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Making practice appraisal process work best for you

Written by: Steve Bailey
Published on: 19 Mar 2024


Image © Mongkol / Adobe Stock

Here’s a question for you to ponder: what changed as a result of your last appraisal?

Why do I ask? Because I have a sneaky feeling that, for a significant majority of readers, the answers are likely to range from “nothing” to “not very much”, and with a smattering of “I haven’t a clue what we talked about” thrown in for good measure.

And yet, each year virtually all practices will devote a considerable amount of time, and therefore money, to performing this annual organisational ritual.


Perhaps, it’s worth us pausing to remind ourselves why objective setting and appraisal processes are thought to be important. At their best, they are pre-planned opportunities for both the employee and the employer – usually in the guise of the immediate line manager – to hit the collective “pause” button. They are a chance for both sides to lift their gaze above the day-to-day fray and to set meaningful and challenging objectives for the year ahead that stretch and develop the appraisee. Also, they complete the circle by reviewing progress against the objectives set the previous year to check that levels of performance are in line with expectations.

Modern appraisal processes are two-way conversations, designed to set stretching goals for the employee that allow both parties to monitor career progression and skills development. They are also for the organisation to formally recognise the part it needs to play in supporting that development. This could be in the form of training courses or other “formal” staff development, adjustments to working conditions, well-being support or access to mentoring and the opening of other career doors. And then, a set period of time later – usually 12 months, but it needn’t be – to come back together to review progress against those objectives. It is the time to note the successes, marking where things may have changed or fallen short, and why, before starting all over again.

Deeds not words

It’s hard to argue with the intent behind the aforementioned. In my experience, what often lets it down is what happens next. Or, to be more accurate, what doesn’t happen next.

A good test is to think back to the amount of times that you have referred back to the goals and actions that you have agreed for the year ahead. Regularly? Occasionally? Rarely? Or never? Or, at least, not until the week before the following year’s appraisal.

Unless the answer is “regularly” – for example, monthly or, at the outside, quarterly – and unless your line manager is doing similar, the chances are that the goals you agreed and the plans that were made are achieving very little indeed.

Day-to-day work continues unaffected, courses are booked because they happen to be “cheap” and local rather than aligned with goals and desires to explore new areas or to develop new skills go either unfulfilled, or gratefully grabbed, but only when happenstance allows.

Make it worth the effort

So, as the appraisee, what can you do to try to make sure that you get value out of your appraisal process.

  • Make the form work for you. Virtually all employers have templates they use to collect the information from the appraisee. These can vary considerably in quality: some prepared with considerable forethought and refined over years of practice; others thrown together yonks ago and wheeled out annually without so much as a backward glance. If your practice falls into the latter camp, consider using the form as your starting point but don’t feel constrained by it or limited to it. If it asks you to score or comment against two questions joined as one – for example, “Are you happy at work and do you feel supported?” – feel free to pull them apart and answer them separately. If there is no invitation to talk about your career aspirations, add your own. This is not about subverting the process, merely augmenting it and turning the evidence on which the conversation will be based into something that is meaningful and helpful to all.
  • Ask for a time and space that works for you. If we are talking about a meeting that will define the essence of your work for the next 12 months, I would argue that this is not something that should be shoe-horned between consults, announced at little or no notice or conducted in an office with phones ringing and constant interruptions. Ask for a time in the diary that will – barring total meltdown emergencies – be stuck to by both parties and can be prioritised and planned around. This allows you to prep for it and for all concerned to give the conversation the full attention it deserves. Going off site is even better if circumstances allow. A quiet coffee shop, or even a park bench, can often be a far more conducive place for an open and honest conversation than a noisy office or the staff kitchen.
  • Remember it’s a conversation, not an interrogation. The best appraisal meetings are when there is a genuine dialogue between the two parties. Of course, it is important that the business is able to examine your performance and to ask potentially searching questions about it, but so too is it right and proper for you to make similarly robust enquiries you feel you need from them and about the promises made and actions agreed by them to you.
  • Ask for specifics. If something has been agreed – perhaps, for example, a review of working hours or opportunities to increase surgical time in the year ahead – why not go further and try to nail down some specific actions? By what date should the review have taken place? What needs to happen to increase time in theatre? Who will be responsible for doing what? And make sure these are captured in some way in writing: either in the form itself, or by way of a follow-up email.
  • What happens next? If there is one question I urge you to ask at the end of your appraisal it is simply: “So, what happens next?” Being required to answer this question is your best hope of ensuring that the form won’t just be filed, the box ticked and conversation forgotten until the same time next year. The answer to the question will, of course, vary but will hopefully illicit some commitment to future actions, such as “Let’s meet again in a month’s time to see where we are at”; “I’ll speak to head office to see if we can get that change of hours agreed”; or “I’ll ask Christine to get you booked on that course”. If the question is avoided, or answered with vague assurances, refer back to point three and ask for specifics. And if they are still not forthcoming, don’t be surprised if little has changed in 12 months’ time…

Same time next quarter?

Most organisations have an annual appraisal process, but it needn’t be so and, I would argue, making it so is one of the reasons they often have so little impact. Some of the best appraisal processes I have seen involve a quarterly check-in, with objectives set for the next three months and progress discussed on the previous three. Yes, this adds to the commitment, but it also helps significantly to make the transition from “tick-box exercise” to “conversations that drive actions”.

It may be out of your gift to be able to make such a change, but there is nothing to stop you from referring back to your objectives and the (shared) actions they contain as a starting point for every regular catch-up you have with your line manager. After all, why wouldn’t you? If this is what you have both agreed as the structure that will shape your year, surely it makes sense for both sides to keep referring back to them throughout the year?

And if you don’t have regular check-ins with your line manager? Well, that’s definitely something to bring up at your next appraisal.