Performance management

Back in my HR days, tackling performance issues within the organisation was one of the most daunting jobs that I had to do and I am sure most practice managers or staff partners would feel the same.

Our first MDDUS Bleak Practice film shows how a practice receptionist breaches confidentiality by informing a patient’s mother that her daughter was due to attend an appointment that day to get test results. The patient’s mother confronts her daughter with this information leading to an argument which prompts the woman to attend the surgery angrily demanding answers about her daughter’s treatment – not a good situation for anyone!

This raises a number of questions, one of which is whether the receptionist should have given information about the patient to her mother and whether she should have looked in the patient’s records at all?

The way the receptionist behaved triggers concerns about her performance and suggests further training or even disciplinary action may need to be taken in light of this breach of patient confidentiality.

Employees do have a contractual duty to be competent in their role and to perform it in an acceptable manner. When this fails to happen, a practice is within their rights to speak to the employee about the areas of concern. Therefore, when dealing with performance issues, you need to know the facts and have clear examples to discuss. By doing so, the employee can be made aware of what exactly is expected of them in terms of performance standards and you can ensure they have the right skills and competencies to achieve these objectives.

Any meeting to discuss performance issues must be held in private and provided in a calm and professional manner. As this is an informal meeting, at this stage, the employee does not have the right to be accompanied but you could allow this if you wish. The right to be accompanied is by a work colleague or a trade union representative – not a family friend who happens to be a lawyer or an expert on employment law!

The employee should be given the opportunity to respond to the issues and to either agree or disagree with what is being said. As long as the employee’s performance does not present any risk to patient care they should be allowed take the feedback on board and continue working. It is also important to establish possible causes for the underperformance, for example does the employee require further training in a particular area or are there external personal factors affecting their performance?  If the reason is due to external factors, the practice’s hands may be tied on such issues but it is important to help assist the employee where possible. If the performance issues are straightforward competency issues then these can be addressed through additional training or support from a colleague.

Notes should be kept from the meeting so that there is an accurate record of what has been discussed and how it will be addressed.

A reasonable timescale for improvement should be set along with review dates and the employee should be given feedback regularly on both negative and positive behaviours. At the end of the review period, there should be no surprises for the employee as to how things have progressed.

There will then be a decision to make. If there has been sufficient improvement then you should give this positive feedback to the employee and thank them for their efforts. It would make sense to document this conversation in case you need to refer to it at a later date.

If, however, 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.

Further advice on any performance issues or how to invoke disciplinary procedures can be ascertained from MDDUS’ employment law advisers.