Implementing an appraisal and development framework in healthcare : An action research study.

In October 2006 the Knowledge and Skills Framework (KSF) became the mechanism of pay progression for approximately one million National Health Service (NHS) staff (NHS Employers 2008). Integral to the Agenda for Change (AfC) pay reform, the introduction of KSF was intended to define the knowledge and skills that staff must demonstrate to deliver quality services whilst providing the basis for both pay and career progression (Moss, 2004, Watts, 2004, Wilkinson, 2004). The establishment of KSF is reliant upon integrating a system of appraisal; by which staff and their managers can identify personal development requirements and evidence elements of the KSF that have been achieved. Implementation of KSF has been hindered by complexity, leading to a debatable realisation of its purported benefits in terms of people and service development (O'Dowd, 2007).This study utilised Action Research (AR) to implement KSF within the Facilities directorate at a large acute healthcare Trust in the North of England (TRUST A). The Trust employs approximately 6500 employees with 25 per cent of staff working within Facilities. For numerous Facilities directorates there had been scant evidence of either appraisal or career development mechanisms previously. The introduction of AfC and KSF has, consequently, been widely problematic (May et al., 2006). Focus groups and semi structured interviews were used to gather data that informed the AR process. Focus groups and interviews were transcribed verbatim and analysed using NVIVO qualitative analysis software. Appendices 1 & 2 provide an overview of Agenda for Change and the Knowledge and Skills Framework.The AR process led to 'micro' and 'macro' interventions. Micro interventions included changing appraisal documentation for support staff, implementing accelerated learning methodologies for awareness raising of KSF, developing a self assessment tool for pay band navigation and the cessation of sending KSF outlines with job applications. Macro interventions were the establishment of an employability scheme to facilitate recruitment and the creation of a bespoke career development pathway for staff. In addition to assisting with KSF implementation, findings from this study may be transferable for use in the broader contexts of organisational development and change management.