Practice management

Managing poor performance

How can you support your team to ensure they perform at their best?

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  • Date: 07 February 2023
  • |
  • 5 minute read

THESE are stressful times for healthcare teams and in recent months we have noticed an increase in the number of advice calls asking for help in managing staff performance. Issues vary and can relate to a slip in the quality of work being carried out, poor attitude, erratic timekeeping or other kinds of unprofessional behaviour.

Even in the most difficult of circumstances, it is crucial that practice teams remain professional and continue to deliver a high standard of patient care.

Often the managers who contact MDDUS for help describe a situation that has been going on for a few years, with many reluctant to take action. They want to keep up staff morale and ensure employees are happy, so the notion of giving negative performance feedback can seem counterproductive.

But the fact is that avoidance makes performance issues worse.

If you don’t tell an employee that their performance is not meeting expectations and explain what needs to change, then it is highly unlikely that the situation will improve. In the meantime, their behaviour could be negatively affecting the whole team.

If you are trying to get the best out of your team, consider the following points.

Offer support. Employees have a responsibility to manage their performance. They are expected to do the work they are paid for, as per their job description, to an agreed standard. However, employers also have a responsibility to provide adequate support. The more support you are prepared to offer an employee, the better their chances of reaching and exceeding the standards you expect and within a quicker time frame.

Regular performance reviews. This is a very useful tool for managers. Regular reviews give the opportunity for all parties to discuss employee performance, successes, failures and opportunities for training. This is the core of what all performance management is based on. The employee’s line manager is usually best placed to lead on performance management as they are the ones who are in daily contact with the employee and can talk, listen and coach team members in this area.

Acting swiftly. It is essential that any performance issues are dealt with quickly and fairly to try to alleviate any issues and to give the employee a chance to turn things around. Ignoring the issue will allow the employee to continue to act in the same manner, which can cause tensions with colleagues.

Specific examples. Before arranging to discuss concerns with an employee, make sure that you have examples and evidence of the conduct in question. Dealing with specifics can help the employee to understand exactly what are the issues.

Two-way conversation. Give the employee an opportunity to have their say on why they feel the issues are happening and to establish whether further training is required, or if there are personal circumstances that the practice needs to be aware of. It should be a two-way dialogue between the manager and the employee.

Create an action plan. Ideally, the employee and manager will work together to create an action plan so that the employee can be supported to make the necessary changes. It is important to be open and honest with the employee about the concerns you have and to explain that there needs to be an improvement in their performance at work either in successfully completing all the tasks of the role or improving their attitude and behaviours.

Set a timescale. Once a performance plan has been agreed, a reasonable timescale for improvement and review dates should be set. The manager should give feedback to the employee regularly, noting both negative and positive behaviour. At the end of the review period, there should be no surprises for the employee as to how things have progressed.

Final decision. Once the review period has finished, there may then be a decision to make. If there has been sufficient improvement, then the employee should be given this positive feedback and advised that no further action will be taken. However, the employee needs to understand that this improvement needs to be maintained and what the consequences may be if their performance dips again. It would make sense to document this conversation in case you need to refer to it at a later date.

Next steps. If there has not been a sufficient improvement in performance, then you may wish to extend the review period to gather further evidence or proceed to a disciplinary hearing.

If the matter is to progress to a formal disciplinary stage, then it is essential that the correct procedure is followed. This includes writing to the employee to invite them into a formal disciplinary hearing, enclosing any evidence that will be referred to at the hearing and clearly outlining the potential outcomes following the hearing. You should also highlight the employee’s right to be accompanied by a work colleague or a trade union rep and allow the right of appeal at the end of the process.

Further reading

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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