01Appraisal is tied to pay steps in the NHS
Most NHS staff in England are employed on Agenda for Change terms. Under the pay progression framework agreed in 2018, moving to the next pay step depends on a pay-step review. It checks that the appraisal process has been completed, statutory and mandatory training is up to date and there are no live formal capability or disciplinary issues. Line managers have extra requirements of their own, including completing appraisals for their teams. The details vary between the UK nations, so check the current NHS terms and conditions handbook.
02Professional revalidation runs alongside
Doctors have an annual medical appraisal and revalidate with the General Medical Council, normally every five years, on the recommendation of a responsible officer. Nurses and midwives revalidate with the Nursing and Midwifery Council every three years. They need practice hours, continuing professional development, practice-related feedback, written reflective accounts, a reflective discussion and confirmation. These are separate from the employer’s appraisal, but they draw on the same material: feedback, reflection and evidence of learning. A well-kept record saves clinicians from assembling it twice.
03Supervision is where most development happens
Clinical supervision, preceptorship for newly registered staff and regular one-to-ones carry more of the day-to-day performance conversation than the annual appraisal. In adult social care, regular supervision is a core expectation of providers. The Care Quality Commission looks at how staff are supported, supervised and appraised when it assesses whether a service is well led. An appraisal works best as the point where a year of those conversations is drawn together.
04Time, rotas and several lines of accountability
Ward managers can have very large teams working days, nights and weekends. A healthcare assistant may rarely share a shift with the person who appraises them. Many clinicians have a professional lead and an operational manager. Consultants work to job plans agreed with a clinical director. Staff survey questions ask whether an appraisal helped people do their job, and the honest answer is often no. The fix is usually simpler paperwork, delegated appraisers who know the person’s work, and a wellbeing conversation built in.
