC form is confidential to those directly involved in the
process. The relevant developmental sections of the form may be made available to the relevant HR Manager or
AND of HR for specific career and developmental purposes. The employee may make the form available to their
representative

2.5. Resolution of disagreement
In the event of disagreement on the conduct of the process between the manager and the job holder either party
may invoke the HSE Grievance Procedure.

2.6. Incremental progression
Existing processes relating to the payment of increments will continue during each first year of implementation.
The link between increments and the PRC will be the subject of separate discussions in 2012.

2.7. Promotion
The link between promotions and the PRC will be the subject of a separate review which will examine current
recruitment and selection practices. The recruitment and selection practices and process will be reviewed with

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the objective of ensuring that they comply with the principles of the HSE’s Recruitment Licence and associated
Codes of Practice. The review will involve appropriate consultation with the Commission for Public Service
Appointments, the Department of Public Expenditure & Reform other stakeholders.

2.8. PRC process evaluation and modifications
The purpose of the Evaluation Questionnaire is to get feedback from all involved on how the process worked
during the year. This feedback will facilitate the monitoring of the process at national level and identify areas for
improvement.

3. Performance Improvement Plan
The Performance Improvement Plan (PIP), appendix 3, is a time bound process designed to address in a formal
manner a performance issue. Is not an end of year activity but is a process that should be implemented as
required to address performance issues that are not being improved through normal formative feed back. This
process is designed to be managed within a department or unit between the two parties involved and requires
constructive discussions between a manager and their direct report where performance problems are identified.
If performance does not improve following the use of the Performance Improvement Plan consideration should
then be given to moving to other corrective or supportive HR processes, e.g. EAP, Occupational Health,
Disciplinary Process, etc.

4. Performance Management Cycle –Team Management Process
4.1. General
TBPM is based on the process set out in August 2003 in the document titled “Performance Management – The
Process and How it Will Work” with its emphasis on team processes and dynamics. The structure of the current
Team Based Performance Management (TBPM) process provides a template for the management of team
planning meetings and can be augmented to include the assignment of responsibilities and identification of
desired team processes and behaviours. The TBPM process will continue to be used in its current format and
will be reviewed in 2012 as part of the next phased implementation of the Performance Management Cycle.

4.2. Interdisciplinary Teams and Intra-disciplinary Teams
The option of using alternative team specific performance management processes is relevant for interdisciplinary
and intra-disciplinary teams where success depends upon the governance arrangements and the team
behaviours and processes used by clinical and non clinical team members. The development of a performance
management process for these structures will be examined in conjunction with the establishment of Area
structures. The development of a Team Based Performance Management process will be discussed with the
Integrated Service Directorate, Quality and Patient Safety and The National Primary Care Services.

4.2.1 Multi-source Feedback
Consideration will be given to using multi-source feedback in 2012. Feedback from multiple sources may be
more appropriate, and may give added validity, in situations where direct reports are at a distance from their
manager, in matrix structures or where an individual works with more that one manager.

5. Education and Support
5.1. Supporting Guidance documents
Specific educational, briefing and guidance documents will be developed by the Regional Performance and
Development teams in conjunction with Performance Management & Management Information or the PRC.
These documents will be placed on a dedicated site on the HSE’s intranet. This material will be reviewed and
updated annually as required following feedback from those involved in the process.

5.2. Training and supports to date
The training and support given on the introduction of the existing managerial and developmental programmes;
Performance, Planning and Review process, Team Based Performance Management and the developmental
programmes have provided the participants with the foundation required to implement the Performance
Management Cycle.        These programmes include; Team Based Performance Management, People
Management; The Legal Framework, Senior Managers Leadership Programme, the recently launched First Time
Manager’s Programme and e-learning programmes on www.hseland.ie.

5.3. Briefing Sessions on the Performance Management Cycle
Performance Management & Management Information supported by Corporate and Regional HR teams will
deliver briefing sessions for the managers included in Phase 1. These sessions will be supported by the briefing
and educational material which will also be available on the HSE’s intranet.

5.4. Future training requirements for Phase 2

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Training and supports for the extension of the Performance Management System to the next level will be
developed from the learning derived from the implementation of Phase 1.

6. Support from National Directorates and HSE Regions
The successful implementation and continued operation of the Performance Management System is dependant
upon all Directorates and service units supporting the process as appropriate to their function.

6.1. Integrated Service Directorate and Regions
Support the development and implementation of Performance Management System in the region through
Regional HR and local HR Managers. Provide appropriate training and support to individuals engaged in the
Performance Review Cycle, CPD and PDP.

6.2 Quality and Patient Safety Directorate
Support the performance management process through the service wide implementation of the Guiding
Principles for Clinical Governance Development. Assist the regulatory bodies and registered practitioners in the
development of compulsory CPD or professional competencies schemes as required by relevant legislation.

6.3. National HR Directorate
Performance Management & Management Information
Lead the Performance Management System Project Team. Develop, in conjunction with regional nominations,
the briefing and training required to support the implementation of the PRC. Lead, in conjunction with
Succession Management and Recruitment a review of current recruitment and selection practices and process
with the objective of ensuring that they comply with the principles of the HSE’s Recruitment Licence and
associated Codes of Practice.

