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The appraisal of clinical directors using a process developed for non-clinical NHS managers

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Aim: To determine whether a system of appraisal developed for non-clinical managers could be used to appraise clinical directors in a NHS trust.

Method: The trust's medical director, using a system of appraisal developed for non-clinical managers, appraised ten clinical directors in a NHS trust. The clinical directors were first asked to complete a self-assessment of their skills in six main areas of competence using a simple four-point scale. Their self-assessment was then compared with assessments made by the appraiser. Specific outcome measures were used to identify satisfactory performance and the clinical directors were each asked to provide examples of how they could demonstrate their competence. The developmental needs of the clinical directors were then determined.

Results: All the trust's ten clinical directors participated in the process to varying degrees. The clinical directors graded themselves as fully competent in 67% of the competencies being assessed. Personal effectiveness, self-management and communication style were the competencies most often identified as lacking. Others identified as lacking included budget management, financial management, delegation and stress management. The clinical directors felt that their strengths were tenacity, innovation and managing change. Feedback on the process was mainly positive, with only one clinical director finding the process unhelpful. Most found it helped them to identify their developmental needs and gave them the confidence they needed to put together a personal development plan (PDP). The majority indicated their preference for an annual appraisal, with more frequent feedback on their performance during the year.

Conclusions: This study shows that an appraisal system developed for general non-clinical managers can be used to appraise clinical managers. The emphasis on clinical governance has led to clinical directors becoming deskilled with regard to business planning and financial management. Clinical directors perceived their greatest need for development to be in the area of personal effectiveness. In this area, competencies where there was the greatest developmental need were delegation, self-management and stress management.


Document Type: Research Article

Publication date: September 1, 2001

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