1. Dealing effectively with difficult people issues

2. Learning Objectives
To equip ourselves with the tools needed to manage performance
To understand the range of leadership and management tools available
Recognising the benefits of early intervention
Consideration of your leadership and management style and approach in dealing with such issues

3. Trust Objective
To provide successful and effective delivery of services to patients by ensuring performance at work is maintained at a high level. To manage and resolve employee capability and capacity issues at work consistently, fairly and empathetically to balance the needs of both the individual and the needs of the service.

4. Performance Management
Supports the business strategy
Is values based
Enables employees to manage own performance
Sets out expectations (clarifies roles and responsibilities)
Creates partnership between
management and employee

5. Performance Management
Emphasises importance of measurement, feedback, and reinforcement
Empowers employees
Getting work done through others
Manager’s performance is only as good
as his/her employee’s performance

6. Our processes - Personal Responsibility Framework Policy & Procedure
Appraisal Policy (Individual Performance review) HR46
Managing Performance and Capability (HR21)
Disciplinary procedures (HR24 )
Medical Appraisal Framework (HR64)
Procedure for dealing with cases involving conduct, capability and concerns about health for medical and dental staff (HR42)
Governing bodies
Maintaining High Professional Standards (MHPS)
Professional Codes of Conduct

7. What about talking: Could we resolve issues informally?
When to step in?
Who to talk to?

8. WHY Performance Manage
Achieve good level of Performance/Behavior
Plan for Future (promotion, transfer, career development)
Facilitate Decision-Making
Facilitate Human Resource Planning
Create Culture
Building Good Relationships
Increase Organisational loyalty
Think about impact on other staff

9. How shall we assess Performance?
Traditional - Annual Review (Appraisal)
Agreeing SMART Objectives linked to strategy
Management-by-Objective
Peer Review / Upward Feedback / 360 Degree
Incidents or by exception
Regular meetings (1-1)
Personal Development Plan

10. WHO Should Assess Performance
Managers or Supervisors
Clinical Supervisor
Peers
Self
Others

11. PROBLEM = Deviation from expectations
Do something in a different way
Not do something
Do something not expected/needed

12. Understanding the reasons why:
CAUSAL ANALYSIS
Understanding the reasons why:
When problem began
What else has changed
PARETO’S LAW: Rule of 20/80
“80% of any problem is
caused by 20% of possible
causes.”

13. Contributing factors to poor performance
Lack of motivation
Team Dynamics
Role boundaries/ clarity
Leadership style
Training/Induction
Conduct/Behaviour
Outside influences
Lack of understanding of contract
Disability
Health
Sickness Absence
Substance Misuse
Personal Circumstances
Stressors
Colleagues style
Lack of understanding of role

14. Personal Responsibility What is it?
Individuals bringing forward concerns or issues in confidence that will be dealt with appropriately and without over-reaction or formal process
Individually taking personal responsibility for demonstrating appropriate attitude/conduct or acts/omissions that impact on others

15. Personal Responsibility
Move away from punitive blame culture
Achieve a more constructive work environment
Develop a supportive approach to changing behaviour and practice

16. Personal Responsibility Objectives
Dealing with matters quickly and informally
Develop Culture
Reduce Disciplinary Cases
Change Behaviours/Attitudes
Improve Staff Side Relationships
Empower Staff and Managers
Improve morale

17. Personal Responsibility Remedial Action/Support
Specific training
Supervised practice
Staff support services
Mentoring
Research/project
Coaching
Relationship mediation
Reviewing policy/protocol
Local solution
Communication

18. Capability Policy & Procedure (HR 21) Informal
Managers should:-
Conduct regular appraisals
Ensure when performance issues are identified immediate action is taken
Personal Responsibility Framework
Action Plan – Agree, Monitor and Review
Appropriate Referral to Occupational Health
Follow up, follow up
Communication

19. The Action Plan What should go on an Action Plan? Area of development
Target for improvement
Timeframe
How it will be done?
By Whom?
Support Mechanisms
Mentor / Buddy
Supervision
Training
121 Coaching
Modifications/
Adjustments
Occupational Health advice
Redeployment

20. Formal Capability Gross Incompetence Serious Performance Issues
Where the cause of poor performance is found
to be wilful negligence; misconduct or a continuation of concerns the Trust’s Disciplinary Policy will apply

21. Referral to Professional Bodies
Clinical & Professional Staff are responsible for complying with relevant standards set by their professional regulatory body
All referrals to be discussed with the Senior Management Team who will make decision whether to refer to their Professional Body
Trust may take any action under Capability Policy regardless of and independent of the outcome of the referral

22. Formal Review Meeting
Inform the individual that their standard of performance is unacceptable – give examples
Allow the individual an opportunity to identify reasons for perceived poor performance.
Advise the individual of the standard of performance required and how that will be measured.
Advise the individual of the timescale for improvement (usually 4-8 weeks) and the consequences of failure to improve and maintain improvement.
Identify any further support or training required to assist the individual in achieving the required standard of performance, e.g. supervision, mentoring etc.

23. The Formal Review Meeting
Make it clear if the individual is being issued with a first or final written warning under the Capability Policy
The manager will make it clear to the individual what the consequences are of not meeting the required standard in the agreed timescale for example this may result in dismissal.
Review and amend Action Plan - monitor
Follow up letter within 10 days of meeting
Continuous review

24. Medical staffing Appraisal
Revalidation - Good Medical Practice Framework
360
GMC Code of Conduct
HR42 policy - Procedure for Dealing with cases involving Conduct, Capability and Concerns about Health for Medical and Dental Staff

25. HR42 -Procedure for Dealing with cases involving Conduct, Capability and Concerns about Health for Medical and Dental Staff
Sets out the procedures to be followed in cases of conduct, capability or when handling concerns about a doctor’s health.
Written in line with:
Restriction of Practice and Exclusion from Work Directions 2003,
Maintaining High Professional Standards in the Modern NHS (revised February 2005)
Trust disciplinary procedure.

26. Support from Human Resources
Coaching
Advice on policy interpretation
Provision of Template Letters & Resource Pack to Guide Managers
Quality checking complex letters
Involvement in meetings
Advising on options and assessing risk
Assisting with the case presentation

27. Remember it’s good to talk
Records
Where held and kept
Release of documents and information
Keeping notes/records
Remember it’s good to talk