Salford Royal FT - adapting the KSF


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

Salford Royal NHS Foundation Trust is a large teaching trust with approximately 5,000 staff, 850 patient beds and around 400,000 patients per year. The trust provides a comprehensive range of services to 220,000 residents in Salford, as well as a wider range of services across Greater Manchester, the north west and nationally.

SHA region

North West

What we did and why

The trust recognised that implementing the full KSF was creating substantial additional work for managers and their staff, leading to a dramatic drop in appraisal compliance rates across the organisation. To address this problem, SRFT decided to adapt and simplify the KSF for their own use.

Initially SRFT consulted with managers and staff to establish their key requirements. They wanted a simple appraisal and KSF framework, linking trust values and priorities, with performance and development plans.

The trust then identified the following key aims and criteria for the KSF:

  • be simple enough for managers and staff to pick up and use without reading more than two pages of guidance notes
  • be integrated with the existing appraisal process and not be an entirely new piece of work
  • make the existing appraisal system more effective and efficient, linking knowledge and skills development needs to individuals’ work objectives, which in turn could be linked to trust objectives and give clear context to the development need
  • be incorporated into existing appraisal documentation to avoid additional paperwork for staff and managers
  • be robust and comprehensive enough to be used by all trust departments, including those not directly involved in patient care.

The trust used the criteria to develop a radically revised version of the KSF that has four core dimensions for all staff:

  • attitude
  • safety
  • communication
  • quality.

Each of these dimensions has one single level and all are applicable to every member of staff. The trust also developed one additional dimension, leadership and management, for staff who influence or manage others.

How we did it

SRFT produced a draft Salford Knowledge and Skills Framework (SKSF) based on feedback from staff and trade unions, before getting approval from the trust's executive board.

The trust  also revised its appraisal documentation, to ensure that the SKSF fits easily within the appraisal system and is integral to its successful completion.

Piloting the system

The trust piloted the system in areas with both good and poor appraisal compliance rates. Following really positive feedback, the trust implemented the revised framework across the whole organisation. 

Several departments have now incorporated the framework into their local training and development programmes.

Linking KSF to objectives

To support staff on appraisals, SRFT developed a flow chart to show how individual and local objectives should link directly to the corporate plan, encouraging staff to link their personal objectives to the local, divisional and corporate ones.  Both managers and staff say that this helps them to understand how they contribute to the trust’s objectives.

At each key stage, the trust audited staff and managers’ perceptions of the revised framework. The feedback has been extremely supportive of the revised framework.

A simple e-learning programme takes staff through the main stages of appraisal, using the SRFT, with face-to-face training on request.

Training and development options to support KSF

The trust has also developed a list of training options that are directly linked to the simplified KSF areas, to support training and development discussions, with more details on-line. For example, for communication, the development options range from support on literacy and numeracy, to stress management training for managers.

There are also internal 'practice development' and 'practice trainer' teams who can advise managers on different training and development opportunities, to meet individual staff needs. Any investment in training is assessed and agreed against current service needs.

Results and next steps

  • Salford’s appraisal compliance rates have increased dramatically, from 48 per cent to 78 per cent over three years.
  • Over the same timeframe, the ‘percentage of staff with appraisal with personal development plan in the last 12 months’ has risen from 46 per cent to 64 per cent. 
  • The trust is now in the top 20 per cent on staff survey results for appraisal compliance rates.
  • Most staff report that their appraisal and personal development plan helps them to do their job better, and the trust has achieved higher satisfaction results in the NHS staff survey for the past two years, since this framework has been introduced.
  • Staff consistently report that they prefer the revised KSF framework and appraisal compliance has steadily increased month-on-month.

The trust has now set a target of 80 per cent overall appraisal compliance.  It also plans to base all its KSF/appraisal information online to make it more efficient and to concentrate training on the 'softer' side of appraisals, for example conversation and communication.

Tips for other trusts

The trust believes that the key tip is to keep it simple, relevant and timely, especially if the organisation adopts new behaviours and values. The KSF needs to be linked to these developments to remain live and relevant.

Staff and managers will engage with, and use, the KSF if it helps them to do their job.  To ensure local ownership, they encourage local managers to edit guidance notes to include examples from their own departments and make it relevant to their staff.

Ensuring that the KSF is integral to key stages of an individual’s employment is also key, for example:

  • part of pre-recruitment literature/person specification
  • part of local induction
  • integrated into the annual appraisal review
  • central to all development reviews and requests for training support.


Mary Douglas
Head of learning and development
Salford Royal NHS Foundation Trust
Stott Lane
Salford M6 8HD
0161 206 4150 

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