Performance Review Process for Chairman and Non Executive ...

Chairman and Non Executive Directors
Performance Review System
Performance Review Form
NAME:
POSITION:
REVIEW YEAR:
REVIEWER(S):
DATE OF REVIEW:

1. Review of Previous Year – self assessment
• Putting patients first
• Aiming to get it right first time
Trust Values
• Recognising that everybody counts
• Doing everything openly and honestly
Using the Trust values set out your key achievements against your personal objectives for the previous
year. These should include those objectives which were not met and any relevant factors which arose in
the course of the year. This should be provided to your appraiser prior to the appraisal meeting.
Objective Achieved Not Achieved
Actions required to support the
achievement of this objective
Please provide an assessment of your role as a Board member, in response to the following:
How would you describe your participation in Board debate?
How do you relate your previous experience to providing health care in the Trust?
How do you manage your time and ensure you are available when required, sometimes at short notice?
How do you network in your role as a representative for the hospital?
How do you engage with the Executive Team and members of staff?
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Describe what you deliver on your own initiative outside your lead responsibilities?
How do you enhance your relationships with the Governors?
How do you assure yourself that patients in this hospital are getting a good quality experience?
How do you see your role developing?
Please detail the development/mandatory training undertaken during the year, and your agreed lead roles.
Personal Development:
Lead responsibilities:
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2. Future Objectives
Using the Trust values, and in line with the Trust’s strategic direction, outline your personal contribution to
the work of the Board of Directors in the year ahead.
Objective When to be achieved Support required
Additional information/comment on the challenges of the next 12 months:
3. Review Record
3.1 Reviewer’s Comments - These should include the individuals/groups of individuals consulted,
key outcomes/action points/objectives and development needs from the review discussion. Constructive
feedback on how performance could be even better, or existing skills can be utilised.
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3.2 Overall Assessment - Note: In general only individuals classified as Box 1 or Box 2 would be
regarded as reaching the minimum standard required for an uncontested reappointment. Many individuals
may have a Box 3 in their first year in post. Boxes 1 and 4 will be rare occurrences to mark the extremes of
performance.
Box 1
Box 2
Box 3
Box 4
Outstanding Has influenced decision making of executive team to form and
create strategy. Exceptional performance in all areas of responsibility. Planned
objectives were achieved well above the established standards and
accomplishments were made in unexpected areas.
Exceeds Expectations Is visible to the organisation and regularly challenges
the executive team and seeks clarity on strategy. Provides regular evidence of
external stakeholder commitment. Consistently exceeds established standards
in most areas of responsibility. All requirements were met and objectives were
achieved above the established standards.
Meets Expectations Regularly attends at Board and Committees. All job
requirements were met delivering key areas and planned objectives were
accomplished within established standards. There were no critical areas where
accomplishments where less than planned.
Needs Improvement/Developing Performer Performance in one or more
critical areas does not meet expectations. Not all planned objectives were
accomplished within the established standards and some responsibilities were
not completely met e.g. has just joined the executive team, shows poor
attendance at Board, no involvement with external stakeholders.
Individual’s Comments – You may record here whether you are content with the way the
appraisal was conducted or ways it might be improved.
Any appeal against the outcome must be in writing to the Deputy Chairman of the Governors
Council within two weeks of completion of the appraisal process.
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4. Outcome
Information to be included in the report to the Governors Council Nomination & Remuneration Committee/Governors Council.
Name
Progress: Previous year’s
Objectives
Achievements
Training
requirements
(and provider if
applicable)
Performance
Rating
Succession
Planning*
Next Year’s Objectives
(in addition to Trust
objectives)
* Delete as appropriate
This individual has another 1/2/3 years* remaining of their term of office. At the current time they would/would not* wish to be considered for reappointment
This appraisal forms part of the process for succession planning in line with the Non Executive Directors appointment timetable.
Individual’s signature Date
Chairman’s signature Date