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Diary of a practice manager: a hair-appraising prospect for us both

15 December 2008

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Edward Picot

Practice Manager

Edward Picot has been a practice manager for 17 years. His website,, features a collection of his writing, poetry, short stories and animations.

The truth is, nobody much enjoys staff appraisals. The staff feel uncomfortable with them, and so do those of us who have to do the appraising. They just don’t seem to relate to the realities of surgery life.

When I first started work about 30 years ago, selling adverts for a local paper, “staff assessments” were basically an opportunity for the boss to tell his staff what he thought of them. The sound of raised voices and desk-thumping would be heard from his office. Eventually the door would open and a huge gust of cigarette smoke would come rushing out, followed by a white-faced sales rep, who would roar off in a Ford Capri to the nearest industrial estate, to sell a double-page spread or look for a new job – those being the two options the boss had outlined.

These days, there’s meant to be a bit more give and take. All the same, as soon as you, the boss, set aside a bit of time to have a chat with an employee about his or her position and prospects, a lot of the usual easygoing friendliness disappears from the atmosphere, and the employee can’t help feeling under scrutiny.

One problem is the assumption that you, the boss, have a wise and dispassionate overview of your staff’s strengths and weaknesses, whereas they’re not supposed to think anything about you. In real life, they probably wish you’d get your hair cut, wear a suit, sort out that halitosis and stop blaspheming; but as far as the appraisal process is concerned, the improving advice flows downwards, not upwards.

There’s also an underlying assumption that everyone is supposed to be getting better all the time, in accordance with their personal development plans (PDPs). When you employ a lot of part-time staff, the truth is that most of them are busy with their partners and families. Their main reason for working is to earn a bit of extra housekeeping, and they may not be all that interested in career development.

And although a lot of retraining and job development does take place every year, much of it comes down from on high rather than being a matter of employee choice. During the last 12 months, for example, all admin staff had to obtain smart cards, learn the basics of Choose and Book and undergo information governance training. None of this was on anybody’s PDP last year.

Another danger of the appraisal process is the can-of-worms. Asking employees about their relationships with colleagues may have the unfortunate effect of revealing that they all hate each other – or, alternatively, they’ve all been having affairs with each other. Asking them about their weaknesses can give them attacks of self-doubt. Asking where they see themselves in five years can sometimes provoke torrents of despairing sobs.

The best thing to do is give them the old praise-and-criticism sandwich. “You do make a very nice cup of coffee, Deirdre. Your work is rubbish, but you do make lovely coffee. I’ll have one now, if you’re making one.”