Underperforming employees have a demotivating and general detrimental effect on the whole working environment, meaning you must tackle any issues as soon as you become aware of them. It’s important in any workplace but in a medical practice employee performance sits at the core of all you do.

(1) Inform and investigate – find out why the employee is underperforming

Schedule a private meeting to give both you and the employee the opportunity to discuss the issues and to:

• make sure that the employee is aware of the standards they need to meet (i.e. exactly what is expected of them). It’s vital that all employees understand the standard and what it should look like.

• let the employee know that they are underperforming – avoid generalisations (such as “your work isn’t up to scratch”) and fully explain your concerns giving clear examples of the employee’s underperformance.

• find out the reason for underperformance

Underperformance usually is because of one or both of the following:

• external issues such as physical and/or mental health concerns or personal problems

• internal issues such as an inability to perform due to lack of training or adequate management, a retraining need or unrealistic expectations/too heavy a workload. Equally an employee may feel uncertain, under-challenged and generally demotivated.

(2) Take Action

Once you’ve established:

• underperformance and
• the reasons for it

agree on what the employee needs to do. Set clear SMART objectives so progress is easy to track and follow.

External issues?

Refer the employee to relevant professional assistance such as a counselling service available from your practice or reputable national organisations.

Internal issues?

Discuss and agree what support you will give and ensure you deliver it promptly. For example, if you agree retraining, make it happen quickly.

If there is a general demotivation issue, consider whether a coaching programme may help the individual.

(3) Review

You must then set up a regular review process, not only to review progress but to build up trust and develop your relationship with the employee. Bear in mind that sometimes employees may be reluctant to discuss the nature of their problem, particularly if it involves another employee, so reviews are important.

(4) Follow your policies

Always follow any relevant practice policies such as disciplinary and grievance.

(5) Record keeping

Keep careful records of your meetings and exactly what has been agreed because this is  vital if you subsequently need to take any other disciplinary action.

(6) Review employee engagement

Does the practice have markers that indicate an employee has generally “given up”:

• increased absenteeism
• not talking to / approaching management as often as previously
• careless work
• lack of interest
• dissatisfaction

Regular communication with employees and being aware of employee motivations can easily be overlooked in a busy practice but plays a vital role to stop issues escalating.

Finally, review your recruitment and induction process:

• robust recruitment will help you to engage the right employees. Even if you don’t regularly impose probation periods, factor in regular initial reviews
• thorough induction should cover not only training but ensure that your employees know what’s expected of them from the outset and what to do if they experience performance problems