Poor performance comes to the attention of the regulatory authorities when people lack insight into their own difficulties and do not realise they are working at a level well below most of their peers. Poor performance procedures are aiming to achieve improvement when the individual person has not resolved the issues themselves in the time they had. The aim is to develop insight, help the individual,and lead to actions which resolve the original issues
Someone who is underperforming will usually prefer not to discuss the issues in depth or full extent of the problems. In this situation it is important to get a full history at the start otherwise you will end up with surprises and waste time covering less relevant areas. Always ask about the existence of performance procedures. If it is a doctor: ask if there are any procedures with the General Medical Council, or local or national organisations. Be specific and look the person in the eye! Ask about employment history and explore gaps. Ask about alcohol and drugs misuse. Ask about what happened before and if anything helped (precedent set diagnosis)
It is easier to avoid the issues than address them in the short term. Try to be explicit about the issues and ensure ownership with any plans to address these. Writing down the action plan together will help and should be routine. Ensure the action plans is SMART. Specific Measureable Achievable Realistic and Timed.
Fit a clear date to achieve the action by and set a plan for review. IAR.www Issue Action Review by who, when and what/how. Get permission to call and follow up. (see IAR.www)
Be very explicit about the consequences within their work environment when their underachieve. Often people lack insight and do not see the problems when others might be horrified. Some people are brought up to not admitt any difficulties or mistakes and this makes it much harder to learn from what you have done.
At the same time keep the positive. Help the individual understand what can be achieved and where they are placed when their performance is viewed against their peers. The aim is to motivate them to provide better care in their work and see what good performance can lead to. It is easier to work to a positive goal than dwell on the negative.