Succession Management
Develop appropriate Leadership and Management Development Programmes that that are appropriately linked
with the Performance Management System

Medical Education and Training, Nursing and HSCP Education and Development
Develop appropriate programmes which aid PDP, CPD, and Professional Supervision as a support to individuals
participating in the Performance Review Cycle. Develop practices that support individuals in compiling with
compulsory professional competencies schemes.

7 Performance Management System Oversight
The development, implementation and monitoring of the Performance Management System is overseen by a
Steering Group. The Steering Groups is chaired by the National Director of Human Resources and includes
nominations from Quality & Patient Safety, Clinical Strategy & Programmes, Finance Directorate, ISD PFM, HR
Directorate, Commercial and Support Services, Nursing & Midwifery Services Director and the Health and Social
Care Professional Advisory Group.




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Appendix 1     HSE Values Charter

                                                   Respect

Valuing patients / clients and each other: Recognising the fundamental worth of people through trust, courtesy,
                                    mutual communication and collaboration

      We will respect our patients / clients, their families and each other as individuals
      In our communications we will be caring, loyal, truthful, respectful, kind, considerate and empathetic
      We will actively listen to the views and opinions of all stakeholders and consider them in our actions, and
      We will show dignity, courtesy and professionalism at all times.

                                            Fairness and Equity
   Providing health and personal social services based on need and striving for an equitable health service

    We will deliver high quality, reliable, person-centred services, delivered as close to the point-of-care as
     possible
    We will pursue equality of access and delivery of the full range of services for everyone, based on need,
     and
    We will ensure that those most disadvantaged and marginalised in our community have their health and
     personal care needs met.

                                                  Excellence

                     Striving for the highest level of achievement in all aspects of our work
      We will continue to strive to deliver evidence based best practice
      We will continually audit and evaluate our performance / services and act upon the findings
      We will encourage and facilitate continuous training and development for all our staff, and
      We will support innovation and encourage creativity.

                                                  Leadership

                                       Directing the future of the HSE
    We all have a role to play in leadership by communicating the vision, taking responsibility, building trust
     and confidence among colleagues and service users.
    Lead by example – We are all human beings with different strengths; we will learn from the strength of
     others who have enriched our lives, and
    We will respect and acknowledge the role of our staff and instil pride in delivering our services.

                                     Accountability and Responsibility

                 Honesty, consistency and accountability in decisions, words and actions
    We will provide health and personal social services within our allocated budget
    We will ensure integrity in our processes and practices
    We will encourage and allow individual responsibility and empower staff to manage their services
    We will recognise performance and challenge underperformance and non performance, and when
     something goes wrong, we will acknowledge, we will apologise and find out what happened
    We will put mechanisms in place to ensure it will not happen again.




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Appendix 2    Individual Performance Review Cycle



                        Preliminary Team Meeting                                        Mid-Cycle review and feedback
            Discussion of team objectives, roles & processes
                                                                                    Individual and manager review progress on
                                                                                     performance and personal plans
     Individual Performance Planning-Operational focus
     Discuss & Agree                                                                Give recognition and acknowledgement
         Role, Responsibilities and accountabilities
                                                                                    Amend plans as required to include
            Individual’s plan and contribution to achieve team and                  emerging challenges, new objectives and
             personal objectives                                                     contingency planning if required

            Support and resources available

            Identify risks
                                                                                        Cycle-end review and feedback
     Personal Development
                                                                                    Individual and manager review progress on
     Discuss
                                                                                     performance and personal plans
         Skills, knowledge, role competencies that influence job
           and personal performance
                                                                                    Joint assessment on achievement on agreed
                                                                                     objectives and Learning & Growth
            Service driven CPD or PDP, Professional Registration                    requirements
            Availability of development programmes or assignments
                                                                                    Identify items to carry forward to next cycle
             to develop career

            Agreed actions




       Next cycle
                                               Leadership & Development programmes                                Corrective Actions
                                                         Mobility, projects,

a




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Appendix 3

                                              Performance Improvement Plan



  1. Identify the performance gap by reviewing
  the using the review process.




  2. Meet the employee
       Describe the difference between
          agreed performance and agreed
          performance and the negative
          impact of the current performance.            Supports
       Ask the employees for their views on            Training, Occupational
          what is causing the situation.                Health, EAP
       Jointly plan time bound action based
          on the meeting and the root cause of
          the problem.
       Agree supports available                                       Beneficial to Resume steps 1,
       Set follow-up review dates.                                    2 and 3?
       Both parties sign off on plan
       Document the meeting and provide                               Assess if person can
          employee with a copy.                                        improve–has the skills etc but
                                                                       not the motivation to do so.

                                                                       Or
    3. Follow through                                                  Is incapable of improving-does
         Implement the agreed action plan                             not have the skills or motivation
         Monitor the situation and look for                           to improve
            opportunities to support the performance
         Acknowledge improvement                                      Or

                                                                       Other underlying problem

    Is the performance improving?
                                                             NO.


                                                                             Move to support processes
                                                                             as appropriate, Occupational
                                                                             Health, EAP, Development
         Yes.



                Acknowledge improvements
                                                                      Move to Disciplinary Process,
                Consider reduction of supervision/contact as
                improvements continue

                Close out as required standard is achieved




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