1. OBJECTIVES 2013 – 2014 (To be completed by 30 Sept 2013) CORE ORGANISATIONAL /TEAM OBJECTIVES OUTPUT TARGET DATE COMMENTS / CHALLENGES RAG RATING SPECIFIC PERSONAL OBJECTIVES OUTPUT TARGET DATE COMMENTS / CHALLENGES RAG RATING

2. SKILLS ASSESSMENT 2013 – 2014 (To be completed by 30 Sept 2013) SKILLS / TRAINING IDENTIFIEDHOW CAN THIS BE ACHIEVEDCOMMENTS

3. SKILLS ASSESSMENT 2013 – 2014 (To be completed by 30 Sept 2013) SKILLS / TRAINING IDENTIFIEDHOW CAN THIS BE ACHIEVEDCOMMENTS

4. INTERIM APPRAISAL 2013 – 2014 (To be completed by 30 Sept 2013) AREACOMMENTS / CHALLENGES You’ve now agreed objectives for the coming year, how will you incorporate these into your day to day workload Briefly outline your schedule / regular commitments and activities Thinking about the last 6 months and the coming 6 months, are you clear about your role within NHS Cumbria CCG and your contribution to the organisation LINE MANAGERCOMMENTS / CHALLENGES LLS ASSE

5. APPRAISAL 2013 – 2014 (To be completed by 30 March 2014) AREACOMMENTS / CHALLENGES What have been your main achievements since your last appraisal? How do you feel you’ve performed on a personal basis? How do you feel your team has performed? Is there anything that could be done differently to help everyone? What have you learnt since your last review that has been most beneficial to you?

6. Is there anything that hasn’t gone so well? And what could have been done differently that might have helped? Apart from specific training needs, what other support do you feel would help your development in coming months? What aspects of your role would you like to develop further? What do you feel are your key targets for the coming 12 months? Anything else that you would like to discuss / add?

7. APPRAISAL 2013 – 2014 (To be completed by 30 March 2014) LINE MANAGERCOMMENTS / CHALLENGES Objectives reviewed? Skills assessment revisited? Have expectations been met? Any additional comments