Cambridge University Hospitals FT - KSF made simple


04 / 11 / 2010

The organisation
SHA region
What we did and why
How we did it
Results and next steps
Tips for other trusts


The organisation

CUH employs approximately 7,000 staff and provides local and regional healthcare services through its hospitals, Addenbrooke’s and the Rosie. As well as being a teaching hospital and a centre for specialist care, it is also one of only five comprehensive biomedical research centres in the UK, where world-class research is undertaken in partnership with the University of Cambridge and the Medical Research Council. 


SHA region

East of England

What we did and why

After adopting the main principles of the NHS KSF and developing over 1,500 outlines, managers and staff felt that the outlines were very lengthy, with some being over 30 pages long.  As a result, they were very difficult to use and seen as a barrier to the appraisal process. 

Because some staff did not have access to IT equipment and the e-KSF system was password protected, the trust used e-KSF just as a library to hold the outlines. This resulted in continuous requests to the training department for individuals’ outlines.

This led to a decision to developing outlines that would be easily accessible to all through the trust's internal communication system, that are simple to use and do not detract from the communication aspect of the appraisal process.


How we did it

Phase one

All outlines stored on the e-KSF system were mapped against the pay bandings for Agenda for Change. Generic profiles (outlines) were developed against the results, initially for clinical and non-clinical roles but ultimately for combined roles.

The trust modified the KSF process so that, as a minimum, staff are required to have a profile based on the six core dimensions.

The examples of application against each indicator in each dimension were grouped, simplified and re-written.

Each dimension and level was also mapped against the trust’s expected behaviours, which underpin its values of ‘kind, safe and excellent’, with an opportunity for individual departments to develop specific behaviour standards for their wards/departments.

The resulting outlines were only six pages long and were fully accessible on the internal communications system.

Phase 2

Focus groups with managers, staff and staff-side representatives showed that staff welcomed the ‘KSF made simple’ approach, but they still felt that the KSF language was difficult to understand.
In consultation with staff and using the feedback from the focus groups, each level in each of the six core dimensions was simplified even further. The trust removed the examples of application and replaced the text on the indicators with bullet points.

Through mapping the outlines on e-KSF, it became clear that the level of skill and knowledge expected at the foundation gateway was, for the majority of posts, identical to that required at the second gateway.

The trust established that continuous achievement of the KSF is expected throughout employment for incremental pay to be awarded. Managers can defer incremental pay progression at any point if the KSF is not being achieved, providing they are following the performance process, the individual is in the formal stage of the process, and where they can give three months' notice of deferment.


Results and next steps

Through this project we achieved:

  • Profiles for each of the bands within AfC that are easily accessible for staff and managers to download on our internal communication system, incorporating the trust values and behaviours.
  • Guidance and training for managers and staff that has ensured the simplified approach is being used.
  • Realisation of the key aspirations of the KSF framework by ensuring that staff have the correct skills and knowledge to be able to deliver the duties and responsibilities of their roles.
  • A considerable decrease in calls requesting outlines and advice.
  • An increase in appraisal and development review meetings from 61 per cent to 88 per cent.  One particular division has also reported that their increase in appraisal rate has coincided with a reduction in sickness rate during the same period.   

Although the trust has simplified the KSF, some of the professional heads have chosen to retain the full KSF because they felt they were using it effectively and it linked to their preceptorship and staff development processes.  

The trust's key message to managers is that ‘KSF made simple’ is the minimum standard that must be applied but staff can still use the full KSF if it is helpful.


Tips for other trusts

  • Make the KSF part of the annual appraisal process.
  • Ensure that staff understand what it is. For example, job descriptions list the duties and responsibilities of the role, and the KSF lists the skills and knowledge required to be able to deliver those duties and responsibilities.
  • Ensure that it is not a paper chase - use observation and feedback from the appraiser’s perspective and reflective practice from the appraisee.
  • Ensure that staff can easily access their outlines.
  • Involve managers, staff and unions in any changes.
  • Keep it simple.



Richard Leigh
NHS Employers

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